Lab
Forma Medical Group LLC
Forma Medical Group LLC was paid $5K by Medicaid between Aug 2023 and Oct 2024, across 34 billing codes. Its largest line is 87635, Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe — 20% of everything it billed.
33Billing provider infoFORMA MEDICAL GROUP LLC
LEWISVILLE, TX 75067
LEWISVILLE, TX 75067
33aNPI1073227179assigned 01/12/2023
33bProvider typeClinical Medical Laboratory
28Total paid$5K
24GClaims4,487
24DCodes billed34
24AFirst – last monthAug 2023 – Oct 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in Texas
Rank by total paid#259 of 436
Median peer was paid$17K
This provider vs. median0.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2023 | 593 | $368.21 | |
| 2024incomplete | 3,894 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 20% | 168 | 165 | $1K |
| 87631 | 16% | 153 | 149 | $838.67 | |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 15% | 445 | 318 | $795.87 |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 5.7% | 406 | 318 | $294.80 |
| 87640 | 5.1% | 406 | 318 | $265.32 | |
| 87500 | 5.1% | 403 | 315 | $265.32 | |
| 87641 | 5.1% | 403 | 315 | $265.32 | |
| 87653 | 5.1% | 399 | 317 | $265.32 | |
| 87481 | 5.1% | 145 | 139 | $265.28 | |
| 87541 | 4.0% | 153 | 149 | $206.36 | |
| 87498 | 4.0% | 153 | 149 | $206.36 | |
| 87581 | 4.0% | 153 | 149 | $206.36 |
22 more codes
| 87486 | 4.0% | 153 | $206.36 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 40 | $49.59 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 118 | $32.65 |
| 83550 | 0% | 53 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 18 | $0.00 |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 15 | $0.00 |
| 82607 | 0% | 43 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 85 | $0.00 |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 0% | 18 | $0.00 |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | 0% | 57 | $0.00 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 47 | $0.00 |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 51 | $0.00 |
| 80053 | Comprehensive metabolic panel | 0% | 65 | $0.00 |
| 81003 | 0% | 18 | $0.00 | |
| 87150 | 0% | 57 | $0.00 | |
| 83540 | 0% | 54 | $0.00 | |
| 84550 | 0% | 14 | $0.00 | |
| G0482 | 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | 0% | 40 | $0.00 |
| 80061 | Lipid panel | 0% | 87 | $0.00 |
| 84439 | 0% | 22 | $0.00 | |
| 84481 | 0% | 22 | $0.00 | |
| 81002 | 0% | 23 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialTILAK, ANUP (OWNER)