COVID-19 InvestigationFebruary 16, 2026·5 min read
The $4.7 Billion COVID Testing Bonanza
COVID testing became one of the biggest single-category payouts in Medicaid history. A single procedure code — U0003 — billed $3.9 billion alone.
Top 100 Testing Billers
$3.20B
U0003 Code Alone
$3.9B
87635 Growth
$406 → $736M
Total Claims
68.9M
When COVID-19 hit, Medicaid paid for millions of diagnostic tests for low-income Americans. The numbers are staggering: code U0003 (Infectious disease detection (COVID-19)) alone accounts for $3.9 billion in Medicaid spending. Code 87635 (COVID-19 SARS-CoV-2 amplified probe detection) went from just $406 in 2019 to $736 million by 2024.
The Infinity Diagnostics question
Among the top billers are expected names like LabCorp ($174M) and Quest Diagnostics ($122M) — the two largest lab chains in America. But one name stands out: Infinity Diagnostics Laboratory, a New Jersey lab that billed $129 million. That's more than Quest Diagnostics — for a single lab facility. This level of billing from a non-chain laboratory is extraordinary and warrants closer examination.
The top 100 COVID testing billers collectively billed $3.20B to Medicaid. While the majority of this spending was likely legitimate — COVID testing was essential — the sheer volume created opportunities for overbilling and fraud that investigators are still examining.
Top 10 COVID Testing Billers
1
Laboratory Corporation of America Holdings
Clinical Medical Laboratory · Burlington, NC
$174.1M
2.8M claims
5
Laboratory Corporation of America Holdings
Clinical Medical Laboratory · Raritan, NJ
$122.0M
2.4M claims
All 100 Top Testing Billers
| # | Provider | State | Total Paid | Claims |
|---|---|---|---|---|
| 1 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | NC | $174.1M | 2.8M |
| 2 | New York Network Ipa INCExclusive Provider Organization | NY | $138.2M | 3.0M |
| 3 | Infinity Diagnostics Laboratory INCClinical Medical Laboratory | NJ | $129.2M | 4.6M |
| 4 | Quest Diagnostics IncorporatedClinical Medical Laboratory | NJ | $122.6M | 2.2M |
| 5 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | NJ | $122.0M | 2.4M |
| 6 | Curative Labs Inc.Clinical Medical Laboratory | CA | $87.4M | 2.1M |
| 7 | Laboratory Corporation of AmericaClinical Medical Laboratory | AZ | $85.9M | 1.4M |
| 8 | Sonora Quest Laboratories LLCClinical Medical Laboratory | AZ | $82.9M | 971K |
| 9 | NPI: 1124417357 | — | $76.4M | 1.8M |
| 10 | Fulgent Therapeutics Llc.Clinical Medical Laboratory | CA | $73.9M | 2.0M |
| 11 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | OH | $72.3M | 1.5M |
| 12 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | NC | $71.9M | 1.7M |
| 13 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | NC | $70.7M | 1.3M |
| 14 | Bioreference Health LLCClinical Medical Laboratory | NJ | $69.4M | 1.5M |
| 15 | Alaska Native Tribal Health ConsortiumGeneral Acute Care Hospital | AK | $64.6M | 120K |
| 16 | Unilab CorporationClinical Medical Laboratory | CA | $62.9M | 1.3M |
| 17 | Quest Diagnostics Clinical Laboratories INCClinical Medical Laboratory | TX | $58.8M | 1.1M |
| 18 | Bn Medicine PCClinic/Center, Primary Care | NY | $50.5M | 1.0M |
| 19 | Healthtrackrx Indiana, INCClinical Medical Laboratory | TX | $48.3M | 964K |
| 20 | Lifescan Labs of Illinois LLCClinical Medical Laboratory | IL | $46.2M | 951K |
| 21 | Crown Heights Medical P.c.Clinic/Center Multi-Specialty | NY | $44.0M | 1.0M |
| 22 | Accu Reference Medical Lab, LLCClinical Medical Laboratory | NJ | $40.0M | 985K |
