Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › PHARR › HIRAM L. GARCIA, M.D., P.A.

HIRAM L. GARCIA, M.D., P.A.

NPI: 1396867636 · PHARR, TX 78577 · Family Medicine Physician · NPI assigned 04/06/2007

$5.79M
Total Medicaid Paid
608,980
Total Claims
476,374
Beneficiaries
161
Codes Billed
2018-01
First Month
2024-02
Last Month

Provider Details

Authorized OfficialPEREZ, MONICA (PRACTICE ADMINISTRATOR)
Parent OrganizationHIRAM L. GARCIA, M.D., P.A.
NPI Enumeration Date04/06/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 45,860 $139K
2019 41,222 $193K
2020 73,795 $530K
2021 164,470 $1.74M
2022 205,020 $2.64M
2023 77,815 $537K
2024 798 $15K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 45,057 36,947 $1.58M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 42,012 34,350 $1.03M
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 32,829 15,152 $358K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 9,874 8,971 $347K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 8,320 7,444 $266K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 5,471 4,932 $216K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 44,816 37,579 $216K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 3,282 3,208 $212K
99444 3,156 1,040 $179K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 2,731 2,696 $175K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 15,021 13,874 $170K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 16,060 10,537 $130K
99423 2,338 778 $128K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 1,695 1,654 $106K
99000 9,337 8,482 $72K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,336 1,319 $61K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 1,253 1,209 $57K
76700 Ultrasound, abdominal, real time with image documentation; complete 711 706 $57K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 7,038 6,577 $48K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 790 766 $45K
90460 Immunization administration through 18 years of age via any route, first or only component 5,466 2,351 $35K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 740 736 $27K
71046 Radiologic examination, chest; 2 views 1,261 1,195 $22K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 295 293 $21K
99421 1,169 540 $20K
99422 801 418 $17K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,049 1,761 $14K
81003 13,590 10,815 $12K
93000 1,361 1,317 $11K
80061 Lipid panel 3,591 3,491 $11K
0001A 427 421 $10K
90472 Immunization administration, each additional vaccine (list separately) 1,583 767 $10K
90461 1,677 1,349 $9K
83036 Hemoglobin; glycosylated (A1C) 2,856 2,785 $9K
72100 369 364 $9K
0002A 336 319 $8K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 157 150 $8K
82947 9,129 6,382 $8K
74018 280 273 $5K
83013 139 133 $5K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 239 219 $4K
72070 181 180 $4K
90658 976 961 $4K
73560 185 145 $4K
87807 346 329 $3K
96110 Developmental screening, with scoring and documentation, per standardized instrument 495 325 $3K
81002 1,474 1,317 $3K
84703 584 545 $3K
J1885 Injection, ketorolac tromethamine, per 15 mg 2,725 2,243 $2K
73620 139 122 $2K
97170 139 133 $2K
J0696 Injection, ceftriaxone sodium, per 250 mg 6,592 6,004 $2K
97169 79 79 $2K
72040 88 88 $2K
99091 60 59 $2K
99381 26 26 $2K
73610 65 55 $1K
82044 743 728 $1K
G0179 Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care 901 901 $1K
73130 54 48 $1K
99454 1,002 995 $1K
76881 12 12 $1K
99382 13 13 $1K
J1100 Injection, dexamethasone sodium phosphate, 1 mg 3,958 3,585 $984.25
0003A 32 31 $920.00
76770 13 13 $910.78
99457 1,040 1,031 $884.84
76536 13 13 $850.26
90715 461 454 $790.85
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 99 95 $775.52
0013A 29 28 $760.00
0011A 28 28 $760.00
99458 926 919 $740.05
0012A 26 26 $720.00
99215 Prolong outpt/office vis 12 12 $663.53
73030 27 24 $614.10
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion 290 236 $564.24
0072A 21 21 $560.00
83014 125 119 $528.00
99384 13 13 $510.07
86580 66 62 $421.11
0071A 13 13 $400.00
J2010 Injection, lincomycin hcl, up to 300 mg 28 24 $390.61
90674 18 18 $317.79
90734 800 784 $290.04
90620 264 258 $290.03
83655 27 26 $271.42
J1040 Injection, methylprednisolone acetate, 80 mg 47 44 $253.96
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 956 823 $205.15
94150 44 42 $161.57
90732 14 14 $101.51
J2405 Injection, ondansetron hydrochloride, per 1 mg 296 283 $98.37
82570 265 263 $92.49
84030 13 12 $74.10
90662 215 209 $54.58
99496 47 44 $44.54
99407 160 158 $22.47
G0444 Annual depression screening, 5 to 15 minutes 483 481 $18.21
36415 Collection of venous blood by venipuncture 5,635 5,331 $15.13
G9716 Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason 134 131 $15.00
94760 29 27 $6.53
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 86 83 $3.78
90650 75 75 $0.03
1160F 12,180 9,846 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 21,104 15,197 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 18,202 13,783 $0.00
G8783 Normal blood pressure reading documented, follow-up not required 15,695 12,440 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 15,661 12,195 $0.00
3078F 6,221 5,261 $0.00
90710 583 567 $0.00
90670 869 852 $0.00
G8753 Most recent systolic blood pressure >= 140 mmhg 4,522 3,748 $0.00
3077F 1,203 1,072 $0.00
90633 543 532 $0.00
0521F 14,965 11,779 $0.00
90648 798 785 $0.00
91300 29 26 $0.00
90700 95 94 $0.00
1159F 400 328 $0.00
G9509 Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5 13 13 $0.00
90649 56 56 $0.00
99490 Ccm add 20min 162 162 $0.00
84439 86 84 $0.00
90685 22 18 $0.00
96160 12 12 $0.00
99453 25 25 $0.00
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) 39 37 $0.00
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 18 17 $0.00
3075F 3,718 3,270 $0.00
G8950 Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented 16,870 12,993 $0.00
3079F 4,435 3,853 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 13,194 10,192 $0.00
3074F 6,432 5,434 $0.00
1036F 33,248 23,418 $0.00
G9903 Patient screened for tobacco use and identified as a tobacco non-user 536 389 $0.00
G8755 Most recent diastolic blood pressure >= 90 mmhg 1,049 946 $0.00
1126F 13,948 10,980 $0.00
G0008 Administration of influenza virus vaccine 288 244 $0.00
G8754 Most recent diastolic blood pressure < 90 mmhg 19,066 14,235 $0.00
3080F 659 598 $0.00
G8418 Bmi is documented below normal parameters and a follow-up plan is documented 3,156 2,823 $0.00
90723 565 554 $0.00
90680 508 498 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 353 348 $0.00
2000F 34,494 23,982 $0.00
1125F 6,266 5,084 $0.00
1111F 902 861 $0.00
1000F 289 253 $0.00
99439 163 163 $0.00
G8510 Screening for depression is documented as negative, a follow-up plan is not required 112 107 $0.00
G8422 Bmi not documented, documentation the patient is not eligible for bmi calculation 306 243 $0.00
0001F 164 138 $0.00
90696 213 206 $0.00
3008F 45 35 $0.00
84443 Thyroid stimulating hormone (TSH) 17 14 $0.00
91301 55 55 $0.00
G0009 Administration of pneumococcal vaccine 13 13 $0.00
1101F 14 14 $0.00
90657 15 15 $0.00
1170F 22 14 $0.00
1034F 13 12 $0.00