This provider's $27.3M in total Medicare payments ranks in the 96th 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 | $36.24 | $16.81 | 2.16x | $19.43 | $3.0M | 201.3K | 66.0K |
| 2015 | $44.16 | $16.05 | 2.75x | $28.11 | $2.8M | 202.5K | 61.4K |
| 2016 | $60.15 | $17.38 | 3.46x | $42.77 | $2.5M | 158.2K | 48.9K |
| 2017 | $57.41 | $19.50 | 2.94x | $37.91 | $2.9M | 155.1K | 52.4K |
| 2018 | $63.39 | $18.40 | 3.45x | $44.99 | $3.1M | 136.5K | 47.3K |
| 2019 | $52.46 | $16.24 | 3.23x | $36.22 | $2.9M | 137.0K | 52.0K |
| 2020 | $50.51 | $16.37 | 3.09x | $34.14 | $3.1M | 134.0K | 58.3K |
| 2021 | $48.03 | $16.41 | 2.93x | $31.62 | $3.3M | 139.9K | 64.1K |
| 2022 | $52.12 | $17.97 | 2.90x | $34.15 | $2.3M | 134.4K | 62.4K |
| 2023 | $56.07 | $18.36 | 3.05x | $37.71 | $1.4M | 91.9K | 45.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80307 | Testing for presence of drug | 63.7K | $4.3M | $67.39 | 1.86x |
| G0480 | Drug test def 1-7 classes | 32.9K | $3.6M | $108.24 | 3.23x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 33.5K | $2.8M | $82.15 | 1.22x |
| G0481 | Drug test def 8-14 classes | 13.4K | $2.0M | $151.03 | 2.92x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 20.2K | $1.9M | $96.07 | 1.23x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 138.7K | $1.3M | $9.14 | 3.70x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 13.1K | $1.0M | $77.51 | 1.61x |
| 80053 | Blood test, comprehensive group of blood chemicals | 72.5K | $836.2K | $11.54 | 3.05x |
| 36415 | Insertion of needle into vein for collection of blood sample | 224.2K | $732.6K | $3.27 | 3.12x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 37.5K | $727.2K | $19.41 | 2.40x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 45.7K | $608.5K | $13.31 | 3.25x |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within | 23.7K | $590.6K | $24.95 | 1.00x |
| 85610 | Blood test, clotting time | 92.2K | $451.5K | $4.90 | 5.91x |
| 82306 | Vitamin D-3 level | 12.7K | $415.0K | $32.74 | 2.01x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge. | 34.4K | $347.1K | $10.08 | 2.40x |
| 83036 | Hemoglobin A1C level | 28.9K | $317.2K | $10.98 | 4.05x |
| 80048 | Blood test, basic group of blood chemicals | 30.2K | $290.2K | $9.61 | 3.25x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 6.6K | $155.0K | $23.42 | 1.02x |
| 82055 | Alcohol (ethanol) level | 9.5K | $137.9K | $14.45 | 1.98x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 7.8K | $137.8K | $17.58 | 2.48x |
This provider submits charges 2.52 times higher than what Medicare actually pays.
A markup ratio of 2.52x means for every $100 Medicare pays, this provider initially charges $252. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Clinical Laboratories Inc | Norristown, PA | $340.6M | ✓ Clear |
| Quest Diagnostics Of Pennsylvania, Inc. | Pittsburgh, PA | $130.4M | ⚠️ Flagged |
| Health Network Laboratories, Llc | Allentown, PA | $125.3M | ⚠️ Flagged |
| Sma Medical, Inc. | Feasterville, PA | $100.9M | ✓ Clear |
| Interpace Diagnostics Corporation | Pittsburgh, PA | $95.6M | ✓ 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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