This provider's $19.1M in total Medicare payments ranks in the 95th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 990% 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 |
|---|---|---|---|---|---|---|---|
| 2018 | $219.38 | $131.82 | 1.66x | $87.56 | $578.1K | 6.3K | 6.0K |
| 2019 | $197.29 | $102.71 | 1.92x | $94.58 | $746.3K | 8.5K | 8.0K |
| 2020 | $288.90 | $235.30 | 1.23x | $53.60 | $1.5M | 6.6K | 6.3K |
| 2021 | $399.41 | $369.39 | 1.08x | $30.02 | $16.2M | 21.8K | 21.6K |
| 2022 | $897.06 | $897.06 | 1.00x | $0.00 | $80.7K | 90 | 90 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81442 | Gene analysis (noonan syndrome) genomic sequence analysis | 3.7K | $8.0M | $2.1K | 1.00x |
| 81413 | Test for detecting genes associated with heart disease, genomic sequence analysis panel, at least 10 genes | 3.6K | $2.1M | $584.90 | 1.00x |
| 81414 | Test for detecting genes associated with heart disease, duplication/deletion analysis panel, at least 2 genes | 3.6K | $2.1M | $584.90 | 1.00x |
| 81185 | Gene analysis (calcium voltage-gated channel subunit alpha1 a) of full sequence | 1.6K | $1.4M | $846.27 | 1.22x |
| 81286 | Gene analysis (frataxin) of full sequence | 4.1K | $1.1M | $274.78 | 1.01x |
| 81411 | Test for detecting genes associated with heart disease | 456 | $615.7K | $1.4K | 1.19x |
| 88377 | Microscopic genetic examination manual | 1.5K | $443.9K | $294.98 | 1.33x |
| 81408 | Molecular pathology procedure level 9 | 178 | $356.0K | $2.0K | 1.02x |
| 81238 | Gene analysis (coagulation factor ix) full sequence analysis | 455 | $273.0K | $600.00 | 1.03x |
| 81439 | Test for detecting genes associated with inherited disease of heart muscle | 456 | $266.7K | $584.90 | 1.04x |
| 81410 | Test for detecting genes associated with heart disease | 456 | $229.8K | $504.00 | 1.19x |
| 88189 | Flow cytometry technique for DNA or cell analysis | 2.5K | $166.2K | $65.88 | 1.44x |
| 88237 | Tissue culture for tumor disorders of bone marrow and blood cells | 941 | $136.4K | $144.93 | 1.10x |
| 88264 | Chromosome analysis for genetic defects | 895 | $129.9K | $145.09 | 1.08x |
| 88120 | Cell examination of urine | 274 | $126.9K | $463.09 | 1.46x |
| 81407 | Molecular pathology procedure level 8 | 117 | $99.0K | $846.27 | 1.00x |
| 81403 | Molecular pathology procedure level 4 | 433 | $79.2K | $182.94 | 1.03x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 42 | $76.6K | $1.8K | 1.00x |
| 81307 | Gene analysis (partner and localizer of brca2) full sequence analysis | 113 | $76.4K | $676.50 | 1.00x |
| 88342 | Tissue or cell analysis by immunologic technique | 965 | $73.9K | $76.62 | 2.43x |
This provider submits charges 1.11 times higher than what Medicare actually pays.
A markup ratio of 1.11x means for every $100 Medicare pays, this provider initially charges $111. 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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