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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Carlos Garcia (NPI 1912984667)

Field	Value
Entity Type	Individual
Organization	Carlos Garcia
Address	525 Ave Fd Roosevelt
City	San Juan
State	PR
ZIP	00918
Taxonomy	Nuclear Medicine Physician
NPI Enumerated	December 23, 2005

Payer Source	Total Paid
Medicare	$248K
Medicaid	$0

Key Findings

This provider is effectively single‑payer at the dataset level: Total Medicare revenue: $248K and there is no Medicaid billing on file. The absence of any Medicaid claims means analyses of payer mix should treat this entity as Medicare‑focused and not rely on Medicaid activity for cross‑payer comparisons or state‑level Medicaid benchmarking.

Revenue for this provider is highly concentrated in a small set of nuclear medicine services: the precomputed top 3 Medicare codes by revenue account for 71.6% of this provider's total Medicare revenue. The three revenue leaders are A9502 ($92.2K, 37.3%), 78452 ($54K, 21.8%), and A9584 ($30.9K, 12.5%), which together drive the majority of billed Medicare dollars and therefore define the core commercial footprint.

The code mix indicates a clinical focus on nuclear cardiology and radiopharmaceutical supply/dispensing: A9502 (Technetium tc-99m tetrofosmin), 78452 (multi‑SPECT cardiac studies), and frequent use of J2785 (regadenoson) and 93015 (stress test interpretation) point to a workflow centered on myocardial perfusion imaging and pharmacologic stress testing. A9584 (Iodine 1‑123 ioflupane) and A9521 (Technetium exametazime) show additional nuclear diagnostic activity such as neurologic and cerebral perfusion imaging, suggesting the operation handles both cardiac and non‑cardiac nuclear scans as part of its services.

Competitive standing across top Medicare codes is modest and mixed by code. For the largest revenue driver, A9502, the provider "ranks #428 of 2724 providers nationally (84th percentile; typical, unremarkable volume for this code)", indicating it is within the typical national distribution rather than a dominant outlier; for 78452 it "ranks #1892 of 14946 providers nationally (87th percentile; typical, unremarkable volume for this code)", again suggesting routine national activity levels; A9584 is listed with the label "typical, unremarkable volume for this code" but appears in a small peer set ("ranks #122 of 149 providers nationally (15th percentile)"), so its presence in that niche test is notable but not volumetrically large.

There are a few statistical or operational flags in the claim-level mix that merit attention: J0153 is reported as 2K claims with $0 avg paid/claim and $0 revenue, and J7050 is reported as 197 claims with $0 avg paid/claim and $0 revenue. These high‑count, $0‑paid items could reflect pass‑through reporting, bundled payments, or billing artifacts for infusion supplies and adenosine administration rather than direct revenue drivers, and they should be reviewed when reconciling utilization versus paid‑dollar analyses.

One item appears unique in national reporting: A9521 (Technetium tc-99m exametazime) shows 19 claims, $26K revenue and is recorded as "ranks #1 of 1 providers nationally (0th percentile; no national peer volume comparison available)", indicating no comparable peer volume in the national dataset. This suggests either an uncommon radiopharmaceutical usage pattern or a reporting idiosyncrasy that could affect peer benchmarking for that specific reagent.

The provider has long tenure in the NPI file, which supports stability of the billing record: NPI enumerated (registered): 2005-12-23 (~21 years ago). Given the multi‑year presence and concentration in a defined set of nuclear imaging services, analysts can reasonably treat current patterns as established operational practice rather than brief or transient activity.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9502	Technetium tc-99m tetrofosmin, diagnostic, per study dose	250	$360	$92.2K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	160	$330	$54K
A9584	Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries	10	$2,210	$30.9K
A9521	Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries	20	$1,370	$26K
78803	The provider uses a nuclear imaging test called SPECT to localize a tumor, inflammatory process, or radioactive tracer distribution. Vascular flow and blood pool imaging are included if performed.…	40	$270	$10.2K
J2785	Injection, regadenoson, 0.1 mg	240	$40	$9.4K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	140	$50	$7K
A9500	Technetium tc-99m sestamibi, diagnostic, per study dose	70	$90	$6.6K
78315	The provider performs a three–phase bone scan (also known as scintigraphy), a specialized nuclear medicine procedure in which the provider injects a radionuclide prior to imaging to examine the…	20	$260	$5.4K
78306	The provider performs a bone scan (also known as scintigraphy), a specialized nuclear medicine procedure in which the provider injects a radionuclide prior to imaging to examine the various bones of…	20	$200	$3.3K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Carlos Garcia — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9502	1	10	250	$360	$92.2K
A9584	1	10	10	$2,210	$30.9K
A9521	1	10	20	$1,370	$26K
78803	3	10	40	$270	$11.4K
78452	1	20	60	$210	$10.1K
A9500	6	10	80	$90	$7.6K
J2785	1	10	150	$40	$6.2K
78315	2	10	20	$230	$3.9K
78306	4	10	20	$160	$3.6K
93015	1	20	20	$50	$1.5K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sandra Gracia-lopez	PR	Nuclear Medicine Physician	$26.7K	$4.1M
Hector Velez Cortes	PR	Hematology & Oncology Physician	$4.3K	$4M
Hiram Ortega	PR	Gastroenterology Physician	$8.8K	$3.1M
Nelson Medina	PR	Gastroenterology Physician	$1.5K	$2.7M
Eduardo Perez Rodriguez	PR	Ophthalmology Physician	$21.7K	$2.3M
Santa Merle	PR	Hematology & Oncology Physician	$4.5K	$2M
Amarilys Santiago Rolon	PR	Gastroenterology Physician	$510	$1.6M
Harry Alverio Rodriguez	PR	Physical Medicine & Rehabilitation Physician	$3.7K	$1.5M
Adalberto Mendoza	PR	Anatomic Pathology & Clinical Pathology Physician	$13.3K	$1.5M
Luz Butler Moya	PR	Physical Therapist	$0	$1.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio De Patologia Dr Noy	PR	Anatomic Pathology Physician	$0	$45.7M
Hato Rey Pathology Associates Inc	PR	Clinical Medical Laboratory	$58.5K	$42M
Home Orthopedics Corp	PR	Prosthetic/Orthotic Supplier	$0	$20.7M
Orthobone, Inc	PR	Customized Equipment (DME)	$0	$15.5M
Smith & Nephew Inc.	PR	Prosthetic/Orthotic Supplier	$0	$12M
Laboratorio Clinico Noy Inc	PR	Clinical Medical Laboratory	$76.1K	$9.9M
Servicios Radiologicos Asociados Jorge Perez Brais	PR	Diagnostic Radiology Physician	$0	$2.9M
Luis Torres Vera	PR	Allergy Physician	$21.5K	$2.7M
Inspira Psychiatric Services Psc	PR	Adult Mental Health Clinic/Center	$0	$2.5M
Frankie Alvarado	PR	Pulmonary Disease Physician	$7.3K	$2.4M

Carlos Garcia — Billing Profile & Reimbursement Data

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Carlos Garcia — 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