This provider's $23.9M in total Medicare payments ranks in the 96th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 6.35x is significantly above the specialty median of 3.7x.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 445% in 2021
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 |
|---|---|---|---|---|---|---|---|
| 2019 | $303.56 | $33.06 | 9.18x | $270.50 | $723.2K | 42.5K | 39.2K |
| 2020 | $812.83 | $133.82 | 6.07x | $679.01 | $3.5M | 58.4K | 45.9K |
| 2021 | $804.80 | $129.82 | 6.20x | $674.98 | $19.3M | 69.4K | 53.9K |
| 2022 | $315.12 | $23.68 | 13.31x | $291.44 | $424.1K | 23.1K | 20.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81442 | Gene analysis (noonan syndrome) genomic sequence analysis | 2.2K | $4.7M | $2.1K | 5.17x |
| 81408 | Molecular pathology procedure level 9 | 2.3K | $4.5M | $2.0K | 5.17x |
| 81411 | Test for detecting genes associated with heart disease | 2.2K | $2.9M | $1.4K | 5.17x |
| 81407 | Molecular pathology procedure level 8 | 2.2K | $1.9M | $846.27 | 5.17x |
| 81413 | Test for detecting genes associated with heart disease | 2.2K | $1.3M | $584.90 | 5.17x |
| 81414 | Test for detecting genes associated with heart disease | 2.2K | $1.3M | $584.72 | 5.18x |
| 81410 | Test for detecting genes associated with heart disease | 2.2K | $1.1M | $504.00 | 5.21x |
| 81405 | Molecular pathology procedure level 6 | 2.3K | $678.9K | $301.35 | 5.17x |
| 81406 | Molecular pathology procedure level 7 | 2.3K | $637.3K | $282.88 | 5.17x |
| 81404 | Molecular pathology procedure level 5 | 2.3K | $618.9K | $274.83 | 5.17x |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 3.0K | $602.9K | $197.93 | 15.06x |
| 81403 | Molecular pathology procedure level 4 | 2.2K | $412.4K | $185.20 | 5.17x |
| 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 | 5.0K | $375.9K | $75.07 | 15.71x |
| 81401 | Molecular pathology procedure level 2 | 2.3K | $316.6K | $136.89 | 5.17x |
| 80307 | Testing for presence of drug | 3.5K | $219.0K | $62.14 | 15.95x |
| 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 | 5.0K | $124.7K | $25.00 | 12.77x |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source | 4.5K | $115.2K | $25.46 | 11.99x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 5.9K | $101.4K | $17.12 | 12.02x |
| 84403 | Testosterone (hormone) level | 3.6K | $96.1K | $26.44 | 11.91x |
| 82670 | Estradiol (hormone) level | 3.3K | $94.7K | $28.59 | 11.91x |
This provider submits charges 6.35 times higher than what Medicare actually pays.
A markup ratio of 6.35x means for every $100 Medicare pays, this provider initially charges $635. 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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