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NPI 1467433292 · Coppell, TX · Anatomic Pathology & Clinical Pathology Physician
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Inform Diagnostics, Inc. is a anatomic pathology & clinical pathology physician provider located in Coppell, Texas. This profile covers 48 Medicare and 46 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 | Inform Diagnostics, Inc. |
| Address | 1111 S Freeport Pkwy |
| City | Coppell |
| State | TX |
| ZIP | 75019 |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| NPI Enumerated | November 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.9M |
| Medicare | $10.9M |
INFORM DIAGNOSTICS, INC. operates primarily as a high-volume anatomic and clinical pathology lab: its top Medicare revenue code is 88305 ($4.9M revenue) and the same code is the largest driver of Medicaid revenue ($7.7M), indicating the business centers on surgical pathology specimen examination and reporting across both payers. The presence of numerous immunohistochemistry (88341, 88342, 88360, 88361) and molecular/genetic codes (81479, 81206, 81338, 81270) in the top lists shows the operation performs a broad mix of histology, IHC, in situ hybridization and molecular testing rather than only basic histopathology. This mix suggests an integrated laboratory workflow that includes both slide-based diagnostics and higher-value molecular assays.
Revenue concentration is high for both payers: the top 3 Medicare codes account for 59.6% of total Medicare revenue and the top 3 Medicaid codes account for 70.3% of total Medicaid revenue. For Medicare the top code 88305 alone represents $4.9M (45.1% of Medicare revenue), and for Medicaid 88305 represents $7.7M (48.5% of Medicaid revenue), showing a heavy reliance on core surgical pathology services to generate overall throughput and reimbursement. Such concentration implies business sensitivity to volume or pricing shifts in a small set of high-yield services.
The provider has materially different scale across payers but is active in both: lifetime Medicare revenue is $10.9M versus lifetime Medicaid revenue of $15.9M, so Medicaid represents the larger single-payer source on a lifetime basis while Medicare is also a significant contributor. This dual-payer footprint combined with the large absolute Medicaid revenue suggests the lab serves substantial state-level outpatient or hospital-contracted specimen flows in Texas in addition to national Medicare samples.
INFORM DIAGNOSTICS is a dominant outlier on many codes versus peers. Nationally for Medicare, the provider ranks at the 100th percentile or near it on high-volume pathology codes such as 88305 (rank #2 of 14580, described as an "extreme outlier"), 88313, 88341 and several others, indicating volumes far above typical national providers for those services. In-state for Medicaid the provider is routinely rank #1 for major codes including 88305, 88342, 88313, 88312 and 88341 (all 100th percentile, described as "extreme outlier"), which establishes it as a top pathology services hub in Texas for both routine and specialty stain volumes.
Specific high-value molecular and ISH services appear strategically present but at more typical volumes: Medicare code 81479 (unlisted molecular pathology) contributes $738.2K (6.9% of Medicare revenue) and ranks #25 of 80 providers nationally (70th percentile, labelled "typical, unremarkable volume"), while ISH-related codes like 88377 and 88368 show substantial Medicare revenue and high national percentiles. This pattern indicates the lab supplements high-throughput histopathology with targeted molecular and ISH testing but does not appear to be an extreme national outlier in all molecular categories.
Tenure supports an established operation: the provider NPI was enumerated on 2005-11-09 (~21 years ago), indicating long-standing market presence which is consistent with the large cumulative Medicare and Medicaid lifetime revenues reported. Multiple high-percentile rankings across many codes combined with two decades of enumeration suggest an operational scale and referral network developed over time rather than a new entrant spike.
Several procedural categories are consistently flagged as statistically exceptional in volume: Medicare codes such as 88305, 88341, 88312, 88313, 88304, and G0416 are marked as "extreme outlier" or similarly high percentiles, and many of those same codes are top-ranked in-state for Medicaid. This repeated label across surgical pathology and special stain codes points to exceptional throughput in slide-based pathology services, likely driven by centralized processing contracts or large specimen referral volumes.