| 23 | Empire City Laboratories, INCClinical Medical Laboratory | NY | $39.6M | 982K |
| 24 | Eurofins Diatherix Laboratories LLCClinical Medical Laboratory | AL | $38.2M | 953K |
| 25 | Northwell Health LaboratoriesClinical Medical Laboratory | NY | $36.5M | 705K |
| 26 | Lenco Diagnostic Laboratories,inc.Clinical Medical Laboratory | NY | $36.0M | 727K |
| 27 | Signal Diagnostics LLCClinical Medical Laboratory | CA | $35.4M | 919K |
| 28 | Wellnow Urgent Care, P.c.Clinical Medical Laboratory | NY | $32.8M | 686K |
| 29 | Quest Diagnostics LLCClinical Medical Laboratory | MA | $32.2M | 659K |
| 30 | Quest Diagnostics LLC ILClinical Medical Laboratory | IL | $31.2M | 533K |
| 31 | Quest Diagnostics Incorporated MDClinical Medical Laboratory | MD | $31.1M | 479K |
| 32 | Avellino Lab Usa, Inc.Clinical Medical Laboratory | CA | $31.0M | 504K |
| 33 | Quest Diagnostics Clinical Laboratories INCClinical Medical Laboratory | GA | $29.6M | 489K |
| 34 | Quest Diagnostics Massachusetts LLCClinical Medical Laboratory | MA | $29.0M | 496K |
| 35 | University of WashingtonClinical Medical Laboratory | WA | $26.4M | 514K |
| 36 | Sherman Abrams Laboratory INCClinical Medical Laboratory | NY | $25.8M | 641K |
| 37 | Sunrise Medical Laboratories, Inc.Clinical Medical Laboratory | NY | $25.0M | 563K |
| 38 | Mvml Inc.Clinical Medical Laboratory | CA | $24.7M | 439K |
| 39 | Simple Laboratories LLCClinical Medical Laboratory | IL | $24.6M | 567K |
| 40 | Dart Medical Laboratory, INCClinical Medical Laboratory | NY | $23.3M | 725K |
| 41 | Helix, Inc.Clinical Medical Laboratory | CA | $22.7M | 629K |
| 42 | Clinical Pathology Laboratories, Inc.Clinical Medical Laboratory | TX | $22.1M | 648K |
| 43 | Laboratory Corporation of AmericaClinical Medical Laboratory | CA | $21.9M | 1.0M |
| 44 | Atvivo LLCClinical Medical Laboratory | NJ | $21.5M | 531K |
| 45 | Quest Diagnostics of Pennsylvania, Inc.Clinical Medical Laboratory | PA | $20.8M | 352K |
| 46 | Curative Labs Inc.Clinical Medical Laboratory | TX | $19.9M | 748K |
| 47 | Mayo Collaborative Services, INCClinical Medical Laboratory | MN | $19.8M | 441K |
| 48 | MD Tox LaboratoryMedical Genetics, Molecular Genetic Pathology | CA | $19.7M | 431K |
| 49 | Yale New Haven HospitalGeneral Acute Care Hospital | CT | $19.4M | 428K |
| 50 | City Medical of Upper East Side PLLCClinic/Center Urgent Care | NY | $18.5M | 1.0M |
| 51 | Gentech Laboratories LLCClinical Medical Laboratory | TX | $18.5M | 507K |
| 52 | Centers Lab Nj LLCClinical Medical Laboratory | NJ | $18.5M | 494K |
| 53 | Optimalab INCClinical Medical Laboratory | IL | $18.2M | 421K |
| 54 | Inspire Diagnostics LLCClinical Medical Laboratory | CA | $18.0M | 381K |
| 55 | Southeast Alaska Regional Health ConsortiumPodiatrist | AK | $17.8M | 27K |
| 56 | Topcare Medical Group INCPediatrics | TX | $17.5M | 536K |
| 57 | Acutis Diagnostics INCClinical Medical Laboratory | NY | $17.4M | 406K |
| 58 | Labone LLCClinical Medical Laboratory | KS | $17.3M | 283K |
| 59 | Genesis Laboratory Management, LLCClinical Medical Laboratory | NJ | $16.9M | 388K |
| 60 | Apple Diagnostics LabClinical Medical Laboratory | NJ | $15.5M | 372K |
| 61 | Dx Solutions, LLCClinical Medical Laboratory | KY | $15.4M | 590K |
| 62 | Accurate Diagnostics Labs, Inc.Clinical Medical Laboratory | NJ | $15.4M | 372K |
| 63 | Associated Pathologists, LLCMedical Genetics, Clinical Genetics (M.D.) | TN | $14.9M | 293K |
| 64 | Rca Laboratory Services, LLCClinical Medical Laboratory | VA | $14.8M | 347K |
| 65 | Quest Diagnostics LLC IlClinical Medical Laboratory | IL | $14.7M | 260K |
