Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Massachusetts (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Michael Garcia (NPI 1013397488)

Field	Value
Entity Type	Individual
Organization	Michael Garcia
Address	800 Washington St
City	Boston
State	MA
ZIP	02111
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	June 1, 2015

Payer Source	Total Paid
Medicare	$95K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	430	$170	$74K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	160	$100	$16.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$150	$1.6K
31500	The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway.	10	$120	$1.4K
36556	The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.	20	$70	$1.1K
36620	In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood…	20	$40	$630

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Michael Garcia — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	8	2,150	50	$170	$12.8K
99233	1,065	4,170	70	$100	$12.6K
99223	4,267	4,430	30	$140	$7.6K
31500	27	50	10	$110	$1.7K
36556	68	190	20	$70	$1.1K
36620	233	410	20	$40	$890

Related Providers

Other providers that share a Tax Identification Number (TIN) with Michael Garcia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District 1 Of King County	WA	General Acute Care Hospital	$0	$120.6M
Valley Medical Group-renton	WA	General Acute Care Hospital	$0	$28.3M
Reza Masoomi	WA	Interventional Cardiology Physician	$319.1K	$0
Omar Dorzi	WA	Vascular Surgery Physician	$264.4K	$0
Andrew Brockenbrough	WA	Nephrology Physician	$186.3K	$0
Amitoj Marwaha	WA	Cardiovascular Disease Physician	$169.9K	$0
Rajib Choudhury	WA	Cardiovascular Disease Physician	$160.9K	$0
George Dolack	WA	Clinical Cardiac Electrophysiology Physician	$140.5K	$0
Hamilton Gillespie	WA	Clinical Cardiac Electrophysiology Physician	$129.6K	$0
Sumeet Subherwal	VA	Cardiovascular Disease Physician	$127.1K	$0

Nearby Providers

Other providers in the same ZIP code as Michael Garcia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tufts Medical Center, Inc.	MA	General Acute Care Hospital	$0	$164.6M
Boston Senior Home Care	MA	Case Management Agency	$0	$118.8M
Boston Senior Home Care	MA	Case Management Agency	$0	$38.9M
South Cove Community Health Center, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$20.5M
Trustees Of Tufts College	MA	Dental Clinic/Center	$0	$18.2M
Pratt Pediatric Associates Inc	MA	Pediatrics Physician	$0	$7.7M
Boston Center For Independent Living, Inc.	MA	Personal Care Attendant	$0	$7.2M
Tufts Medical Center Ep LLC	MA	Emergency Medicine Physician	$0	$6.6M
Minping Liu	MA	Internal Medicine Physician	$14.7K	$6.6M
Andre Witkin	MA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0

Michael Garcia — Billing Profile & Reimbursement Data

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Michael Garcia — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References