Flow cytometry and cytogenetic services also contribute meaningfully and at elevated volumes: Medicare shows strong ranks for flow-related codes 88185, 88189 and 88184 (noted as "notably above typical" to "99th percentile"), and Medicaid lists 88185 and 88189 with top in-state ranks. These patterns imply the lab supports hematopathology workflows (immunophenotyping and cytogenetics) in addition to solid-tissue pathology, broadening its service-line relevance to oncology and hematology providers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
48 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 124,730 | $40 | $4.9M |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 12,510 | $70 | $813.3K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 590 | $1,250 | $738.2K |
| 88377 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 2,720 | $270 | $720.3K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 12,540 | $40 | $551.5K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 27,950 | $20 | $475.2K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 8,030 | $60 | $465.4K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 9,160 | $50 | $448.8K |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 1,460 | $240 | $352.1K |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 4,260 | $70 | $293.6K |
Showing 1–10 of 48
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 48 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
48 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 1 | 10 | 590 | $1,250 | $738.1K |
| 81279 | 12 | 20 | 270 | $180 | $86.8K |
| 81206 | 3 | 10 | 150 | $160 | $56.8K |
| 88305 | 1 | 1,120 | 400 | $40 | $51.6K |
| 88264 | 2 | 10 | 40 | $140 | $47.7K |
| 88185 | 2 | 80 | 560 | $20 | $45.7K |
| 88275 | 5 | 10 | 150 | $50 | $44.9K |
| 88377 | 1 | 40 | 50 | $160 | $37.7K |
| 88271 | 5 | 10 | 230 | $20 | $30.2K |
| 0333U | 1 | 10 | 20 | $1,280 | $29.4K |
Showing 1–10 of 48
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.
46 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 191,890 | $40 | $7.7M |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 60,100 | $30 | $2M |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 58,630 | $20 | $1.4M |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 38,750 | $30 | $1.1M |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 3,940 | $240 | $945.8K |
| 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… | 18,130 | $50 | $942.8K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 6,470 | $70 | $446.4K |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 2,610 | $90 | $234.4K |
| 88377 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 1,610 | $140 | $228.6K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 4,870 | $30 | $155.7K |
Showing 1–10 of 46
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
46 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… | 17 | 340 | 400 | $50 | $553.5K |
| 88356 | After a lab analyst prepares slides, the qualified provider, typically a pathologist, performs a morphometric analysis to evaluate size, shape, and other physical features of a nerve. | 2 | 10 | 1,690 | $180 | $304.2K |
| 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,… | 98 | 260 | 640 | $20 | $137.2K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1 | 300 | 400 | $50 | $131.2K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 2 | 10 | 30 | $160 | $114.9K |
| 88314 | The lab analyst performs the technical lab steps to perform a histochemical stain on a frozen tissue block; this code also includes interpretation and a report. You should report this code separately… | 2 | 10 | 1,020 | $80 | $83.7K |
| 88377 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 2 | 10 | 380 | $120 | $80.3K |
| 88307 | The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 93 | 110 | 250 | $60 | $58.5K |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 1 | 10 | 230 | $70 | $48.9K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 1 | 80 | 120 | $40 | $45.3K |
Showing 1–10 of 46
Other providers in the same ZIP code as Inform Diagnostics, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Fifty 50 Medical LLC | TX | Durable Medical Equipment & Medical Supplies | $0 | $54.7M |
| Biodx Labs | TX | Clinical Medical Laboratory | $15.1M | $1.9M |
| Sterling Ems, LLC | TX | Ambulance | $587.6K | $1.3M |
| Pathologists Bio-medical Laboratories PLLC | TX | Clinical Medical Laboratory | $1.1M | $80K |
| Lavanya Boddu | TX | Emergency Medicine Physician | $41.9K | $511.6K |
| Steven Swaldi | TX | Family Medicine Physician | $122.8K | $0 |
| Diana Coxsey | TX | Family Medicine Physician | $79.2K | $0 |
| Priyanka Chaudhry | TX | Neurology Physician | $23.7K | $0 |
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