Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Texas (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Nstx, Inc (NPI 1235528225)

Nstx, Inc is a clinical medical laboratory provider located in Austin, Texas. This profile covers 0 Medicare and 21 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Nstx, Inc
Address	13011 Mccallen Pass Ste 100
City	Austin
State	TX
ZIP	78753
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	January 14, 2015

Payer Source	Total Paid
Medicaid	$58.2M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	102,760	$280	$28.6M
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	41,290	$270	$11.2M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	46,380	$170	$7.7M
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,…	51,780	$30	$1.7M
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	9,470	$170	$1.6M
81161	The lab analyst performs the technical lab test to analyze specific changes involving deleted, or possibly repeated, nucleotide sequences in the dystrophin gene, also known as the DMD gene.	41,400	$40	$1.5M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	4,490	$310	$1.4M
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	31,910	$30	$893.6K
81401	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 2 molecular pathology code.	30,680	$20	$644.3K
81405	The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code.	30,280	$20	$635.8K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.

Claims Volume vs. Texas Distribution

Nstx, Inc — 17 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	1	20	950	$300	$3.2M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	1	20	180	$200	$923K
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	1	10	1,040	$280	$552.5K
81408	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code.	1	40	100	$230	$335.3K
81422	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell–free fetal DNA in maternal blood for chromosomal microdeletion(s) associated with conditions such as DiGeorge…	1	10	130	$140	$230.8K
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,…	1	20	70	$40	$178.1K
81161	The lab analyst performs the technical lab test to analyze specific changes involving deleted, or possibly repeated, nucleotide sequences in the dystrophin gene, also known as the DMD gene.	1	10	90	$40	$177.9K
81361	The lab analyst performs the technical lab test to detect the presence of specific changes in the hemoglobin, subunit beta (HBB) gene specifically for common variants, such as HbS, HbC, HbE.	1	10	960	$30	$154.6K
81257	The lab analyst performs the technical lab test to detect the presence of specific changes and possible deleted nucleotides in the alpha globin 1 and alpha globin 2 genes, also known as HBA1/HBA2,…	1	10	930	$20	$72.9K
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	1	20	230	$10	$53.9K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Quest Diagnostics Incorporated	NJ	Clinical Medical Laboratory	$111.2M	$637.7M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Texas Community Health Centers	TX	Federally Qualified Health Center (FQHC)	$0	$23.6M
Neeraj Shah	TX	Internal Medicine Physician	$2M	$0
Robert Izor	TX	Neurology Physician	$483.7K	$0
Maintenance And Recovery Services, Inc.	TX	Methadone Clinic	$72.7K	$303K
Keith Lamy	TX	Family Medicine Physician	$89.2K	$0
Kirby Reed	TX	Family Nurse Practitioner	$32.5K	$0

Nstx, Inc — Billing Profile & Reimbursement Data

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Nstx, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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