| 66 | Laboratory Corporation of AmericaClinical Medical Laboratory | WA | $14.7M | 299K |
| 67 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | NC | $14.2M | 177K |
| 68 | Primex Clinical Laboratories Inc.Clinical Medical Laboratory | CA | $14.0M | 308K |
| 69 | Mako Medical Laboratories, LLCClinical Medical Laboratory | NC | $13.6M | 326K |
| 70 | Elite Medical LabClinical Medical Laboratory | NJ | $13.2M | 297K |
| 71 | Oxford Clinical Laboratory Inc.Clinical Medical Laboratory | NJ | $13.1M | 412K |
| 72 | Ridgewood Diagnostic Laboratory, LLCClinical Medical Laboratory | NJ | $13.1M | 282K |
| 73 | Pmh Laboratory INCClinical Medical Laboratory | CA | $13.0M | 379K |
| 74 | Ashland Hospital CorporationClinic/Center, Rural Health | KY | $12.8M | 274K |
| 75 | Quest Diagnostics Clinical Laboratories INCClinical Medical Laboratory | FL | $12.7M | 212K |
| 76 | New York City Health and Hospitals CorporationInternal Medicine | NY | $12.5M | 226K |
| 77 | Orchard Laboratories CorpClinical Medical Laboratory | MI | $12.2M | 252K |
| 78 | Northwest Pathology PLLCPathology, Neuropathology | WA | $12.0M | 273K |
| 79 | Curative Labs Inc.Clinical Medical Laboratory | DC | $11.9M | 412K |
| 80 | Karen ThorntonFamily Medicine | NY | $11.5M | 302K |
| 81 | Confucius Plaza Medical Laboratory CorpClinical Medical Laboratory | NJ | $11.4M | 348K |
| 82 | Laboratory Corporation of America HoldingsClinical Medical Laboratory | AL | $11.4M | 240K |
| 83 | Siparadigm LLCClinical Medical Laboratory | NJ | $11.3M | 279K |
| 84 | Quest Diagnostics Clinical Laboratories INCClinical Medical Laboratory | PA | $11.1M | 149K |
| 85 | University of RochesterGeneral Acute Care Hospital | NY | $11.1M | 193K |
| 86 | California Department of Public HealthClinical Medical Laboratory | CA | $10.9M | 252K |
| 87 | Louisiana State University Health Sciences CenterClinical Medical Laboratory | LA | $10.6M | 532K |
| 88 | Montefiore Medical CenterGeneral Acute Care Hospital | NY | $10.5M | 166K |
| 89 | Norton Sound Health CorporationGeneral Acute Care Hospital, Critical Access | AK | $10.4M | 65K |
| 90 | Medarbor LLCClinical Medical Laboratory | PA | $10.3M | 294K |
| 91 | A2cl Services, LLCClinical Medical Laboratory | WI | $10.3M | 216K |
| 92 | Rhb Laboratories INCClinical Medical Laboratory | MI | $10.2M | 252K |
| 93 | Ethos Holding CorpClinical Medical Laboratory | KY | $10.1M | 264K |
| 94 | Brio Clinical INCClinic/Center, Radiology, Mobile | CA | $10.0M | 191K |
| 95 | Dayton Children's HospitalGeneral Acute Care Hospital, Children | OH | $10.0M | 55K |
| 96 | New York City Health and Hospitals CorporationInternal Medicine | NY | $10.0M | 202K |
| 97 | Quest Diagnostics IncorporatedClinical Medical Laboratory | NV | $9.9M | 205K |
| 98 | Health Network Laboratories, LLCClinical Medical Laboratory | PA | $9.6M | 158K |
| 99 | Tricore Reference LaboratoriesClinical Medical Laboratory | NM | $9.6M | 153K |
| 100 | Pasteur INCClinical Medical Laboratory | CA | $9.6M | 220K |
Key Takeaways
- ▸A single COVID test code (U0003) billed $3.9 billion to Medicaid — one of the largest single-code payouts in program history.
- ▸LabCorp and Quest Diagnostics are the top two billers, as expected for the nation's largest lab chains.
- ▸Infinity Diagnostics, a single NJ lab, billed $129M — more than Quest Diagnostics. This is an extraordinary amount for a non-chain laboratory.
- ▸Code 87635 went from $406 in spending to $736M — a demonstration of how COVID reshaped Medicaid billing patterns overnight.
Source: HHS Medicaid Provider Spending Data (2018–2024) · 227M records