This provider's $17.3M in total Medicare payments ranks in the 94th 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 98% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $36.70 | $13.34 | 2.75x | $23.36 | $1.4M | 187.2K | 95.9K |
| 2017 | $34.85 | $12.55 | 2.78x | $22.30 | $2.9M | 371.1K | 142.4K |
| 2018 | $33.87 | $12.64 | 2.68x | $21.23 | $3.2M | 416.0K | 171.1K |
| 2019 | $35.82 | $12.05 | 2.97x | $23.77 | $2.7M | 370.7K | 163.0K |
| 2020 | $38.45 | $14.34 | 2.68x | $24.11 | $2.4M | 235.2K | 119.3K |
| 2021 | $46.18 | $15.01 | 3.08x | $31.17 | $2.0M | 215.0K | 110.8K |
| 2022 | $43.01 | $14.39 | 2.99x | $28.62 | $1.5M | 170.9K | 95.5K |
| 2023 | $41.27 | $14.20 | 2.91x | $27.07 | $1.2M | 119.6K | 69.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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) | 377.9K | $2.0M | $5.20 | 2.54x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 95.8K | $1.8M | $18.38 | 2.23x |
| 80053 | Blood test, comprehensive group of blood chemicals | 128.7K | $1.5M | $11.97 | 2.86x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 134.4K | $1.2M | $9.03 | 2.52x |
| 80048 | Blood test, basic group of blood chemicals | 97.5K | $940.5K | $9.64 | 2.75x |
| 82306 | Vitamin D-3 level | 26.2K | $795.4K | $30.33 | 2.26x |
| 83036 | Hemoglobin A1C level | 65.2K | $700.0K | $10.74 | 2.96x |
| 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 | 7.2K | $674.7K | $93.95 | 2.55x |
| 87086 | Bacterial colony count, urine | 70.2K | $638.9K | $9.11 | 2.70x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 13.8K | $553.3K | $40.24 | 2.59x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 70.8K | $514.9K | $7.27 | 2.30x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 35.4K | $511.8K | $14.47 | 2.86x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 43.9K | $427.0K | $9.73 | 2.75x |
| 87077 | Bacterial culture for aerobic isolates | 43.6K | $395.8K | $9.08 | 2.48x |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 390.2K | $387.8K | $0.99 | 2.44x |
| 87088 | Bacterial urine culture | 37.9K | $343.8K | $9.08 | 2.70x |
| 85610 | Blood test, clotting time | 64.9K | $309.7K | $4.77 | 2.71x |
| 80164 | Valproic acid level | 19.0K | $297.8K | $15.68 | 2.70x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 16.8K | $275.5K | $16.36 | 2.20x |
| 81001 | Manual urinalysis test with examination using microscope | 65.2K | $239.9K | $3.68 | 2.71x |
This provider submits charges 2.59 times higher than what Medicare actually pays.
A markup ratio of 2.59x means for every $100 Medicare pays, this provider initially charges $259. 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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