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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Circulogene Theranostics, Inc.
๐Ÿ”ฌ
Organization

Circulogene Theranostics, Inc.

NPI: 1780308262
Pensacola, FL
1 year of data
Clinical Laboratory
$6.3M
Total Payments
9
Beneficiaries
4.9K
Services
2.03x
Markup Ratio

Peer Comparison

85th
percentile in specialty
This provider$6.3M
Specialty median$1.9M

๐Ÿ“‹ Key Findings

1Billed $6.3M over 1 year
22.03x markup ratio (above median)
โœ“ No flags detected

๐Ÿ”Ž Data Analysis

This provider's $6.3M in total Medicare payments ranks in the 85th percentile of Clinical Laboratory providers nationally.

70% of their billing comes from a single procedure code (81455 โ€” Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders).

AI-generated analysis based on Medicare payment data.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2023$2.6K$1.3K2.03x$1.3K$6.3M4.9K9

Top Procedures (9)

81455Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders
$4.4M
1.5K services$2.9K/svc2.02x markup
81194Gene analysis (neurotrophic receptor tyrosine kinase 1, 2, and 3) translocation analysis
$711.1K
1.4K services$507.91/svc2.02x markup
81301Microsatellite instability analysis
$535.6K
1.6K services$341.59/svc2.02x markup
81456Targeted genomic sequence analysis panel of rna of 51 or greater genes associated with blood and lymphatic system disorders
$497.9K
174 services$2.9K/svc2.05x markup
81435Test for detecting genes associated with colon cancer, genomic sequence analysis panel, at least 10 genes
$52.2K
91 services$573.20/svc2.04x markup
81436Test for detecting genes associated with colon cancer, duplication/deletion analysis panel, at least 5 genes
$50.4K
88 services$573.20/svc2.04x markup
81432Test for detecting genes associated with inherited breast cancer-related disorders
$26.6K
40 services$665.47/svc2.04x markup
81351Gene analysis (tumor protein 53) full sequence analysis
$10.7K
17 services$629.01/svc2.04x markup
81163Gene analysis (breast cancer 1 and 2) of full sequence
$6.4K
14 services$458.64/svc2.04x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
81455Targeted genomic sequence analysis panel of dna or combine dna and rna of 51 or greater genes associated with blood and lymphatic system disorders1.5K$4.4M$2.9K2.02x
81194Gene analysis (neurotrophic receptor tyrosine kinase 1, 2, and 3) translocation analysis1.4K$711.1K$507.912.02x
81301Microsatellite instability analysis1.6K$535.6K$341.592.02x
81456Targeted genomic sequence analysis panel of rna of 51 or greater genes associated with blood and lymphatic system disorders174$497.9K$2.9K2.05x
81435Test for detecting genes associated with colon cancer, genomic sequence analysis panel, at least 10 genes91$52.2K$573.202.04x
81436Test for detecting genes associated with colon cancer, duplication/deletion analysis panel, at least 5 genes88$50.4K$573.202.04x
81432Test for detecting genes associated with inherited breast cancer-related disorders40$26.6K$665.472.04x
81351Gene analysis (tumor protein 53) full sequence analysis17$10.7K$629.012.04x
81163Gene analysis (breast cancer 1 and 2) of full sequence14$6.4K$458.642.04x

Markup Analysis

Charge-to-Payment Ratio

2.03x

This provider submits charges 2.03 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. This is higher than the national average.

Location

Pensacola, FL

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Clinical Laboratory providers in FL for peer comparison.

Circulogene Theranostics, Inc. (you)
$6.3M
Quest Diagnostics Clinical Laboratories Incโš ๏ธ
$1.0B
Laboratory Corporation Of Americaโš ๏ธ
$463.1M
Quest Diagnostics Clinical Laboratories Incโš ๏ธ
$417.1M
American Health S, Llc
$175.7M
Ameripath Florida Llc
$80.1M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Quest Diagnostics Clinical Laboratories IncTampa, FL$1.0Bโš ๏ธ Flagged
Laboratory Corporation Of AmericaTampa, FL$463.1Mโš ๏ธ Flagged
Quest Diagnostics Clinical Laboratories IncMiramar, FL$417.1Mโš ๏ธ Flagged
American Health S, LlcDavie, FL$175.7Mโœ“ Clear
Ameripath Florida LlcPompano Beach, FL$80.1Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

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