This provider's $9.8M in total Medicare payments ranks in the 90th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 6744% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1766% 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 | $202.99 | $36.92 | 5.50x | $166.07 | $20.0K | 516 | 507 |
| 2018 | $190.18 | $54.56 | 3.49x | $135.62 | $372.6K | 7.9K | 7.5K |
| 2019 | $291.85 | $81.74 | 3.57x | $210.11 | $832.1K | 17.0K | 14.9K |
| 2020 | $292.92 | $78.91 | 3.71x | $214.01 | $2.0M | 32.3K | 26.9K |
| 2021 | $323.84 | $168.53 | 1.92x | $155.31 | $3.4M | 47.9K | 41.3K |
| 2022 | $208.47 | $69.13 | 3.02x | $139.34 | $1.8M | 27.3K | 22.7K |
| 2023 | $188.09 | $64.46 | 2.92x | $123.63 | $1.4M | 24.6K | 19.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88120 | Cell examination of urine | 3.1K | $1.4M | $472.05 | 3.20x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 9.5K | $779.6K | $81.75 | 4.33x |
| 87801 | Detection test for multiple organisms | 6.9K | $497.9K | $71.90 | 3.34x |
| 87798 | Detection test for organism | 11.7K | $412.8K | $35.37 | 3.03x |
| 87653 | Detection test for Strep (Streptococcus, group B) | 10.2K | $363.0K | $35.44 | 2.94x |
| 87500 | Detection test for Vancomycin resistance strep (VRE) | 10.0K | $356.2K | $35.60 | 2.99x |
| 87651 | Detection test for Strep (Streptococcus, group A) | 9.9K | $348.9K | $35.41 | 2.91x |
| 87481 | Detection test for candida species (yeast) | 9.2K | $327.1K | $35.53 | 2.90x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 6.1K | $319.4K | $52.64 | 4.93x |
| 87633 | Detection test for multiple types of respiratory virus | 746 | $310.3K | $416.01 | 3.06x |
| 87900 | Infectious agent drug susceptibility analysis | 2.4K | $307.9K | $127.71 | 2.80x |
| 87582 | Detection test for Mycoplasma pneumoniae (bacteria) | 964 | $289.5K | $300.35 | 3.05x |
| 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 | 2.9K | $283.6K | $97.18 | 2.57x |
| 87482 | Detection test for candida species (yeast) | 5.1K | $282.6K | $55.19 | 2.99x |
| 87640 | Detection test for Staphylococcus aureus (bacteria) | 7.3K | $263.5K | $36.07 | 3.04x |
| G0481 | 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 | 1.6K | $239.3K | $153.67 | 2.53x |
| 87652 | Detection test for Strep (Streptococcus, group A) | 5.3K | $228.5K | $43.17 | 3.05x |
| 87799 | Detection test for organism | 4.6K | $204.9K | $44.88 | 3.36x |
| 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 | 903 | $177.2K | $196.27 | 2.52x |
| 88104 | Cell examination of body fluid | 3.1K | $158.2K | $51.76 | 3.36x |
This provider submits charges 3.18 times higher than what Medicare actually pays.
A markup ratio of 3.18x means for every $100 Medicare pays, this provider initially charges $318. 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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