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

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

Miguel Garcia-caro (NPI 1508859455)

Field	Value
Entity Type	Individual
Organization	Miguel Garcia-caro
Address	146 Yorktown Dr
City	Alexandria
State	LA
ZIP	71303
Taxonomy	Rheumatology Physician
NPI Enumerated	August 25, 2005

Payer Source	Total Paid
Medicare	$1.1M
Medicaid	$0

Key Findings

This is a rheumatology physician in ALEXANDRIA, LA with a Medicare lifetime revenue of $1.1M and no Medicaid billing on file, making the provider effectively single‑payer (Medicare) in the available claims data. The provider’s NPI was enumerated 2005-08-25 (~21 years ago), indicating long tenure and an established billing history in the Medicare program.

Revenue is highly concentrated in a few infused biologic drugs and related office visits: the precomputed top 3 Medicare codes account for 88.2% of total Medicare revenue, led by J1602 at $458K (41.9% of Medicare revenue) and J0129 at $409.7K (37.5% of Medicare revenue), with 99213 contributing $96K (8.8%). This concentration implies dependence on a small set of high-revenue codes rather than a broad mix of low‑value services.

The code mix and high-paid drug lines point to an infusion/biologic service line: dominant codes J1602 (golimumab) and J0129 (abatacept) are injectable biologics and are complemented by infusion/administration codes such as 96413, 96401, 96415 and 96365. Together these codes suggest the practice operates an infusion-focused rheumatology workflow (administration of parenteral biologic therapies) rather than primarily office‑based procedures.

Competitive standing for the top biologic is strong: J1602 ranks #55 of 1041 providers nationally (95th percentile) and is labeled notably above typical national volume, indicating this provider is a high‑volume national participant for golimumab infusions. J0129 is more modestly placed at rank #367 of 1221 (70th percentile), representing a typical-to-above-average volume for abatacept in the national peer set.

Several administration and infusion codes are also elevated versus peers: 96413 is ranked #292 of 7514 providers (96th percentile) and described as notably above typical national volume, reinforcing that the provider delivers substantial infusion services rather than occasional injections. By contrast, numerous ancillary codes (e.g., J0897, 99214, 20610) are ranked in mid-percentiles and show typical, unremarkable volumes, indicating the practice’s activity is concentrated on biologic infusions rather than a wide array of procedural services.

The practice’s payer mix is effectively Medicare-only in the available data—Medicaid shows none below and no Medicaid revenue is on file—so any analysis of access to Medicaid populations or state Medicaid contracting would be limited by the absence of claims. This Medicare dependence creates operational sensitivity to changes in Part B drug reimbursement and infusion administration policy for biologics.

The presence of 99213 as a high-volume evaluation-and-management code (1.6K claims, $96K revenue; rank #1850 of 457151 providers nationally, 100th percentile, labeled an extreme outlier) indicates a heavy volume of routine established-patient visits in addition to infusion services. That combination (high E/M volume plus high biologic infusion volume) suggests the practice manages ongoing, longitudinal rheumatology care for a sizable Medicare panel, not just episodic infusions.

Given that the top two drug codes (J1602 and J0129) together represent the largest shares of Medicare revenue and the top three codes account for 88.2% of Medicare revenue, the provider’s financial profile is concentrated and biologic-centric; payers and network planners should be aware that shifts in coverage, reimbursement, or drug utilization could disproportionately affect this provider’s revenue stream.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1602	Injection, golimumab, 1 mg, for intravenous use	45,800	$10	$458K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	12,050	$30	$409.7K
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…	1,570	$60	$96K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	680	$90	$61.4K
J0897	Injection, denosumab, 1 mg	2,280	$20	$41K
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…	110	$90	$9.2K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	110	$50	$5.6K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	90	$50	$4.2K
99203	The provider sees a new 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 provider…	40	$70	$2.9K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	90	$20	$1.8K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Louisiana Distribution

Miguel Garcia-caro — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1602	3	10	26,920	$10	$526.5K
J0129	6	10	9,490	$30	$506.1K
J0897	46	70	3,120	$20	$105.6K
96413	5	70	140	$90	$22.8K
99214	3,343	6,670	110	$80	$16.5K
96401	25	50	130	$50	$12.9K
99213	17	6,060	70	$50	$8.1K
96365	62	80	60	$40	$6.4K
20610	208	590	60	$50	$4.7K
99203	691	2,100	30	$70	$3K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clhg-avoyelles, LLC	LA	General Acute Care Hospital	$0	$4.6M
Manish Dhawan	LA	Hematology & Oncology Physician	$870.9K	$24.3K
Ryan Tompkins	FL	Diagnostic Radiology Physician	$496.4K	$0
David Allie	LA	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$343.3K	$4.1K
Caleb Rivera	FL	Diagnostic Radiology Physician	$315.7K	$0
Ralph Abraham	LA	Diagnostic Radiology Physician	$304.6K	$0
Rolando Prieto	FL	Vascular & Interventional Radiology Physician	$235.3K	$0
Michael Rolen	VA	Diagnostic Radiology Physician	$141.3K	$80K
Brent Rochon	LA	Cardiovascular Disease Physician	$215.4K	$0
Sameh Sakla	FL	Diagnostic Radiology Physician	$204.2K	$110

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fairway Counseling Agency, Inc.	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38.1M
Afnb Home Care LLC	LA	In Home Supportive Care Agency	$0	$14.7M
Guardian Angels Care Services Inc	LA	Personal Care Attendant	$0	$13M
Kid's Dental Zone Alexandria LLC	LA	Pediatric Dentistry	$0	$8.4M
Prescribed Pediatric Extended Care, Inc	LA	Medically Fragile Infants and Children Day Care	$0	$8.1M
Baymark Health Services Of Louisiana, Inc.	LA	Substance Use Disorder Rehabilitation Clinic/Center	$166.6K	$6.8M
Red River Associates LLC	LA	Specialist	$0	$6.9M
Crossroads Regional Hospital, LLC	LA	Psychiatric Hospital	$0	$5.8M
Alexandria Eye And Laser Center, LLC	LA	Ophthalmology Physician	$0	$5.3M
We Care Behavioral Health, LLC	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.6M

Miguel Garcia-caro — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References