Physician
Garcia, Marlene
Garcia, Marlene was paid $980K by Medicaid between Sep 2022 and Jun 2024, across 52 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 32% of everything it billed.
33Billing provider infoGARCIA, MARLENE
DONNA, TX 78537
DONNA, TX 78537
33aNPI1356797021assigned 05/11/2016
33bProvider typePediatrics Physician
28Total paid$980K
24GClaims35,519
24DCodes billed52
24AFirst – last monthSep 2022 – Jun 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#371 of 1,136
Median peer was paid$329K
This provider vs. median3.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 4,922 | $118K | |
| 2023 | 21,560 | $608K | |
| 2024incomplete | 9,037 | $254K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 8,367 | 6,711 | $314K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 8.2% | 2,069 | 1,896 | $80K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 7.8% | 988 | 944 | $76K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 6.1% | 4,424 | 2,071 | $60K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.1% | 738 | 721 | $60K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 5.7% | 440 | 406 | $56K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 5.4% | 3,924 | 3,609 | $53K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 5.0% | 563 | 558 | $49K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.9% | 617 | 610 | $48K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 4.3% | 879 | 840 | $42K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.3% | 419 | 408 | $32K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.9% | 3,152 | 1,384 | $29K |
40 more codes
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.0% | 810 | $20K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.9% | 2,843 | $18K |
| 99214 | Doctor's office visit, returning patient (more involved) | 1.6% | 298 | $16K |
| 87634 | 1.2% | 209 | $12K | |
| 87081 | <1% | 970 | $5K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 27 | $2K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 253 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 29 | $2K |
| 86318 | <1% | 73 | $1K | |
| 82570 | <1% | 174 | $739.50 | |
| 90461 | <1% | 299 | $496.01 | |
| 87807 | <1% | 52 | $473.00 | |
| 96160 | <1% | 207 | $443.25 | |
| 81003 | <1% | 238 | $438.48 | |
| 80176 | <1% | 31 | $370.20 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 17 | $200.43 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 201 | $117.30 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 14 | $112.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 92 | $83.64 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 12 | $10.38 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 14 | $2.34 |
| 90686 | <1% | 466 | $1.04 | |
| 90697 | 0% | 184 | $0.00 | |
| 90651 | 0% | 108 | $0.00 | |
| 90680 | 0% | 168 | $0.00 | |
| 90620 | 0% | 35 | $0.00 | |
| 97802 | 0% | 90 | $0.00 | |
| 90716 | 0% | 80 | $0.00 | |
| 90696 | 0% | 26 | $0.00 | |
| 90670 | 0% | 312 | $0.00 | |
| 90681 | 0% | 48 | $0.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 27 | $0.00 |
| 90700 | 0% | 41 | $0.00 | |
| 90734 | 0% | 69 | $0.00 | |
| 90707 | 0% | 96 | $0.00 | |
| 90671 | 0% | 104 | $0.00 | |
| 90633 | 0% | 129 | $0.00 | |
| 90715 | 0% | 28 | $0.00 | |
| 90648 | 0% | 44 | $0.00 | |
| 90473 | 0% | 21 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.