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NPI 1508416058 · Sugar Land, TX · Clinical Medical Laboratory
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Topblood LLC is a clinical medical laboratory provider located in Sugar Land, Texas. This profile covers 8 Medicare and 2 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 | Topblood LLC |
| Address | 7830 Highway 90a |
| City | Sugar Land |
| State | TX |
| ZIP | 77478 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 17, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.7M |
| Medicaid | $630 |
TOPBLOOD LLC presents as a specialized clinical molecular laboratory driven by high-complexity sequencing work: its three top Medicare revenue codes are 87913 ($2M, 43.7%), 81185 ($1.4M, 29.3%), and 81223 ($1.2M, 26.5%), and those three codes together account for 99.5% of the provider's total Medicare revenue. The dominance of these NGS and full-gene sequencing codes indicates the operation is focused on technical, molecular diagnostic services rather than broad routine lab testing.
Revenue is heavily Medicare-weighted: lifetime Medicare revenue totals $4.7M versus just $628 in Medicaid receipts, making this provider effectively Medicare-dominant in scale. The precomputed concentration measures reinforce that risk profile: the top three Medicare codes contribute 99.5% of Medicare revenue, and Medicaid’s top codes account for 100% of Medicaid revenue.
Competitive standing is mixed by code: 81223 (CFTR full-gene sequencing) ranks #4 of 68 providers nationally and is described as "notably above typical" (96th percentile), indicating a strong national position for CFTR testing. By contrast, 81185 (CACNA1A full-gene sequencing) ranks #4 of 25 (88th percentile) and 87913 (SARS–CoV–2 genotype NGS) ranks #6 of 11 (50th percentile), reflecting a high standing on some specialized genetic tests but only typical/mid-level volume for viral genotype sequencing.
Medicaid activity is minimal and concentrated: total Medicaid revenue is $628, and 87428 (immunoassay antigen testing) accounts for 100% of reported Medicaid revenue with 68 claims at a $9 avg paid/claim and a rank of #458 of 587 in-state. This pattern indicates negligible Medicaid market penetration and that any state-facing volume is confined to low-paying antigen/assay work rather than the lab’s higher-revenue sequencing services.
The provider shows little service-line diversification beyond its sequencing portfolio: outside the top three Medicare codes, revenue contributions are very small (examples include G0480 at $2.5K and 80307 at $1.3K), and those low-dollar codes have low national rank/percentile positions (G0480 at #1367 of 1590, 14th percentile; 80307 at #4335 of 4760, 8th percentile). This underscores operational dependence on a narrow set of high-value molecular codes and limited ancillary testing revenue.
Operational implications from the code mix point to a lab model that monetizes technical sequencing components rather than high-volume immunoassays: the top Medicare codes (81185, 81223) are full-gene sequencing technical codes and 87913 is an NGS viral genotype code, while typical immunoassay codes (87428) appear only as low-revenue outliers in Medicaid and low-volume items in Medicare. Contracting or network discussions should therefore treat TOPBLOOD as a specialized sequencing partner rather than a broad-spectrum clinical lab.
Tenure is relatively recent but shows rapid scaling in a narrow niche: the NPI was enumerated on 2019-09-17 (~7 years ago), and the provider has accumulated $4.7M in Medicare revenue concentrated in sequencing codes within that timeframe. That timeline suggests focused growth in molecular diagnostics rather than long-established, diversified clinical lab operations.
From a payer risk and vendor-management perspective, the concentration (99.5% of Medicare revenue from three codes) creates single-service-line exposure: changes in coverage, reimbursement, or clinical guidelines for those specific sequencing codes would materially affect revenue. Analyses of utilization trends for 81223, 81185, and 87913 should be prioritized because shifts in those codes will drive most of the provider’s financial and operational variability.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87913 | Code 87913 describes genotype analysis using a specimen from a patient with confirmed severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) infection. The test uses next–generation sequencing… | 8,090 | $250 | $2M |
| 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. | 1,650 | $830 | $1.4M |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 2,530 | $490 | $1.2M |
| 81325 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the peripheral myelin protein 22, or PMP22, gene. | 20 | $750 | $11.3K |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 10 | $590 | $8.2K |
| 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… | 20 | $110 | $2.5K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 20 | $60 | $1.3K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 10 | $30 | $390 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 70 | $10 | $610 |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 10 | $0 | $0 |
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
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 1,337 | 1,350 | 320 | $30 | $101.2K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 458 | 590 | 380 | $50 | $78.1K |
Other providers in the same ZIP code as Topblood LLC, ranked by combined Medicare and Medicaid revenue.
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