Loading...
NPI 1013525286 · Richardson, TX · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
American Premier Labs is a clinical medical laboratory provider located in Richardson, Texas. This profile covers 67 Medicare and 58 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | American Premier Labs |
| Address | 670 W Arapaho Rd Ste 11a |
| City | Richardson |
| State | TX |
| ZIP | 75080 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 14, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $28.6M |
| Medicaid | $10.5K |
This entity is overwhelmingly Medicare-funded: Total Medicare revenue is $28.6M compared with Total Medicaid revenue of $10.5K, so Medicare dominates the payer mix and the provider is effectively a Medicare-centric operation. The disparity in scale suggests strategic focus and billing infrastructure oriented to Medicare reimbursement flows rather than Medicaid contracting.
The provider’s code mix shows a specialized clinical molecular/genetic testing footprint combined with high-volume infectious-disease panels. High-revenue Medicare codes such as 81185, 81249, 81302 and oncology/translocation codes 81191/81192 indicate extensive full-gene sequencing and molecular oncology services, while codes like 87798, 87502 and 87631 point to multiplex infectious and respiratory pathogen testing capability.
Medicare revenue is concentrated: the top 3 Medicare codes by revenue account for 33.7% of this provider's total Medicare revenue, driven primarily by 81185 (12.7% of Medicare revenue, $3.2M revenue), 87798 (11.8%, $2.9M revenue) and 81249 (9.2%, $2.3M revenue). This one-third concentration in three codes highlights dependency on a mix of high-value genetic sequencing and amplified-probe infectious testing.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes by revenue account for 53.8% of this provider's total Medicaid revenue, led by 87798 (28.4% of Medicaid revenue, $2.9K revenue), 81185 (16.4%, $1.6K revenue) and 81321 (9.0%, $910 revenue). Given Medicaid’s tiny absolute dollar volume ($10.5K), these three codes dominate an otherwise minimal state-level footprint.
Nationally for Medicare the provider is a major player on several specialty tests: 81249 is labeled an extreme outlier and ranks #2 of 62 providers nationally (98th percentile), 81185 ranks #2 of 25 providers nationally (96th percentile), and 87502 is a 100th-percentile extreme outlier. Multiple other Medicare codes are described as "notably above typical national volume" (for example 87798 at the 98th percentile and 87631 at the 99th percentile), indicating the provider operates at atypically high volume on several advanced genetic and multiplex infectious assays.
By contrast, the Medicaid competitive standing in-state is modest. The Medicaid instance of 87798 ranks #147 of 243 in Texas (40th percentile) and most Medicaid codes sit in the mid-to-lower percentiles statewide, with the exception of 81185 which ranks #2 of 6 in-state (80th percentile). This pattern shows limited Medicaid market share despite strong national Medicare volumes.
Operational-volume signals reinforce a Medicare-scale laboratory: several Medicare codes show thousands of claims — for example 87798 has 85.9K Medicare claims and 87502 has 3.4K Medicare claims — demonstrating substantial test throughput on Medicare even as Medicaid claim counts remain small (e.g., 87798 has 238 Medicaid claims). These claim volumes align with the provider’s revenue concentration in high-throughput molecular and sequencing assays.
The provider’s NPI was enumerated on 2020-07-14 (~6 years ago), indicating relatively recent market entry yet rapid scaling of Medicare activity. Building a $28.6M Medicare revenue base in roughly six years suggests an aggressive expansion in specialty molecular/genetic testing capacity focused on Medicare-reimbursed services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
67 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 3,810 | $830 | $3.2M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 85,930 | $30 | $2.9M |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 3,900 | $590 | $2.3M |
| 81302 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the methyl CpG binding protein 2, or MECP2 gene. | 3,810 | $520 | $2M |
| 81325 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the peripheral myelin protein 22, or PMP22, gene. | 1,950 | $750 | $1.5M |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 2,040 | $660 | $1.4M |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 2,040 | $660 | $1.4M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 2,040 | $630 | $1.3M |
| 81238 | The lab analyst performs the technical lab test to analyze the full gene sequence of the coagulation factor IX (F9) gene. | 2,040 | $590 | $1.2M |
| 81189 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the cystatin B gene (CSTB). | 3,810 | $270 | $1M |
Showing 1–10 of 67
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 67 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
67 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81185 | 2 | 10 | 110 | $820 | $906.1K |
| 81325 | 2 | 10 | 90 | $750 | $582.2K |
| 81302 | 2 | 10 | 90 | $520 | $479.9K |
| 81317 | 2 | 20 | 220 | $660 | $382.7K |
| 81298 | 2 | 20 | 220 | $630 | $362.7K |
| 81307 | 2 | 20 | 150 | $660 | $361.4K |
| 81249 | 2 | 20 | 80 | $590 | $319.2K |
| 81238 | 2 | 20 | 110 | $590 | $281.7K |
| 81309 | 2 | 10 | 110 | $270 | $278.9K |
| 81189 | 2 | 10 | 110 | $270 | $278.2K |
Showing 1–10 of 67
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
58 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 240 | $10 | $2.9K |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 60 | $30 | $1.6K |
| 81321 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the phosphatase and tensin homolog, or PTEN, gene. | 70 | $10 | $910 |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 240 | $1 | $710 |
| 81189 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the cystatin B gene (CSTB). | 60 | $10 | $550 |
| 81309 | The lab analyst performs the technical lab test to analyze specific gene sequences of the phosphatidylinositol–4, 5–biphosphate 3–kinase, catalytic subunit alpha (PIK3CA) gene. | 60 | $10 | $550 |
| 81286 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the frataxin gene (FXN). | 30 | $10 | $250 |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 240 | $1 | $240 |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 240 | $1 | $240 |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 240 | $1 | $240 |
Showing 1–10 of 58
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
58 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 147 | 240 | 420 | $30 | $296.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 287 | 290 | 410 | $20 | $225K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 294 | 300 | 410 | $20 | $223.4K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 102 | 140 | 180 | $60 | $215.9K |
| 81329 | The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,… | 13 | 20 | 70 | $40 | $178.1K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 254 | 350 | 230 | $70 | $120.3K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 100 | 170 | 440 | $20 | $93.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 594 | 730 | 1,270 | $10 | $84.8K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 243 | 420 | 340 | $20 | $73.4K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 288 | 380 | 130 | $10 | $66.4K |
Showing 1–10 of 58
Other providers in the same ZIP code as American Premier Labs, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Outreach Health Community Care Services LP | TX | Home Health Agency | $0 | $46.7M |
| Viva Medical Group, LLC | TX | Home Health Agency | $0 | $39.1M |
| Vital Home Health Care, Inc | TX | Home Health Agency | $0 | $17.2M |
| The Warren Center, Inc | TX | Multi-Specialty Clinic/Center | $0 | $15.1M |
| Excel Home Health Services, LLC | TX | Home Health Agency | $0 | $13.6M |
| Keystone Healthcare Inc | TX | Home Health Agency | $0 | $12.4M |
| Nicole Lee | TX | Gerontology Nurse Practitioner | $2.5M | $0 |
| Demia Louis | TX | Family Nurse Practitioner | $1.7M | $0 |
| Aspara Wyatt | TX | Family Nurse Practitioner | $1.5M | $0 |
| Rongna Sun | TX | Family Nurse Practitioner | $1.3M | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.