This provider's $20.2M in total Medicare payments ranks in the 95th 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 | $27.49 | $9.75 | 2.82x | $17.74 | $2.6M | 385.9K | 129.7K |
| 2015 | $35.36 | $16.37 | 2.16x | $18.99 | $3.5M | 428.6K | 144.0K |
| 2016 | $35.77 | $17.34 | 2.06x | $18.43 | $3.7M | 456.2K | 149.5K |
| 2017 | $36.77 | $17.86 | 2.06x | $18.91 | $3.8M | 478.8K | 157.0K |
| 2018 | $41.24 | $17.47 | 2.36x | $23.77 | $3.6M | 456.4K | 149.1K |
| 2019 | $32.18 | $15.28 | 2.11x | $16.90 | $2.9M | 391.5K | 134.9K |
| 2020 | $31.20 | $11.44 | 2.73x | $19.76 | $94.7K | 14.1K | 11.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 268.4K | $2.6M | $9.81 | 2.56x |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 533.8K | $2.6M | $4.84 | 2.37x |
| 80053 | Blood test, comprehensive group of blood chemicals | 125.1K | $1.6M | $12.75 | 2.69x |
| 80048 | Blood test, basic group of blood chemicals | 147.7K | $1.5M | $10.41 | 2.65x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 62.5K | $1.3M | $21.46 | 2.60x |
| 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. | 364.7K | $1.2M | $3.36 | 1.18x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 49.5K | $730.0K | $14.76 | 3.01x |
| 85610 | Blood test, clotting time | 129.7K | $662.8K | $5.11 | 2.58x |
| 83036 | Hemoglobin A1C level | 49.9K | $618.6K | $12.39 | 2.59x |
| 82306 | Vitamin D-3 level | 13.0K | $496.8K | $38.31 | 2.56x |
| 80164 | Dipropylacetic acid (valproic acid) level | 25.7K | $442.4K | $17.24 | 2.58x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 32.4K | $355.3K | $10.95 | 2.50x |
| 36415 | Insertion of needle into vein for collection of blood sample | 104.7K | $307.9K | $2.94 | 2.55x |
| 87086 | Bacterial colony count, urine | 29.4K | $302.5K | $10.28 | 2.60x |
| 80307 | Testing for presence of drug | 4.0K | $276.7K | $68.56 | 2.67x |
| 81001 | Manual urinalysis test with examination using microscope | 61.7K | $249.6K | $4.05 | 2.49x |
| 87088 | Bacterial urine culture | 26.5K | $237.0K | $8.95 | 2.93x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 12.3K | $235.3K | $19.20 | 2.60x |
| 87077 | Bacterial culture for aerobic isolates | 21.0K | $212.2K | $10.12 | 2.54x |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 247.3K | $212.1K | $0.86 | 1.02x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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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