Physicians Group Laboratories, LLC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $13.2M (2019) to $43.6M (2020) — a 230% swing with $30.4M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: 87150 at 7.8× median, 87498 at 2.7× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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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.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $299.03 per claim for 0225U — 3.7× the national median of $81.81.
Bills $201.83 per claim for 87150 — 7.8× the national median of $25.98.
Bills $23.87 per claim for 87541 — 3.3× the national median of $7.29.
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
This provider's total spending of $208.1M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$208.1M
$208,133,531
Total Claims
4.6M
Beneficiaries
3.8M
1.2 claims/patient
Avg Cost/Claim
$45
#426 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Physicians Group Laboratories, LLC is a Clinical Medical Laboratory provider based in Houma, LA. From the 2018–2024 period, this provider received $208.1M in Medicaid payments across 4.6M claims.
Why This Matters
This provider received $208.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,016 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (0225U) accounts for 20% of total spending.
$42.4M
142K claims · 20.4%
$39.0M
156K claims
$250.02
$169.17
Respiratory virus detection, 12-25 targets, nucleic acid
$39.0M
156K claims · 18.7%
$27.4M
533K claims
$51.35
$26.72
Infectious agent detection, nucleic acid, not otherwise specified
$27.4M
533K claims · 13.1%
$12.4M
61K claims · 5.9%
$8.2M
341K claims
$23.98
$28.46
Streptococcus Group A detection, nucleic acid, amplified probe
$8.2M
341K claims · 3.9%
$8.1M
339K claims · 3.9%
$7.9M
331K claims · 3.8%
$7.9M
332K claims · 3.8%
$7.0M
293K claims · 3.4%
$6.6M
266K claims · 3.2%
$6.2M
97K claims
$64.65
$63.08
Infectious disease detection (COVID-19)
$6.2M
97K claims · 3.0%
$5.9M
21K claims · 2.9%
$4.7M
197K claims · 2.3%
$4.7M
197K claims · 2.3%
$2.4M
32K claims
$75.44
$100.62
Respiratory virus detection, 3-5 targets, nucleic acid
$2.4M
32K claims · 1.1%
$1.3M
37K claims · 0.6%
$1.2M
58K claims · 0.6%
$1.0M
44K claims · 0.5%
$877K
37K claims
$23.98
$24.95
Chlamydia detection, nucleic acid, amplified probe
$877K
37K claims · 0.4%
$864K
37K claims · 0.4%
$861K
37K claims
$23.08
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$861K
37K claims · 0.4%
$846K
37K claims
$23.12
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$846K
37K claims · 0.4%
$805K
59K claims · 0.4%
$779K
11K claims
$69.39
$65.45
Respiratory virus detection, 3-5 targets, multiplex
$779K
11K claims · 0.4%
$681K
42K claims
$16.31
$15.76
Infectious disease detection, COVID-19, antigen
$681K
42K claims · 0.3%
$597K
20K claims
$30.38
$39.70
COVID-19 SARS-CoV-2 amplified probe detection
$597K
20K claims · 0.3%
$556K
39K claims · 0.3%
General health panel
$480K
25K claims · 0.2%
Vitamin D, 25 hydroxy
$435K
30K claims · 0.2%
Testosterone, total blood test
$398K
23K claims · 0.2%
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