Statistical flag only — not an accusation of fraud
This provider's $299.4M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 5.61x is significantly above the specialty median of 3.7x.
This provider has been statistically flagged with a risk score of 82/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
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 | $64.35 | $12.20 | 5.27x | $52.15 | $31.1M | 2.5M | 247 |
| 2015 | $64.20 | $12.14 | 5.29x | $52.06 | $29.9M | 2.5M | 243 |
| 2016 | $65.20 | $12.59 | 5.18x | $52.61 | $32.1M | 2.5M | 297 |
| 2017 | $68.83 | $13.27 | 5.19x | $55.56 | $34.2M | 2.6M | 328 |
| 2018 | $71.14 | $13.44 | 5.29x | $57.70 | $33.8M | 2.5M | 327 |
| 2019 | $69.97 | $11.98 | 5.84x | $57.99 | $29.8M | 2.5M | 325 |
| 2020 | $69.42 | $11.42 | 6.08x | $58.00 | $26.8M | 2.3M | 316 |
| 2021 | $69.46 | $11.48 | 6.05x | $57.98 | $28.0M | 2.4M | 331 |
| 2022 | $67.54 | $11.12 | 6.07x | $56.42 | $26.4M | 2.4M | 329 |
| 2023 | $69.53 | $11.27 | 6.17x | $58.26 | $27.2M | 2.4M | 335 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 2.7M | $29.4M | $10.76 | 4.25x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 1.4M | $27.4M | $19.67 | 5.27x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 1.8M | $26.4M | $14.72 | 6.02x |
| 82306 | Vitamin d-3 level | 625.4K | $20.8M | $33.19 | 6.37x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 2.2M | $19.9M | $9.05 | 3.36x |
| 83036 | Hemoglobin a1c level | 1.2M | $13.7M | $11.27 | 6.13x |
| 36415 | Insertion of needle into vein for collection of blood sample | 2.5M | $9.0M | $3.54 | 6.47x |
| 83970 | Parathormone (parathyroid hormone) level | 154.5K | $7.2M | $46.77 | 3.63x |
| 87086 | Bacterial colony count, urine | 592.8K | $5.7M | $9.53 | 5.33x |
| 84153 | Psa (prostate specific antigen) measurement, total | 226.3K | $4.9M | $21.48 | 5.85x |
| 84439 | Thyroxine (thyroid chemical), free | 451.9K | $4.7M | $10.44 | 9.00x |
| 84403 | Testosterone (hormone) level, total | 131.5K | $3.9M | $30.00 | 5.62x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 207.5K | $3.6M | $17.43 | 6.11x |
| 86235 | Measurement of antibody for assessment of autoimmune disorder, any method | 165.2K | $3.4M | $20.75 | 5.95x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 78.4K | $3.3M | $41.59 | 5.21x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 316.9K | $3.2M | $10.25 | 7.26x |
| 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 | 29.1K | $3.2M | $110.25 | 2.01x |
| 82728 | Ferritin (blood protein) level | 201.6K | $3.1M | $15.60 | 4.89x |
| 80307 | Testing for presence of drug, by chemistry analyzers | 49.1K | $3.1M | $63.41 | 4.63x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 127.0K | $2.8M | $21.67 | 5.70x |
This provider submits charges 5.61 times higher than what Medicare actually pays.
A markup ratio of 5.61x means for every $100 Medicare pays, this provider initially charges $561. 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 |
| Inform Diagnostics, Inc | Coppell, TX | $246.3M | ✓ Clear |
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