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

Laboratory Corporation of America Holdings

Clinical Medical Laboratory·Charleston, WV·NPI: 1891770806SharePrint 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:

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

Billing Velocity4735.0 claims/working day

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

Compared to Clinical Medical Laboratory Peers

Total spending distribution among 88 providers in this specialty

P25MedianP75P90

This provider's total spending of $220.0M is at the 75th percentile among 88 Clinical Medical Laboratory providers.

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

Total Paid

$220.0M

$220,037,248

Total Claims

8.8M

Beneficiaries

7.7M

1.1 claims/patient

Avg Cost/Claim

$25

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

🔍 Analysis

Provider Overview

Laboratory Corporation of America Holdings is a Clinical Medical Laboratory provider based in Charleston, WV. From the 2018–2024 period, this provider received $220.0M in Medicaid payments across 8.8M claims.

Why This Matters

This provider received $220.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,504 Medicaid beneficiaries for a full year at average per-enrollee costs.

151% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$15.0M
+27%
2019
$19.1M
+27%
2020
$24.3M
+33%
2021
$32.4M
+37%
2022
$44.5M
+5%
2023
$46.9M
-19%
2024
$37.8M

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 23% of total spending.

87491Normal range

Chlamydia detection, nucleic acid, amplified probe

$49.7M

1.7M claims · 22.6%

Your Cost: $28.84/claim|Median: $24.95
1.2× median
87591Normal range

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$49.3M

1.7M claims · 22.4%

Your Cost: $28.53/claim|Median: $23.39
1.2× median
87661Normal range

Trichomonas vaginalis detection, nucleic acid, amplified probe

$28.7M

1.3M claims · 13.0%

Your Cost: $22.30/claim|Median: $21.08
1.1× median
87798Normal range

Infectious agent detection, nucleic acid, not otherwise specified

$19.6M

537K claims · 8.9%

Your Cost: $36.62/claim|Median: $26.72
1.4× median
87801Normal range

Infectious agent detection, amplified probe, multiple organisms

$19.1M

436K claims · 8.7%

Your Cost: $43.88/claim|Median: $38.79
1.1× median
88175Normal range

Cytopathology, cervical or vaginal, ThinPrep

$16.1M

947K claims · 7.3%

Your Cost: $16.99/claim|Median: $19.06
0.9× median
87624Normal range

HPV detection, high-risk types, nucleic acid

$14.5M

631K claims · 6.6%

Your Cost: $23.01/claim|Median: $25.57
0.9× median
87389Top 10%

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

$5.3M

128K claims · 2.4%

Your Cost: $41.80/claim|Median: $18.03
2.3× median
U0003Normal range

Infectious disease detection (COVID-19)

$4.2M

64K claims · 1.9%

Your Cost: $66.32/claim|Median: $63.08
1.1× median
88141Normal range

$1.9M

160K claims · 0.9%

Your Cost: $11.73/claim|Median: $14.87
0.8× median
88142Normal range

$1.1M

112K claims · 0.5%

Your Cost: $9.79/claim|Median: $14.75
0.7× median
87086Normal range

Urine culture, colony count, with identification

$948K

148K claims · 0.4%

Your Cost: $6.39/claim|Median: $5.31
1.2× median
87625Normal range

$783K

39K claims · 0.4%

Your Cost: $19.83/claim|Median: $20.47
1.0× median
86803Normal range

Hepatitis C antibody

$563K

49K claims · 0.3%

Your Cost: $11.55/claim|Median: $10.17
1.1× median
87563Normal range

$524K

28K claims · 0.2%

Your Cost: $18.64/claim|Median: $16.98
1.1× median
87529Normal range

$504K

22K claims · 0.2%

Your Cost: $23.13/claim|Median: $24.98
0.9× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$438K

15K claims · 0.2%

Your Cost: $29.75/claim|Median: $35.43
0.8× median
86592Normal range

$362K

107K claims · 0.2%

Your Cost: $3.38/claim|Median: $3.35
1.0× median
87340Normal range

$356K

40K claims · 0.2%

Your Cost: $8.99/claim|Median: $5.52
1.6× median
G0483Normal range

Drug test, definitive, 22+ drug classes

$343K

4K claims · 0.2%

Your Cost: $82.65/claim|Median: $90.89
0.9× median
81420Normal range

Fetal chromosomal aneuploidy genomic sequence analysis

$323K

842 claims · 0.1%

Your Cost: $383.99/claim|Median: $358.21
1.1× median
86780Normal range

$311K

29K claims · 0.1%

Your Cost: $10.86/claim|Median: $9.83
1.1× median
86696Normal range

$271K

18K claims · 0.1%

Your Cost: $15.42/claim|Median: $13.89
1.1× median
80074Normal range

$271K

10K claims · 0.1%

Your Cost: $28.32/claim|Median: $27.54
1.0× median
87088Normal range

$241K

36K claims · 0.1%

Your Cost: $6.63/claim|Median: $5.45
1.2× median
87150Normal range

$231K

13K claims · 0.1%

Your Cost: $17.43/claim|Median: $25.98
0.7× median
87186Normal range

$217K

30K claims · 0.1%

Your Cost: $7.29/claim|Median: $4.65
1.6× median
86480Normal range

Tuberculosis test, cell-mediated immunity

$200K

4K claims · 0.1%

Your Cost: $45.32/claim|Median: $38.35
1.2× median
87081Normal range

$188K

40K claims · 0.1%

Your Cost: $4.74/claim|Median: $5.09
0.9× median
88112Top 25%

$181K

4K claims · 0.1%

Your Cost: $42.15/claim|Median: $19.79
2.1× median