Statistical flag only — not an accusation of fraud
This provider's $43.0M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 164907% from 2022 to 2023.
This provider has been statistically flagged with a risk score of 70/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 164907% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2022 | $83.75 | $40.93 | 2.05x | $42.82 | $26.1K | 637 | 2 |
| 2023 | $122.36 | $110.91 | 1.10x | $11.45 | $43.0M | 387.9K | 35 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 125.8K | $4.3M | $34.39 | 1.45x |
| 81185 | Gene analysis (calcium voltage-gated channel subunit alpha1 a) of full sequence | 4.0K | $3.2M | $812.01 | 1.05x |
| 81249 | Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis | 5.4K | $3.2M | $588.00 | 1.02x |
| 81307 | Gene analysis (partner and localizer of brca2) full sequence analysis | 4.3K | $2.9M | $662.97 | 1.06x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [s cerevisiae]) full sequence analysis | 4.3K | $2.8M | $662.97 | 1.06x |
| 81298 | Gene analysis (muts homolog 6 [e coli]) full sequence analysis | 4.3K | $2.7M | $629.01 | 1.11x |
| 81238 | Gene analysis (coagulation factor ix) full sequence analysis | 4.3K | $2.5M | $584.12 | 1.03x |
| 81325 | Gene analysis (peripheral myelin protein 22), full sequence analysis | 2.9K | $2.2M | $754.19 | 1.02x |
| 81302 | Gene analysis (methyl cpg binding protein 2) full sequence analysis | 4.0K | $2.1M | $517.31 | 1.02x |
| 81223 | Gene analysis (cystic fibrosis transmembrane conductance regular) full gene sequence | 4.3K | $1.8M | $407.08 | 1.03x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 33.2K | $1.1M | $34.39 | 1.16x |
| 81309 | Gene analysis (partner and localizer of brca2) targeted sequence analysis | 4.0K | $1.1M | $269.33 | 1.03x |
| 81189 | Gene analysis (cystatin b) of full sequence | 4.0K | $1.1M | $269.33 | 1.03x |
| 81279 | Gene analysis (janus kinase 2) targeted sequence analysis | 4.3K | $787.2K | $181.50 | 1.10x |
| 81339 | Gene analysis (mpl proto-oncogene, thrombopoietin receptor) sequence analysis of exon 10 | 4.3K | $787.2K | $181.50 | 1.10x |
| 81286 | Gene analysis (frataxin) of full sequence | 2.9K | $781.9K | $269.33 | 1.02x |
| 87631 | Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets | 5.3K | $745.0K | $139.75 | 1.04x |
| 81191 | Gene analysis (neurotrophic receptor tyrosine kinase 1) translocation analysis | 2.9K | $592.8K | $203.16 | 1.03x |
| 81192 | Gene analysis (neurotrophic receptor tyrosine kinase 2) translocation analysis | 2.9K | $592.8K | $203.16 | 1.03x |
| 87502 | Detection test by nucleic acid for multiple types influenza virus | 5.3K | $498.5K | $93.86 | 1.07x |
This provider submits charges 1.1 times higher than what Medicare actually pays.
A markup ratio of 1.1x means for every $100 Medicare pays, this provider initially charges $110. 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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