This provider's $4.6M in total Medicare payments ranks in the 79th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 607% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 351% in 2020
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 | $17.50 | $16.77 | 1.04x | $0.73 | $160.2K | 12.3K | 8.7K |
| 2020 | $17.47 | $15.92 | 1.10x | $1.55 | $721.8K | 51.8K | 21.4K |
| 2021 | $35.55 | $15.58 | 2.28x | $19.97 | $1.2M | 78.5K | 30.2K |
| 2022 | $38.24 | $15.17 | 2.52x | $23.07 | $1.3M | 88.0K | 38.2K |
| 2023 | $44.59 | $16.31 | 2.73x | $28.28 | $1.1M | 98.5K | 46.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 10.6K | $859.3K | $80.93 | 1.95x |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 55.1K | $368.2K | $6.69 | 2.31x |
| 80053 | Blood test, comprehensive group of blood chemicals | 22.8K | $239.0K | $10.47 | 2.27x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 30.3K | $233.9K | $7.71 | 2.25x |
| 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 | 7.1K | $179.5K | $25.41 | 2.31x |
| 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 | 6.4K | $158.8K | $24.97 | 2.39x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 8.8K | $146.9K | $16.70 | 2.22x |
| 87798 | Detection test for organism | 3.7K | $129.7K | $34.79 | 2.32x |
| 87500 | Detection test for Vancomycin resistance strep (VRE) | 3.7K | $128.9K | $34.80 | 2.33x |
| 87640 | Detection test for Staphylococcus aureus (bacteria) | 3.7K | $128.3K | $34.80 | 2.33x |
| 87481 | Detection test for candida species (yeast) | 3.6K | $127.1K | $34.81 | 2.32x |
| 87653 | Detection test for Strep (Streptococcus, group B) | 3.6K | $126.1K | $34.81 | 2.31x |
| 82306 | Vitamin D-3 level | 4.1K | $121.3K | $29.45 | 2.26x |
| 87641 | Detection test for Staphylococcus aureus, methicillin resistant (MRSA bacteria) | 3.2K | $110.0K | $34.88 | 2.20x |
| 80048 | Blood test, basic group of blood chemicals | 12.9K | $108.8K | $8.41 | 2.13x |
| 87651 | Detection test for Strep (Streptococcus, group A) | 2.8K | $99.4K | $34.93 | 2.17x |
| 87529 | Detection test for herpes simplex virus | 2.8K | $97.7K | $34.97 | 2.15x |
| 87496 | Detection test for Cytomegalovirus (CMV) | 2.8K | $96.8K | $34.95 | 2.15x |
| 87661 | Detection test for Trichomonas vaginalis (genital parasite) | 2.7K | $95.0K | $34.96 | 2.14x |
| 87563 | Detection of mycoplasma genitalium by dna or rna probe | 2.6K | $91.5K | $34.67 | 2.57x |
This provider submits charges 2.21 times higher than what Medicare actually pays.
A markup ratio of 2.21x means for every $100 Medicare pays, this provider initially charges $221. 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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