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. The pandemic created a blank check for testing labs — billions in taxpayer money with minimal oversight. Testing was just one part of the COVID spending surge — see also who got paid the most for COVID vaccines and the providers with the biggest pandemic billing jumps. The sheer volume created massive opportunities for overbilling and fraud that investigators are still uncovering. How much of this was genuinely necessary, and how much was opportunistic billing?
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