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NPI 1447911409 · Spring, TX · Clinical Medical Laboratory
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Boulder Gx is a clinical medical laboratory provider located in Spring, Texas. This profile covers 24 Medicare and 27 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 | Boulder Gx |
| Address | 25003 Pitkin Rd Ste F300 |
| City | Spring |
| State | TX |
| ZIP | 77386 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 3, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $7.2M |
| Medicaid | $120.5K |
BOULDER GX is registered as a Clinical Medical Laboratory (NPI enumerated 2022-01-03 (~4 years ago)) and its billing is overwhelmingly Medicare-centered: lifetime Medicare revenue is $7.2M versus $120.5K in Medicaid, making Medicare the dominant payer by scale for this entity. This payer imbalance indicates the provider operates primarily in the Medicare market rather than as a balanced dual-payer facility.
Medicare revenue is extremely concentrated: the precomputed top-3 Medicare codes account for 98.8% of the provider’s Medicare revenue, led by K1034 which alone represents 95.4% of Medicare revenue (584.1K claims, $12 avg paid/claim, $7M revenue). K1034 is characterized as an "extreme outlier" nationally (rank #72 of 30143, 100th percentile), indicating BOULDER GX has an unusually large national volume focused on nonprescription, self‑administered COVID-19 test provisioning.
On Medicaid the revenue mix is also concentrated but less extreme: the precomputed top-3 Medicaid codes account for 75.3% of Medicaid revenue, driven by U0003 (45.2% of Medicaid revenue, 892 claims, $61 avg paid/claim, $54.4K), 87637 (15.3%, 171 claims, $108 avg paid/claim, $18.5K), and U0005 (14.8%, 851 claims, $21 avg paid/claim, $17.9K). This shows Medicaid billing is concentrated on high-throughput SARS‑CoV‑2 and multiplex respiratory testing codes rather than the nonprescription self-test code that dominates Medicare.
Competitive standing differs by payer and code: BOULDER GX is a national outlier on K1034 (rank #72 of 30143, extreme outlier), while its other Medicare codes are routine relative to peers (e.g., 87798 ranks #215 of 1319, 84th percentile, described as typical; 81455 ranks #26 of 36, 29th percentile, indicating limited national volume for that genomic panel). In-state Medicaid ranks are middle-of-the-pack for the top Medicaid codes (U0003 rank #132 of 337, 61st percentile; U0005 rank #114 of 257, 56th percentile), so the provider is not a dominant Medicaid lab in Texas.
The CPT/HCPCS mix indicates an operational focus on molecular infectious‑disease testing and mass distribution of COVID-19 self-tests: numerous amplified nucleic acid probe technique codes (87798, 87481, 87641, 87631, etc.) appear across both payers, showing capacity for PCR/molecular workflows for respiratory pathogens and select STI and antimicrobial-resistance testing. The occasional higher‑value genomic code (81455, 27 claims, $2861 avg paid/claim, $77.2K revenue) suggests the lab can bill specialized sequencing panels but at very low volume compared with its COVID testing activity.
Operational model appears payer-dependent: Medicare volume is dominated by very high claim counts at low average payment (K1034: 584.1K claims, $12 avg paid/claim) consistent with large-scale distribution of low‑unit‑price self-tests, whereas Medicaid revenue leans toward fewer, higher‑paid molecular/HT claims (U0003: 892 claims, $61 avg paid/claim; 87637: $108 avg paid/claim). This divergence implies BOULDER GX’s revenue strategy mixes high-volume retail-style test provisioning with contracted high-throughput molecular lab work across payers.
The extreme reliance on a single Medicare code (K1034) and the Medicaid concentration in a small set of COVID/respiratory codes create business risk: with the precomputed top-3 Medicare share at 98.8% and top-3 Medicaid share at 75.3%, the provider’s financial performance would be sensitive to changes in reimbursement, coverage policy, or demand for these specific COVID-related codes. Analysts should treat future revenue projections as contingent on continued coding and payment stability for those code families.
Given its recent enumeration date (2022-01-03 (~4 years ago)) and the massive K1034 volume reported, BOULDER GX appears to have scaled quickly into a niche focused on COVID self-test provisioning and molecular respiratory testing rather than evolving from a long-standing, diversified clinical lab footprint. The combination of a young NPI and highly concentrated code mix suggests a business built around pandemic-era testing demand with limited diversification to date.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 584,130 | $10 | $7M |
| 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… | 5,090 | $30 | $173K |
| 81455 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to… | 30 | $2,860 | $77.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,240 | $30 | $42.2K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 300 | $30 | $10.2K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 290 | $30 | $10K |
| 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,… | 30 | $140 | $3.5K |
| 87150 | The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic… | 90 | $30 | $2.9K |
| 87529 | The lab analyst performs a test for Herpes simplex virus, HSV, using amplified nucleic acid probe technique. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads… | 80 | $30 | $2.8K |
| 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,… | 80 | $30 | $2.8K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87150 | 26 | 30 | 1,260 | $30 | $430.3K |
| 87798 | 58 | 300 | 790 | $30 | $265.1K |
| K1034 | 13 | 2,490 | 450 | $10 | $117.8K |
| 87631 | 67 | 90 | 50 | $140 | $90.1K |
| 87481 | 64 | 270 | 150 | $30 | $68.8K |
| U0003 | 57 | 60 | 100 | $70 | $64.7K |
| 81455 | 2 | 10 | 30 | $2,790 | $64.2K |
| 87529 | 36 | 60 | 90 | $30 | $43.6K |
| 87640 | 211 | 250 | 70 | $30 | $25.9K |
| 87653 | 107 | 230 | 70 | $30 | $24K |
Showing 1–10 of 24
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
27 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 890 | $60 | $54.4K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 170 | $110 | $18.5K |
| 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,… | 850 | $20 | $17.9K |
| 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… | 1,080 | $10 | $11.9K |
| 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,… | 200 | $40 | $7.3K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 360 | $10 | $2.5K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1,970 | $1 | $2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 180 | $10 | $1.3K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 100 | $10 | $620 |
| 87590 | The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique. | 140 | $1 | $570 |
Showing 1–10 of 27
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
27 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 132 | 340 | 400 | $50 | $553.5K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 77 | 120 | 340 | $120 | $422K |
| 87632 | The lab analyst performs a test to identify a respiratory virus using an amplified nucleic acid probe technique. He may also use the multiplex reverse transcription technique. The provider does this… | 14 | 20 | 180 | $170 | $362.6K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 53 | 160 | 200 | $280 | $321.8K |
| 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… | 87 | 240 | 420 | $30 | $296.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 180 | 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,… | 67 | 140 | 180 | $60 | $215.9K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 56 | 90 | 510 | $20 | $160.8K |
| 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,… | 114 | 260 | 640 | $20 | $137.2K |
| 87590 | The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique. | 4 | 10 | 360 | $20 | $123.7K |
Showing 1–10 of 27
Other providers in the same ZIP code as Boulder Gx, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Silver-spring Home Healthcare Services Inc | TX | Home Health Agency | $0 | $34.3M |
| Abbas Jafri | TX | Internal Medicine Physician | $374.8K | $0 |
| John Rush | TX | Emergency Medicine Physician | $252.8K | $0 |
| Crystal Broussard | TX | Family Medicine Physician | $144.4K | $0 |
| Temitope Soares | TX | Dermatology Physician | $125.1K | $0 |
| Jesse Vredenburgh | TX | Family Medicine Physician | $24.9K | $0 |
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