This provider's $49.3M in total Medicare payments ranks in the 98th 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 2859% in 2021
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 | $67.43 | $13.91 | 4.85x | $53.52 | $5.6M | 402.6K | 115 |
| 2015 | $68.23 | $14.02 | 4.87x | $54.21 | $5.2M | 368.3K | 108 |
| 2016 | $67.99 | $13.93 | 4.88x | $54.06 | $5.8M | 415.9K | 115 |
| 2017 | $56.35 | $14.05 | 4.01x | $42.30 | $6.2M | 438.4K | 120 |
| 2018 | $50.99 | $13.90 | 3.67x | $37.09 | $6.1M | 435.6K | 120 |
| 2019 | $51.02 | $12.58 | 4.06x | $38.44 | $4.5M | 360.4K | 106 |
| 2020 | $50.16 | $11.56 | 4.34x | $38.60 | $187.0K | 16.2K | 44 |
| 2021 | $49.77 | $11.96 | 4.16x | $37.81 | $5.5M | 462.9K | 91 |
| 2022 | $49.62 | $11.40 | 4.35x | $38.22 | $5.2M | 454.0K | 88 |
| 2023 | $49.27 | $11.07 | 4.45x | $38.20 | $5.1M | 462.6K | 77 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 676.8K | $8.1M | $12.01 | 4.90x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 359.9K | $7.1M | $19.73 | 3.50x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 493.4K | $6.5M | $13.07 | 4.67x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 492.2K | $4.5M | $9.05 | 3.98x |
| 82306 | Vitamin d-3 level | 120.6K | $4.0M | $33.05 | 3.68x |
| 83036 | Hemoglobin a1c level | 278.6K | $3.1M | $11.22 | 4.42x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 54.5K | $1.2M | $21.47 | 4.69x |
| 84439 | Thyroxine (thyroid chemical), free | 92.3K | $993.0K | $10.75 | 3.49x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 51.0K | $890.4K | $17.47 | 4.18x |
| 82043 | Urine microalbumin (protein) level | 126.4K | $829.9K | $6.56 | 8.94x |
| 84153 | Psa (prostate specific antigen) measurement, total | 36.4K | $778.2K | $21.38 | 4.10x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 121.4K | $726.6K | $5.99 | 5.27x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 64.4K | $635.8K | $9.88 | 4.75x |
| 83970 | Parathormone (parathyroid hormone) level | 11.5K | $562.7K | $49.00 | 3.47x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 13.6K | $549.7K | $40.34 | 3.89x |
| 87086 | Bacterial colony count, urine | 55.0K | $528.5K | $9.60 | 4.71x |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 11.3K | $520.8K | $45.98 | 1.33x |
| 84481 | Thyroid hormone, t3 measurement, free | 25.4K | $514.7K | $20.23 | 7.25x |
| 82728 | Ferritin (blood protein) level | 32.0K | $509.4K | $15.93 | 3.65x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 9.2K | $499.3K | $54.07 | 5.98x |
This provider submits charges 4.36 times higher than what Medicare actually pays.
A markup ratio of 4.36x means for every $100 Medicare pays, this provider initially charges $436. 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 |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data