Statistical flag only — not an accusation of fraud
This provider's $48.8M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
This provider has been statistically flagged with a risk score of 71/100. Statistical flags are not accusations of fraud.
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 | $123.83 | $34.61 | 3.58x | $89.22 | $4.8M | 139.3K | 217 |
| 2015 | $120.61 | $31.76 | 3.80x | $88.85 | $5.0M | 158.3K | 214 |
| 2016 | $115.50 | $30.39 | 3.80x | $85.11 | $5.8M | 190.6K | 233 |
| 2017 | $117.30 | $31.26 | 3.75x | $86.04 | $4.0M | 127.5K | 180 |
| 2018 | $118.51 | $28.73 | 4.12x | $89.78 | $4.1M | 142.0K | 183 |
| 2019 | $125.36 | $26.51 | 4.73x | $98.85 | $4.6M | 173.3K | 208 |
| 2020 | $122.38 | $26.54 | 4.61x | $95.84 | $4.6M | 174.2K | 200 |
| 2021 | $118.13 | $24.34 | 4.85x | $93.79 | $5.2M | 213.5K | 196 |
| 2022 | $111.32 | $23.68 | 4.70x | $87.64 | $5.1M | 216.1K | 203 |
| 2023 | $114.94 | $24.40 | 4.71x | $90.54 | $5.6M | 228.6K | 197 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 486.7K | $13.8M | $28.30 | 2.38x |
| 88120 | Cell examination of urine, manual | 4.7K | $2.4M | $520.97 | 1.96x |
| 88189 | Flow cytometry technique for dna or cell analysis, 16 or more markers | 24.5K | $1.9M | $76.28 | 2.49x |
| 88184 | Flow cytometry technique for dna or cell analysis, first marker | 28.6K | $1.8M | $64.33 | 2.83x |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 15.9K | $1.8M | $111.08 | 1.44x |
| 83921 | Organic acid level | 49.1K | $1.1M | $21.40 | 11.54x |
| 86334 | Immunologic analysis technique on serum (immunofixation) | 33.9K | $853.4K | $25.20 | 6.88x |
| 83883 | Nephelometry, test method using light | 48.6K | $797.3K | $16.41 | 7.61x |
| 87902 | Analysis test by nucleic acid for hepatitis c virus | 2.2K | $713.9K | $319.68 | 2.19x |
| 82784 | Gammaglobulin (immune system protein) measurement | 69.1K | $705.8K | $10.22 | 6.05x |
| 82024 | Adrenocorticotropic hormone (acth) level | 16.0K | $669.4K | $41.73 | 3.60x |
| 84165 | Protein measurement, serum | 44.5K | $538.0K | $12.08 | 4.75x |
| 83970 | Parathormone (parathyroid hormone) level | 10.9K | $518.7K | $47.58 | 4.37x |
| 87799 | Detection test by nucleic acid for organism, quantification | 10.3K | $503.7K | $48.67 | 9.71x |
| 84403 | Testosterone (hormone) level, total | 16.7K | $503.5K | $30.13 | 4.63x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 6.7K | $443.3K | $66.59 | 2.62x |
| 81206 | Translocation analysis (bcr/abl1) major breakpoint | 2.4K | $434.1K | $179.73 | 2.27x |
| 81479 | Molecular pathology procedure | 1.0K | $421.5K | $405.32 | 1.91x |
| 88360 | Microscopic genetic analysis of tumor, manual | 3.6K | $419.9K | $115.40 | 2.65x |
| 84425 | Vitamin b-1 (thiamine) level | 16.5K | $392.6K | $23.84 | 6.64x |
This provider submits charges 4.28 times higher than what Medicare actually pays.
A markup ratio of 4.28x means for every $100 Medicare pays, this provider initially charges $428. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ 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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