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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Carenexa, Llc
๐Ÿ”ฌ
Organization

Carenexa, Llc

NPI: 1790021517
Vancouver, WA
10 years of data
Clinical Laboratory
$70.5M
Total Payments
415.2K
Beneficiaries
769.7K
Services
2x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$70.5M
Specialty median$1.9M
Rank #108 of 232 in specialty

๐Ÿ“‹ Key Findings

1Billed $70.5M over 10 years
22x markup ratio
399th percentile in Clinical Laboratory by payments
48 procedures with >3x markup
โœ“ No flags detected

๐Ÿ”Ž Data Analysis

This provider's $70.5M in total Medicare payments ranks in the 99th 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.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$296.44$91.603.24x$204.84$7.3M79.5K42.9K
2015$264.50$91.602.89x$172.90$6.1M66.6K35.9K
2016$242.62$91.602.65x$151.02$7.9M86.5K46.7K
2017$150.56$91.601.64x$58.96$6.9M75.2K40.5K
2018$339.25$91.603.70x$247.65$7.3M79.5K42.9K
2019$153.59$91.601.68x$61.99$5.1M55.6K30.0K
2020$187.77$91.602.05x$96.17$6.4M69.5K37.5K
2021$262.36$91.602.86x$170.76$6.5M71.4K38.5K
2022$364.30$91.603.98x$272.70$9.4M102.9K55.5K
2023$344.08$91.603.76x$252.48$7.6M82.9K44.7K

Top Procedures (10)

80053Comprehensive metabolic panelโš  4.4x markup
$18.1M
271.4K services$66.56/svc4.37x markup
85025Complete blood cell count with differentialโš  4.8x markup
$11.7M
140.1K services$83.27/svc4.79x markup
84443Thyroid stimulating hormone (TSH) levelโš  4.8x markup
$5.1M
48.5K services$104.34/svc4.78x markup
82306Vitamin D-3 levelโš  5.5x markup
$4.6M
32.9K services$138.75/svc5.54x markup
80061Lipid panel
$4.1M
37.0K services$110.29/svc2.93x markup
83036Hemoglobin A1c level
$4.0M
30.2K services$131.34/svc2.89x markup
82728Ferritin (blood protein) levelโš  4.9x markup
$3.3M
29.2K services$113.56/svc4.86x markup
84153PSA (prostate specific antigen) measurementโš  5.4x markup
$2.4M
37.2K services$65.53/svc5.36x markup
87086Bacterial colony count, urineโš  4.8x markup
$1.9M
30.9K services$62.65/svc4.75x markup
80048Blood test, basic group of blood chemicalsโš  3.6x markup
$1.3M
9.8K services$133.25/svc3.65x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
80053Comprehensive metabolic panel271.4K$18.1M$66.564.37x
85025Complete blood cell count with differential140.1K$11.7M$83.274.79x
84443Thyroid stimulating hormone (TSH) level48.5K$5.1M$104.344.78x
82306Vitamin D-3 level32.9K$4.6M$138.755.54x
80061Lipid panel37.0K$4.1M$110.292.93x
83036Hemoglobin A1c level30.2K$4.0M$131.342.89x
82728Ferritin (blood protein) level29.2K$3.3M$113.564.86x
84153PSA (prostate specific antigen) measurement37.2K$2.4M$65.535.36x
87086Bacterial colony count, urine30.9K$1.9M$62.654.75x
80048Blood test, basic group of blood chemicals9.8K$1.3M$133.253.65x

Markup Analysis

Charge-to-Payment Ratio

2x

This provider submits charges 2 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower than the national average.

Location

Vancouver, WA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Clinical Laboratory providers in WA for peer comparison.

Carenexa, Llc (you)
$70.5M
Laboratory Corporation Of Americaโš ๏ธ
$203.1M
Quest Diagnostics Clinical Laboratories Incโš ๏ธ
$97.9M
Adaptive Biotechnologies Corporation
$54.5M
Regional Toxicology Services, Llc
$37.2M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Laboratory Corporation Of AmericaSeattle, WA$203.1Mโš ๏ธ Flagged
Quest Diagnostics Clinical Laboratories IncSeattle, WA$97.9Mโš ๏ธ Flagged
Adaptive Biotechnologies CorporationSeattle, WA$54.5Mโœ“ Clear
Regional Toxicology Services, LlcTacoma, WA$37.2Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

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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