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    v1.0.28
    OpenPayerNPI Medicare & MedicaidCarlos Garcia
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    Carlos Garcia — Billing Profile & Reimbursement Data

    NPI 1205928793 · Chicago, IL · Anatomic Pathology & Clinical Pathology Physician

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    Carlos Garcia is a anatomic pathology & clinical pathology physician provider located in Chicago, Illinois. This profile covers 0 Medicare and 194 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationCarlos Garcia
    Address2525 S Michigan Avenue
    CityChicago
    StateIL
    ZIP60616
    TaxonomyAnatomic Pathology & Clinical Pathology Physician
    NPI EnumeratedSeptember 29, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$3.6M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    194 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    87633The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…4,060$170$686.6K
    87389The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…6,290$50$333.3K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.9,740$20$214.4K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.9,510$20$209.3K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.7,690$20$176.8K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.34,780$10$173.9K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…40,220$1$120.7K
    80048The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…25,570$1$102.3K
    83735The lab analyst performs a test to measure the amount of magnesium in a patient specimen.23,130$1$92.5K
    87798The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…4,060$20$89.4K

    Showing 1–10 of 194

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Illinois median

    194 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.432801,120$30$218.9K
    87633The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…10170150$200$190.9K
    87389The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…22250450$40$185.7K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.28360600$30$165.1K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.28360630$30$165K
    80050The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…11110200$40$111.1K
    87536A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load.1450290$50$94.7K
    81220The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…253090$140$92.9K
    86480The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.33120140$40$89.7K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.70740960$10$75.9K

    Showing 1–10 of 194

    • More pages

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ven AduanaILAnatomic Pathology & Clinical Pathology Physician$125.7K$5.9M
    Peter BernhardtILHematology (Pathology) Physician$40.4K$2.2M
    Natasha PelloILAnatomic Pathology & Clinical Pathology Physician$50.3K$1.2M
    Maria McintireILAnatomic Pathology & Clinical Pathology Physician$625.2K$152.6K
    April PlattILAnatomic Pathology & Clinical Pathology Physician$87K$239.8K
    Keith KaplanNCAnatomic Pathology & Clinical Pathology Physician$74.6K$65.2K
    Marlyn CieslaILCytopathology Physician$84.6K$52.2K
    Archana BargajeILAnatomic Pathology & Clinical Pathology Physician$58.5K$40.2K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shirley WongILInternal Medicine Physician$234.5K$2M
    Family Guidance Centers, Inc.ILMethadone Clinic$123.8K$2.1M
    Pravin MuniyappaILAllergy & Immunology Physician$29.7K$1.3M
    Rinku ShahILFamily Medicine Physician$43.9K$873.2K
    Michelle ZengILInternal Medicine Physician$248K$139.2K
    Charles PerrottILSurgery Physician$369.9K$0
    Julie RothschildILEmergency Medicine Physician$241.4K$51.5K
    Heidi BrookenthalILFamily Medicine Physician$42.8K$201.7K
    Najma PapaILInternal Medicine Physician$221.4K$10.4K
    Charles LiederILOrthopaedic Surgery Physician$171.5K$10.3K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Illinois Providers
    3 of 4 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Illinois Distribution
    Carlos Garcia — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Illinois