This provider's $21.3M in total Medicare payments ranks in the 95th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 1915% from 2021 to 2023.
94% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1834% 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 | $664.89 | $443.22 | 1.50x | $221.67 | $960.0K | 2.2K | 17 |
| 2022 | $15.63 | $13.79 | 1.13x | $1.84 | $1.0M | 72.5K | 11 |
| 2023 | $12.19 | $11.89 | 1.03x | $0.30 | $19.3M | 1.6M | 5 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1.7M | $20.0M | $11.76 | 1.02x |
| 81408 | Molecular pathology procedure level 9 | 239 | $478.0K | $2.0K | 1.50x |
| 81407 | Molecular pathology procedure level 8 | 116 | $98.2K | $846.27 | 1.50x |
| 81440 | Test for detecting genes | 23 | $74.9K | $3.3K | 1.53x |
| 81223 | Gene analysis (cystic fibrosis transmembrane conductance regular) full gene sequence | 116 | $57.6K | $496.33 | 1.51x |
| 81443 | Genomic sequence analysis panel for severe inherited conditions with sequencing of 15 or more genes | 23 | $55.2K | $2.4K | 1.53x |
| 81406 | Molecular pathology procedure level 7 | 187 | $52.9K | $282.88 | 1.50x |
| 81405 | Molecular pathology procedure level 6 | 174 | $52.4K | $301.35 | 1.50x |
| 81404 | Molecular pathology procedure level 5 | 173 | $47.5K | $274.83 | 1.50x |
| 81419 | Gene analysis panel for evaluation of genes associated with epilepsy | 17 | $40.8K | $2.4K | 1.53x |
| 81307 | Gene analysis (partner and localizer of brca2) full sequence analysis | 50 | $33.5K | $670.55 | 1.51x |
| 81298 | Gene analysis (muts homolog 6 [e coli]) full sequence analysis | 46 | $29.2K | $635.01 | 1.52x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [s cerevisiae]) full sequence analysis | 43 | $28.8K | $668.79 | 1.52x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 12 | $21.9K | $1.8K | 1.50x |
| 81302 | Gene analysis (methyl cpg binding protein 2) full sequence analysis | 41 | $21.5K | $523.49 | 1.51x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 611 | $21.2K | $34.71 | 1.85x |
| 81286 | Gene analysis (frataxin) of full sequence | 71 | $19.5K | $274.83 | 1.50x |
| 81403 | Molecular pathology procedure level 4 | 100 | $18.5K | $185.20 | 1.50x |
| 81238 | Gene analysis (coagulation factor ix) full sequence analysis | 31 | $18.3K | $588.77 | 1.53x |
| 81249 | Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis | 23 | $13.6K | $590.09 | 1.53x |
This provider submits charges 1.05 times higher than what Medicare actually pays.
A markup ratio of 1.05x means for every $100 Medicare pays, this provider initially charges $105. 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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