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 Nevada for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nevada 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. Nevada (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.

Claudia Garcia (NPI 1457450017)

Claudia Garcia is a pediatrics physician provider located in Henderson, Nevada. This profile covers 0 Medicare and 54 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Claudia Garcia
Address	6301 Mountain Vista St Ste 205
City	Henderson
State	NV
ZIP	89014
Taxonomy	Pediatrics Physician
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	7,200	$80	$590.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	6,740	$60	$397.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,550	$90	$330.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,200	$90	$278.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	6,820	$40	$265.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,180	$90	$195.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,090	$90	$102.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	3,070	$30	$98.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	630	$40	$22.7K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	2,010	$10	$22.1K

Showing 1–10 of 54

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Claudia Garcia — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	147	2,250	290	$60	$138K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	177	2,480	330	$50	$107.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	30	300	280	$80	$103.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	27	300	240	$80	$97.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	33	310	410	$40	$95K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	8	10	300	$20	$76.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	34	270	170	$80	$70.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	39	220	130	$80	$57K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	26	40	430	$30	$32.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	116	540	130	$30	$28K

Showing 1–10 of 54

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Qureshi Al-owir PLLC	NV	Critical Care Medicine (Internal Medicine) Physician	$0	$7.4M
Jagannath S. Surpure, M.d.p.c.	NV	Pediatrics Physician	$0	$2.6M
Maryam Sina Dds Ltd	NV	Pediatric Dentistry	$0	$2.6M
Valley Springs Dialysis LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.4M
Henderson Pediatric Dentistry PC	NV	Pediatric Dentistry	$0	$2.3M
Isd Las Vegas LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.2M
Tran Tounian Hoang I, Dds, PLLC	NV	General Practice Dentistry	$0	$1.9M
Reliable Care Registry Corp	NV	Health Maintenance Organization	$0	$1.7M
Gyhe LLC	NV	Community/Behavioral Health Agency	$0	$1.6M
Harout Gostanian	NV	Pediatric Dentistry	$0	$1.5M

Claudia Garcia — Billing Profile & Reimbursement Data

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Claudia Garcia — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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