Statistical flag only — not an accusation of fraud
This provider's $112.0M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 136% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 66/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 144% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $86.11 | $26.96 | 3.19x | $59.15 | $7.9M | 294.7K | 23 |
| 2015 | $83.51 | $26.46 | 3.16x | $57.05 | $5.6M | 211.5K | 20 |
| 2016 | $247.29 | $79.67 | 3.10x | $167.62 | $5.1M | 64.3K | 13 |
| 2017 | $277.69 | $109.70 | 2.53x | $167.99 | $7.2M | 66.0K | 8 |
| 2018 | $176.62 | $79.74 | 2.21x | $96.88 | $8.9M | 111.7K | 22 |
| 2019 | $146.39 | $74.27 | 1.97x | $72.12 | $7.3M | 98.4K | 28 |
| 2020 | $86.07 | $72.18 | 1.19x | $13.89 | $17.8M | 246.8K | 36 |
| 2021 | $75.15 | $51.76 | 1.45x | $23.39 | $16.4M | 316.0K | 36 |
| 2022 | $61.52 | $44.82 | 1.37x | $16.70 | $17.0M | 378.5K | 36 |
| 2023 | $48.73 | $36.49 | 1.34x | $12.24 | $18.7M | 513.3K | 32 |
| 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 | 223.8K | $19.0M | $84.91 | 1.44x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 282.7K | $9.9M | $34.94 | 1.32x |
| G0480 | 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 | 75.9K | $8.0M | $105.01 | 3.12x |
| G0483 | 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 | 27.8K | $6.7M | $242.50 | 1.34x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 185.5K | $6.5M | $34.91 | 1.30x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 61.5K | $5.8M | $94.49 | 2.70x |
| 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 | 33.3K | $4.9M | $147.80 | 2.29x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 69.8K | $4.4M | $63.34 | 2.27x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 115.0K | $4.0M | $35.04 | 1.31x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 113.7K | $4.0M | $35.18 | 1.33x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 104.9K | $3.7M | $35.23 | 1.34x |
| 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 | 18.3K | $3.4M | $184.77 | 1.84x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 22.6K | $3.2M | $140.04 | 1.27x |
| 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 | 94.6K | $2.4M | $24.90 | 1.26x |
| 87633 | Detection test for multiple types of respiratory virus | 4.2K | $1.8M | $430.12 | 1.26x |
| 87661 | Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique | 46.6K | $1.7M | $35.76 | 1.37x |
| 87563 | Detection of mycoplasma genitalium by dna or rna probe | 44.2K | $1.5M | $34.63 | 1.24x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 23.4K | $1.5M | $65.27 | 3.56x |
| 80102 | Drug confirmation test | 85.2K | $1.5M | $17.55 | 2.29x |
| 87529 | Detection test by nucleic acid for herpes simplex virus, amplified probe technique | 33.1K | $1.2M | $36.30 | 1.43x |
This provider submits charges 1.83 times higher than what Medicare actually pays.
A markup ratio of 1.83x means for every $100 Medicare pays, this provider initially charges $183. 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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