This provider's $288.3M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 100% from 2014 to 2023.
61% of their billing comes from a single procedure code (81479 — Molecular pathology procedure).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 85% in 2015
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $2.1K | $770.23 | 2.73x | $1.3K | $20.4M | 26.5K | 15 |
| 2015 | $3.0K | $853.17 | 3.49x | $2.1K | $37.8M | 44.3K | 18 |
| 2016 | $3.0K | $742.99 | 4.04x | $2.3K | $39.1M | 52.6K | 19 |
| 2017 | $1.9K | $717.30 | 2.67x | $1.2K | $30.6M | 42.6K | 17 |
| 2018 | $1.0K | $608.01 | 1.71x | $433.07 | $23.1M | 38.0K | 13 |
| 2019 | $2.0K | $1.6K | 1.25x | $407.17 | $19.4M | 12.0K | 13 |
| 2020 | $2.2K | $1.4K | 1.57x | $792.86 | $20.3M | 14.6K | 11 |
| 2021 | $2.0K | $1.3K | 1.64x | $795.91 | $23.6M | 18.8K | 9 |
| 2022 | $3.4K | $1.6K | 2.06x | $1.7K | $33.3M | 20.4K | 7 |
| 2023 | $4.3K | $1.8K | 2.46x | $2.6K | $40.8M | 23.2K | 3 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81479 | Molecular pathology procedure | 156.0K | $176.0M | $1.1K | 2.66x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 41.7K | $87.1M | $2.1K | 1.55x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis | 10.3K | $7.9M | $764.14 | 2.37x |
| 81404 | Molecular pathology procedure level 5 | 14.9K | $5.2M | $352.32 | 4.54x |
| 81401 | Molecular pathology procedure level 2 | 20.7K | $2.2M | $104.69 | 7.80x |
| 81403 | Molecular pathology procedure level 4 | 21.8K | $2.0M | $93.93 | 14.06x |
| 81405 | Molecular pathology procedure level 6 genetic analysis | 4.0K | $1.6M | $388.93 | 4.87x |
| 81406 | Molecular pathology procedure level 7 | 4.2K | $1.5M | $359.81 | 6.38x |
| 0129U | Gene analysis of genes associated with hereditary breast cancer and related disorders for gene sequence and duplication or deletion variants | 946 | $1.2M | $1.3K | 5.30x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 457 | $778.4K | $1.7K | 2.18x |
| 0101U | Gene sequence analysis panel of 15 genes associated with hereditary colon cancer and related disorders | 379 | $649.9K | $1.7K | 3.97x |
| 81300 | Gene analysis (mutS homolog 6 [E coli]) duplication or deletion variants | 3.0K | $467.2K | $158.00 | 6.36x |
| 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 | 5.5K | $455.6K | $82.91 | 1.39x |
| 81323 | Gene analysis (phosphatase and tensin homolog), duplication or deletion variant | 4.8K | $410.3K | $85.80 | 12.14x |
| 81213 | Gene analysis (breast cancer 1 and 2) uncommon duplication or deletion variants | 263 | $142.3K | $540.94 | 2.27x |
| 81321 | Gene analysis (phosphatase and tensin homolog), full sequence analysis | 209 | $123.5K | $590.88 | 3.77x |
| 81292 | Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis | 142 | $89.6K | $631.23 | 2.87x |
| 81212 | Gene analysis (breast cancer 1 and 2) for 185delag, 5385insc, 6174delt variants | 253 | $81.8K | $323.29 | 2.62x |
| 81295 | Gene analysis (muts homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis | 291 | $68.1K | $233.93 | 5.53x |
| 81201 | Gene analysis (adenomatous polyposis coli), full gene sequence | 84 | $63.5K | $756.43 | 1.14x |
This provider submits charges 2.53 times higher than what Medicare actually pays.
A markup ratio of 2.53x means for every $100 Medicare pays, this provider initially charges $253. 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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