This provider's $11.2M in total Medicare payments ranks in the 91th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 36256% from 2019 to 2023.
93% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6967% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $51.24 | $12.55 | 4.08x | $38.69 | $29.3K | 2.3K | 2 |
| 2020 | $164.26 | $40.17 | 4.09x | $124.09 | $210.8K | 5.2K | 9 |
| 2021 | $131.44 | $27.97 | 4.70x | $103.47 | $207.7K | 7.4K | 6 |
| 2022 | $119.89 | $24.75 | 4.84x | $95.14 | $150.7K | 6.1K | 3 |
| 2023 | $15.46 | $11.90 | 1.30x | $3.56 | $10.6M | 895.1K | 13 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 886.0K | $10.4M | $11.76 | 1.28x |
| 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 | 3.6K | $301.7K | $82.92 | 4.81x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 3.5K | $121.3K | $34.46 | 1.89x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3.1K | $72.0K | $23.36 | 4.26x |
| 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 | 2.0K | $48.6K | $24.84 | 4.03x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 2.2K | $37.6K | $16.92 | 4.41x |
| 84480 | Thyroid hormone, t3 measurement, total | 2.2K | $31.7K | $14.29 | 4.41x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 1.8K | $24.4K | $13.49 | 4.41x |
| 80053 | Blood test, comprehensive group of blood chemicals | 2.2K | $23.7K | $10.64 | 4.41x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 2.2K | $17.5K | $7.83 | 4.41x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 478 | $16.4K | $34.39 | 1.60x |
| 84436 | Thyroxine (thyroid chemical), total | 2.2K | $15.3K | $6.92 | 4.41x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 410 | $14.2K | $34.67 | 2.68x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 410 | $14.2K | $34.67 | 2.70x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 191 | $13.4K | $70.20 | 2.74x |
| 86328 | Test for detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody, qualitative or semiquantitative | 276 | $12.5K | $45.23 | 5.52x |
| 87799 | Detection test by nucleic acid for organism, quantification | 274 | $11.7K | $42.84 | 3.50x |
| 87591 | Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | 240 | $8.3K | $34.39 | 1.60x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 240 | $8.3K | $34.39 | 1.60x |
| 87661 | Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique | 240 | $8.3K | $34.39 | 1.60x |
This provider submits charges 1.47 times higher than what Medicare actually pays.
A markup ratio of 1.47x means for every $100 Medicare pays, this provider initially charges $147. This is lower 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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