This provider's $4.9M in total Medicare payments ranks in the 81th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 11859% from 2021 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 6446% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2021 | $56.97 | $43.96 | 1.30x | $13.01 | $40.4K | 919 | 2 |
| 2022 | $67.89 | $51.40 | 1.32x | $16.49 | $73.8K | 1.4K | 3 |
| 2023 | $57.46 | $37.39 | 1.54x | $20.07 | $4.8M | 129.2K | 45 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 58.0K | $2.0M | $34.39 | 1.54x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 13.4K | $461.2K | $34.39 | 1.54x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 2.1K | $298.9K | $139.78 | 1.53x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 4.5K | $154.9K | $34.39 | 1.54x |
| 87529 | Detection test by nucleic acid for herpes simplex virus, amplified probe technique | 4.0K | $137.6K | $34.39 | 1.54x |
| 87556 | Detection test by nucleic acid for mycobacteria tuberculosis (tb bacteria), amplified probe technique | 3.4K | $137.4K | $40.85 | 1.54x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 3.9K | $134.2K | $34.39 | 1.54x |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | 3.6K | $122.6K | $34.39 | 1.54x |
| 87496 | Detection test by nucleic acid for cytomegalovirus (cmv), amplified probe technique | 3.4K | $115.7K | $34.39 | 1.54x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 2.3K | $113.8K | $50.28 | 1.54x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 3.0K | $103.9K | $34.39 | 1.54x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 2.9K | $101.2K | $34.39 | 1.54x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 2.9K | $101.1K | $34.39 | 1.54x |
| U0003 | 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, making use of high throughput technologies as described by cms-2020-01-r | 1.1K | $79.4K | $74.63 | 1.34x |
| 87541 | Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique | 2.3K | $78.4K | $34.39 | 1.54x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 2.3K | $78.3K | $34.39 | 1.54x |
| 87581 | Detection test by nucleic acid for mycoplasma pneumoniae (bacteria), amplified probe technique | 2.3K | $78.3K | $34.39 | 1.54x |
| 87551 | Detection test by nucleic acid for mycobacteria species (bacteria), amplified probe technique | 1.6K | $76.1K | $47.28 | 1.54x |
| 87563 | Detection of mycoplasma genitalium by dna or rna probe | 2.1K | $72.4K | $34.39 | 1.54x |
| 87591 | Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | 2.1K | $70.6K | $34.39 | 1.54x |
This provider submits charges 1.53 times higher than what Medicare actually pays.
A markup ratio of 1.53x means for every $100 Medicare pays, this provider initially charges $153. This is lower 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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