This provider's $23.6M 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.
Notable: Payments increased 131% in 2020
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 | $69.21 | $20.43 | 3.39x | $48.78 | $812.7K | 48.2K | 36.0K |
| 2015 | $67.47 | $18.80 | 3.59x | $48.67 | $1.1M | 72.3K | 54.4K |
| 2016 | $169.23 | $24.75 | 6.84x | $144.48 | $1.2M | 61.7K | 47.0K |
| 2017 | $214.14 | $24.14 | 8.87x | $190.00 | $1.8M | 59.2K | 43.7K |
| 2018 | $90.74 | $22.34 | 4.06x | $68.40 | $2.9M | 71.7K | 51.7K |
| 2019 | $82.76 | $21.53 | 3.84x | $61.23 | $1.6M | 47.1K | 31.1K |
| 2020 | $32.16 | $22.32 | 1.44x | $9.84 | $3.7M | 57.5K | 30.1K |
| 2021 | $27.93 | $23.37 | 1.20x | $4.56 | $4.0M | 111.7K | 40.0K |
| 2022 | $27.67 | $23.22 | 1.19x | $4.45 | $5.5M | 139.8K | 31.8K |
| 2023 | $30.92 | $27.50 | 1.12x | $3.42 | $972.0K | 26.0K | 10.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 114.6K | $9.3M | $81.00 | 1.43x |
| 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 | 84.8K | $2.1M | $24.83 | 2.52x |
| G0483 | Drug test def 22+ classes | 7.0K | $1.7M | $240.07 | 12.21x |
| G0480 | Drug test def 1-7 classes | 13.8K | $1.5M | $108.72 | 3.92x |
| 80307 | Testing for presence of drug | 17.0K | $1.1M | $67.59 | 5.15x |
| G0481 | Drug test def 8-14 classes | 6.1K | $913.8K | $150.57 | 8.64x |
| G0482 | Drug test def 15-21 classes | 3.9K | $746.4K | $192.83 | 9.45x |
| 82306 | Vitamin D-3 level | 12.1K | $433.7K | $35.99 | 3.09x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 21.3K | $429.9K | $20.22 | 3.10x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 4.2K | $396.2K | $95.40 | 8.25x |
| 80053 | Blood test, comprehensive group of blood chemicals | 33.1K | $382.9K | $11.57 | 3.07x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 25.0K | $344.6K | $13.79 | 3.33x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 34.3K | $321.5K | $9.37 | 3.11x |
| 83036 | Hemoglobin A1C level | 20.4K | $237.5K | $11.63 | 3.16x |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source | 7.8K | $197.9K | $25.40 | 1.06x |
| 36415 | Insertion of needle into vein for collection of blood sample | 60.2K | $186.0K | $3.09 | 2.65x |
| 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 | 2.4K | $183.7K | $75.90 | 10.71x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 9.2K | $164.6K | $17.93 | 2.95x |
| 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 | 7.9K | $159.9K | $20.29 | 1.27x |
| 80048 | Blood test, basic group of blood chemicals | 14.9K | $140.7K | $9.47 | 6.13x |
This provider submits charges 3.75 times higher than what Medicare actually pays.
A markup ratio of 3.75x means for every $100 Medicare pays, this provider initially charges $375. This is higher than the national average.
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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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