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NPI 1659002467 · Plano, TX · Clinical Medical Laboratory
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Lone Star Medlab Laboratory LLC is a clinical medical laboratory provider located in Plano, Texas. This profile covers 1 Medicare and 1 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 | Lone Star Medlab Laboratory LLC |
| Address | 2120 W Spring Creek Pkwy Ste A-2 |
| City | Plano |
| State | TX |
| ZIP | 75023 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 22, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $27.2M |
| Medicaid | $3.2K |
LONE STAR MEDLAB LABORATORY LLC is registered as a Clinical Medical Laboratory and has been enumerated with an NPI since 2022-06-22 (~4 years ago), indicating a relatively recent entry to billing Medicare and Medicaid programs. The provider’s public profile and activity window should be interpreted in the context of pandemic-era service opportunities that emerged around its enumeration date.
Medicare dominates this provider’s payer mix by scale: total Medicare revenue is reported as $27.2M while total Medicaid revenue is $3.2K, making Medicaid effectively immaterial to the provider’s revenue base. Analysts should treat this entity as a Medicare-focused biller for strategic or competitive comparisons rather than a balanced dual-payer operator.
Revenue is extremely concentrated by code for both payers: the precomputed metric shows the top three Medicare codes account for 100.0% of this provider’s total Medicare revenue, and the top three Medicaid codes account for 100.0% of this provider’s total Medicaid revenue. This concentration indicates the business is operating around a very narrow set of billable services rather than a diversified testing portfolio.
At the code level, K1034 is the primary revenue driver on Medicare: it is reported with 2.3M claims, $12 avg paid/claim, and $27.7M revenue and is noted as representing 100.0% of the provider’s Medicare revenue in the code table. K1034’s national rank is #10 of 30143 providers (100th percentile; extreme outlier), which signals an unusually high national volume for provision of nonprescription self-administered COVID-19 tests.
On the Medicaid side, K1034 likewise accounts for 100.0% of this provider’s Medicaid revenue and is reported with 4.2K claims, $1 avg paid/claim, and $4.2K revenue. In-state the provider ranks #4 of 77 for K1034 (96th percentile; notably above typical state volume), showing it is a leading Medicaid supplier of this specific test in Texas even though the absolute Medicaid dollar volume remains very small.
The aggregated code mix—dominated by K1034, which is the provision of nonprescription self-administered and self-collected COVID-19 tests—suggests the organization operates principally as a high-throughput distribution or fulfillment source for OTC COVID tests rather than a broad-spectrum clinical diagnostic laboratory. The combination of very large claim volumes and low per-claim payments is consistent with a high-volume, low-margin service model focused on single-product distribution.
Competitive standing is bifurcated by payer: nationally the provider is a dominant outlier for K1034 on Medicare (top-10 rank and 100th percentile, labeled extreme outlier), while on Medicaid it is a strong state-level performer (rank #4 of 77, 96th percentile, notably above typical). These standings imply the provider occupies a meaningful niche in the COVID-19 test supply chain at scale for Medicare and a prominent but much smaller-dollar role for Medicaid.
Because essentially all reported revenue is tied to a single code family (K1034) and because per-claim reimbursement differs materially between payers ($12 avg paid/claim on Medicare vs $1 avg paid/claim on Medicaid), the provider’s financial performance is highly sensitive to changes in demand for nonprescription COVID-19 tests and to any shifts in reimbursement policy for that specific code. Analysts should consider this concentration when assessing sustainability, payer negotiation leverage, and exposure to policy changes affecting K1034 billing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 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 | 2,312,390 | $10 | $27.7M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 3 | 2,490 | 450 | $10 | $117.8K |
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.
1 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 | 4,160 | $1 | $4.2K |
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
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 4 | 80 | 340 | $1 | $1.5K |
Other providers in the same ZIP code as Lone Star Medlab Laboratory LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Tami Roberts | TX | Family Medicine Physician | $1.1M | $0 |
| Randall Hays | TX | Family Medicine Physician | $843.6K | $0 |
| Iolante Santos | TX | Gerontology Nurse Practitioner | $216K | $0 |
| Louis Torres | TX | Internal Medicine Physician | $95K | $0 |
| Stephanie Calabrese | TX | Physical Therapist | $94.2K | $0 |
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