Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Laboratory Corporation of America

Clinical Medical Laboratory·Tampa, FL·NPI: 1255314704SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Billing Velocity20351.0 claims/working day

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $95.12 per claim for 80055 — 3.4× the national median of $28.10.

This is a statistical summary, not an accusation. See our methodology.

Compared to Clinical Medical Laboratory Peers

Total spending distribution among 88 providers in this specialty

P25MedianP75P90

This provider's total spending of $171.1M is at the 50th percentile among 88 Clinical Medical Laboratory providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$171.1M

$171,132,435

Total Claims

37.6M

Beneficiaries

33.6M

1.1 claims/patient

Avg Cost/Claim

$5

#573 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Laboratory Corporation of America is a Clinical Medical Laboratory provider based in Tampa, FL. From the 2018–2024 period, this provider received $171.1M in Medicaid payments across 37.6M claims.

Why This Matters

This provider received $171.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,391 Medicaid beneficiaries for a full year at average per-enrollee costs.

2260% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+1253%
2019
$15.7M
+16%
2020
$18.2M
+46%
2021
$26.6M
+51%
2022
$40.3M
+3%
2023
$41.6M
-34%
2024
$27.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (87491 (Chlamydia detection, nucleic acid, amplified probe)) accounts for 6% of total spending.

87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$10.7M

1.0M claims · 6.3%

Your Cost: $10.40/claim|Median: $24.95
0.4× median
80050Normal range

General health panel

$9.0M

497K claims · 5.3%

Your Cost: $18.16/claim|Median: $25.59
0.7× median
82306Normal range

Vitamin D, 25 hydroxy

$8.3M

959K claims · 4.9%

Your Cost: $8.70/claim|Median: $18.18
0.5× median
81420Normal range

Fetal chromosomal aneuploidy genomic sequence analysis

$7.7M

33K claims · 4.5%

Your Cost: $231.30/claim|Median: $358.21
0.7× median
81220Normal range

CFTR gene analysis, common variants

$7.1M

39K claims · 4.1%

Your Cost: $180.76/claim|Median: $183.31
1.0× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$6.6M

1.0M claims · 3.9%

Your Cost: $6.51/claim|Median: $23.39
0.3× median
80061Normal range

Lipid panel

$6.0M

2.3M claims · 3.5%

Your Cost: $2.64/claim|Median: $8.41
0.3× median
85025Normal range

Complete blood count (CBC) with differential, automated

$5.5M

2.3M claims · 3.2%

Your Cost: $2.37/claim|Median: $4.71
0.5× median
87798Normal range

Infectious agent detection, nucleic acid, not otherwise specified

$5.3M

253K claims · 3.1%

Your Cost: $21.03/claim|Median: $26.72
0.8× median
U0003Normal range

Infectious disease detection (COVID-19)

$5.0M

78K claims · 2.9%

Your Cost: $63.32/claim|Median: $63.08
1.0× median
80053Normal range

Comprehensive metabolic panel

$4.8M

2.4M claims · 2.8%

Your Cost: $1.99/claim|Median: $7.24
0.3× median
87389Normal range

HIV-1 antigen with HIV-1 and HIV-2 antibodies

$4.5M

636K claims · 2.6%

Your Cost: $7.05/claim|Median: $18.03
0.4× median
87624Normal range

HPV detection, high-risk types, nucleic acid

$4.0M

250K claims · 2.3%

Your Cost: $16.02/claim|Median: $25.57
0.6× median
87801Normal range

Infectious agent detection, amplified probe, multiple organisms

$3.9M

195K claims · 2.3%

Your Cost: $20.17/claim|Median: $38.79
0.5× median
88305Normal range

Surgical pathology, gross and microscopic examination

$3.8M

101K claims · 2.2%

Your Cost: $37.58/claim|Median: $35.80
1.1× median
88175Normal range

Cytopathology, cervical or vaginal, ThinPrep

$3.1M

354K claims · 1.8%

Your Cost: $8.62/claim|Median: $19.06
0.5× median
84443Normal range

Thyroid stimulating hormone (TSH)

$3.0M

1.5M claims · 1.8%

Your Cost: $2.04/claim|Median: $9.87
0.2× median
80081Normal range

$3.0M

97K claims · 1.7%

Your Cost: $30.75/claim|Median: $59.44
0.5× median
83036Normal range

Hemoglobin A1c (glycated hemoglobin)

$2.5M

1.6M claims · 1.5%

Your Cost: $1.56/claim|Median: $5.50
0.3× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$2.5M

119K claims · 1.4%

Your Cost: $20.69/claim|Median: $35.43
0.6× median
84439Normal range

$2.4M

732K claims · 1.4%

Your Cost: $3.28/claim|Median: $6.31
0.5× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$2.1M

295K claims · 1.3%

Your Cost: $7.29/claim|Median: $21.08
0.3× median
80074Normal range

$2.1M

136K claims · 1.2%

Your Cost: $15.34/claim|Median: $27.54
0.6× median
87536Normal range

$1.9M

73K claims · 1.1%

Your Cost: $26.32/claim|Median: $51.73
0.5× median
87086Normal range

Urine culture, colony count, with identification

$1.8M

821K claims · 1.1%

Your Cost: $2.21/claim|Median: $5.31
0.4× median
86003Normal range

$1.8M

94K claims · 1.0%

Your Cost: $18.69/claim|Median: $40.67
0.5× median
80055Top 5%

$1.7M

18K claims · 1.0%

Your Cost: $95.12/claim|Median: $28.10
3.4× median
82607Normal range

Cyanocobalamin (vitamin B-12)

$1.7M

565K claims · 1.0%

Your Cost: $3.02/claim|Median: $8.72
0.3× median
86480Normal range

Tuberculosis test, cell-mediated immunity

$1.5M

83K claims · 0.9%

Your Cost: $18.67/claim|Median: $38.35
0.5× median
85027Normal range

Complete blood count (CBC), automated

$1.5M

397K claims · 0.9%

Your Cost: $3.89/claim|Median: $3.72
1.1× median