This provider's $5.3M in total Medicare payments ranks in the 82th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 3308% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1016% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2017 | $700.00 | $252.42 | 2.77x | $447.58 | $24.4K | 104 | 98 |
| 2018 | $700.00 | $227.18 | 3.08x | $472.82 | $272.4K | 782 | 738 |
| 2019 | $310.45 | $91.98 | 3.38x | $218.47 | $368.4K | 2.4K | 2.1K |
| 2020 | $310.94 | $86.51 | 3.59x | $224.43 | $762.0K | 10.2K | 5.5K |
| 2021 | $146.56 | $40.23 | 3.64x | $106.33 | $1.2M | 25.2K | 6.2K |
| 2022 | $194.52 | $84.34 | 2.31x | $110.18 | $1.9M | 33.8K | 9.3K |
| 2023 | $196.48 | $84.66 | 2.32x | $111.82 | $831.7K | 16.0K | 9.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 31.1K | $2.4M | $78.44 | 3.82x |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within | 24.4K | $604.9K | $24.81 | 3.02x |
| 87507 | Detection test for digestive tract pathogen | 1.1K | $503.4K | $471.81 | 3.18x |
| 87801 | Detection test for multiple organisms | 5.1K | $350.4K | $69.30 | 3.46x |
| 81226 | Gene analysis (cytochrome p450, family 2, subfamily d, polypeptide 6) common variants | 518 | $228.5K | $441.03 | 1.52x |
| 87798 | Detection test for organism | 5.3K | $185.8K | $34.98 | 4.29x |
| 87633 | Detection test for multiple types of respiratory virus | 267 | $125.7K | $470.69 | 3.19x |
| 81225 | Gene analysis (cytochrome p450, family 2, subfamily c, polypeptide 19) common variants | 433 | $123.7K | $285.62 | 1.54x |
| 87653 | Detection test for Strep (Streptococcus, group B) | 2.9K | $101.9K | $34.85 | 3.44x |
| 87640 | Detection test for Staphylococcus aureus (bacteria) | 2.9K | $101.8K | $34.85 | 3.44x |
| 87481 | Detection test for candida species (yeast) | 2.9K | $101.8K | $34.83 | 3.45x |
| 87641 | Detection test for Staphylococcus aureus, methicillin resistant (MRSA bacteria) | 2.1K | $74.0K | $34.77 | 3.49x |
| 87500 | Detection test for Vancomycin resistance strep (VRE) | 2.1K | $72.8K | $34.82 | 3.44x |
| 87493 | Detection test for clostridium difficile | 1.9K | $68.4K | $36.67 | 3.27x |
| 87150 | Identification of organisms by genetic analysis | 1.7K | $59.2K | $34.88 | 3.44x |
| 81291 | Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants | 622 | $39.9K | $64.08 | 1.56x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 580 | $29.2K | $50.28 | 3.20x |
| 87581 | Detection test for Mycoplasma pneumoniae (bacteria) | 536 | $19.8K | $37.01 | 4.73x |
| 87486 | Detection test for Chlamydia pneumoniae | 533 | $19.7K | $37.02 | 4.73x |
| 81328 | Gene analysis (solute carrier organic anion transporter family, member 1b1) for common variant | 103 | $17.7K | $171.38 | 1.55x |
This provider submits charges 3.42 times higher than what Medicare actually pays.
A markup ratio of 3.42x means for every $100 Medicare pays, this provider initially charges $342. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Clinical Laboratory providers in TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Clinical Pathology Laboratories, Inc. | Austin, TX | $541.0M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Irving, TX | $453.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Dallas, TX | $389.6M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Houston, TX | $311.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Houston, TX | $299.4M | ⚠️ Flagged |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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