This provider's $7.0M in total Medicare payments ranks in the 86th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 245306% from 2020 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 33042% 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 |
|---|---|---|---|---|---|---|---|
| 2020 | $226.09 | $100.00 | 2.26x | $126.09 | $2.3K | 23 | 1 |
| 2021 | $216.79 | $143.77 | 1.51x | $73.02 | $762.3K | 5.3K | 21 |
| 2022 | $76.56 | $42.51 | 1.80x | $34.05 | $613.7K | 14.4K | 20 |
| 2023 | $43.43 | $39.37 | 1.10x | $4.06 | $5.6M | 143.4K | 67 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 77.2K | $2.7M | $34.39 | 1.07x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 28.7K | $987.0K | $34.39 | 1.09x |
| 87483 | Test for detecting nucleic acid of organism causing infection of central nervous system | 1.5K | $613.6K | $408.24 | 1.06x |
| 81408 | Molecular pathology procedure level 9 | 115 | $230.0K | $2.0K | 1.00x |
| 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 | 2.9K | $219.0K | $74.97 | 3.07x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 5.1K | $175.5K | $34.39 | 1.20x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 5.0K | $172.1K | $34.39 | 1.21x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 5.0K | $170.7K | $34.39 | 1.21x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 1.1K | $156.6K | $139.78 | 1.07x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 4.3K | $149.6K | $34.39 | 1.21x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 1.5K | $142.7K | $93.88 | 1.10x |
| 86738 | Analysis for antibody to mycoplasma (bacteria) | 7.1K | $92.3K | $12.98 | 1.20x |
| 81249 | Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis | 129 | $76.5K | $592.74 | 1.02x |
| 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 | 2.8K | $69.2K | $24.92 | 3.01x |
| 81440 | Test for detecting genes | 20 | $63.8K | $3.2K | 1.07x |
| 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 | 255 | $61.9K | $242.65 | 1.09x |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2.6K | $60.4K | $23.41 | 5.13x |
| 87498 | Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique | 1.5K | $51.7K | $34.39 | 1.20x |
| 87486 | Detection test by nucleic acid for chlamydia pneumoniae, amplified probe technique | 1.5K | $51.6K | $34.39 | 1.20x |
| 87541 | Detection test by nucleic acid for legionella pneumophila (water borne bacteria), amplified probe technique | 1.5K | $51.6K | $34.39 | 1.20x |
This provider submits charges 1.21 times higher than what Medicare actually pays.
A markup ratio of 1.21x means for every $100 Medicare pays, this provider initially charges $121. 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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