This provider's $9.2M in total Medicare payments ranks in the 90th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 317657% from 2017 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 42214% 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 | $64.50 | $16.92 | 3.81x | $47.58 | $552.64 | 34 | 34 |
| 2018 | $137.60 | $35.85 | 3.84x | $101.75 | $233.8K | 2.9K | 2.7K |
| 2019 | $660.56 | $477.88 | 1.38x | $182.68 | $1.7M | 4.3K | 4.1K |
| 2020 | $328.92 | $259.18 | 1.27x | $69.74 | $2.2M | 4.3K | 4.3K |
| 2021 | $442.64 | $358.94 | 1.23x | $83.70 | $2.1M | 5.7K | 5.4K |
| 2022 | $90.31 | $34.49 | 2.62x | $55.82 | $1.3M | 32.5K | 10.7K |
| 2023 | $43.66 | $14.66 | 2.98x | $29.00 | $1.8M | 56.1K | 20.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81408 | Molecular pathology procedure level 9 | 958 | $1.9M | $2.0K | 1.25x |
| 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 | 21.6K | $1.6M | $73.69 | 2.44x |
| 81407 | Molecular pathology procedure level 8 | 821 | $693.8K | $845.03 | 1.25x |
| 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 | 21.5K | $528.5K | $24.56 | 2.30x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 21.1K | $485.9K | $23.05 | 2.21x |
| 81406 | Molecular pathology procedure level 7 | 1.3K | $371.2K | $281.21 | 1.25x |
| 81411 | Test for detecting genes associated with heart disease, duplication/deletion analysis panel | 254 | $342.9K | $1.4K | 1.24x |
| 81405 | Molecular pathology procedure level 6 | 1.0K | $303.0K | $300.56 | 1.25x |
| 81404 | Molecular pathology procedure level 5 | 1.0K | $276.6K | $274.09 | 1.25x |
| 81201 | Gene analysis (adenomatous polyposis coli), full gene sequence | 340 | $260.8K | $766.92 | 1.27x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis | 387 | $257.6K | $665.66 | 1.26x |
| 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 | 724 | $175.2K | $241.98 | 2.55x |
| 81413 | Test for detecting genes associated with heart disease | 282 | $164.9K | $584.90 | 1.25x |
| 81238 | Gene analysis (coagulation factor ix) full sequence analysis | 235 | $141.0K | $600.00 | 1.24x |
| 81414 | Test for detecting genes associated with heart disease, duplication/deletion analysis panel, at least 2 genes | 206 | $120.5K | $584.90 | 1.25x |
| 81295 | Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis | 285 | $106.6K | $374.07 | 1.27x |
| 81401 | Molecular pathology procedure level 2 | 772 | $105.1K | $136.19 | 1.25x |
| 81286 | Gene analysis (frataxin) of full sequence | 377 | $103.6K | $274.83 | 1.24x |
| 80307 | Testing for presence of drug | 1.4K | $86.6K | $63.97 | 2.71x |
| 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 | 501 | $76.9K | $153.46 | 2.55x |
This provider submits charges 1.73 times higher than what Medicare actually pays.
A markup ratio of 1.73x means for every $100 Medicare pays, this provider initially charges $173. 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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