This provider's $60.1M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $6.87 | $2.48 | 2.77x | $4.39 | $6.6M | 2.6M | 117 |
| 2015 | $6.93 | $2.49 | 2.78x | $4.44 | $6.3M | 2.5M | 112 |
| 2016 | $7.12 | $2.58 | 2.76x | $4.54 | $5.9M | 2.3M | 109 |
| 2017 | $7.49 | $2.68 | 2.79x | $4.81 | $6.2M | 2.3M | 110 |
| 2018 | $6.84 | $2.48 | 2.76x | $4.36 | $6.2M | 2.5M | 109 |
| 2019 | $6.32 | $2.25 | 2.81x | $4.07 | $6.4M | 2.9M | 109 |
| 2020 | $6.99 | $2.57 | 2.72x | $4.42 | $7.0M | 2.7M | 112 |
| 2021 | $6.37 | $2.30 | 2.77x | $4.07 | $6.3M | 2.7M | 108 |
| 2022 | $6.98 | $2.35 | 2.97x | $4.63 | $5.0M | 2.1M | 106 |
| 2023 | $9.00 | $2.86 | 3.15x | $6.14 | $4.2M | 1.5M | 101 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 20.1M | $19.9M | $0.99 | 1.04x |
| 80053 | Blood test, comprehensive group of blood chemicals | 364.1K | $4.2M | $11.55 | 3.25x |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 622.2K | $3.4M | $5.54 | 2.01x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 335.0K | $3.0M | $9.01 | 4.10x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 152.6K | $3.0M | $19.67 | 2.75x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 160.7K | $2.4M | $15.04 | 5.39x |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 26.7K | $2.4M | $88.36 | 2.48x |
| 83036 | Hemoglobin a1c level | 173.5K | $2.0M | $11.39 | 3.44x |
| 82306 | Vitamin d-3 level | 58.5K | $2.0M | $33.67 | 5.07x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 186.0K | $1.8M | $9.75 | 3.41x |
| 36415 | Insertion of needle into vein for collection of blood sample | 546.6K | $1.6M | $2.98 | 3.35x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 158.4K | $1.2M | $7.72 | 3.88x |
| 87086 | Bacterial colony count, urine | 121.0K | $1.2M | $9.66 | 4.34x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 91.6K | $940.8K | $10.28 | 3.06x |
| 85610 | Blood test, clotting time | 181.2K | $905.3K | $5.00 | 4.19x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 45.5K | $797.9K | $17.53 | 2.94x |
| 87088 | Bacterial urine culture | 80.9K | $778.7K | $9.62 | 3.27x |
| 80164 | Valproic acid level, total | 52.6K | $772.3K | $14.67 | 3.33x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 14.0K | $584.4K | $41.84 | 2.99x |
| 82728 | Ferritin (blood protein) level | 30.4K | $494.1K | $16.26 | 3.01x |
This provider submits charges 2.81 times higher than what Medicare actually pays.
A markup ratio of 2.81x means for every $100 Medicare pays, this provider initially charges $281. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Clinical Laboratory providers in GA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Clinical Laboratories Inc | Tucker, GA | $599.2M | ⚠️ Flagged |
| Bakotic Pathology Associates, Llc | Alpharetta, GA | $87.9M | ✓ Clear |
| Lifebrite Laboratories, Llc | Brookhaven, GA | $48.1M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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