Physician
Hiram L. Garcia, M.D., P.A.
Hiram L. Garcia, M.D., P.A. was paid $5.79M by Medicaid between Jan 2018 and Feb 2024, across 161 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 27% of everything it billed.
33Billing provider infoHIRAM L. GARCIA, M.D., P.A.
PHARR, TX 78577
PHARR, TX 78577
33aNPI1396867636assigned 04/06/2007
33bProvider typeFamily Medicine Physician
28Total paid$5.79M
24GClaims608,980
24DCodes billed161
24AFirst – last monthJan 2018 – Feb 2024
Compared with peers
Next to other Family Medicine Physician providers in Texas
Rank by total paid#14 of 1,204
Median peer was paid$31K
This provider vs. median188×
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 | |
|---|---|---|---|
| 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 | |
| 2024incomplete | 798 | $15K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 27% | 45,057 | 36,947 | $1.58M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 18% | 42,012 | 34,350 | $1.03M |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 6.2% | 32,829 | 15,152 | $358K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 6.0% | 9,874 | 8,971 | $347K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 4.6% | 8,320 | 7,444 | $266K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.7% | 5,471 | 4,932 | $216K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.7% | 44,816 | 37,579 | $216K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.7% | 3,282 | 3,208 | $212K |
| 99444 | 3.1% | 3,156 | 1,040 | $179K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.0% | 2,731 | 2,696 | $175K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 2.9% | 15,021 | 13,874 | $170K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 2.2% | 16,060 | 10,537 | $130K |
149 more codes
| 99423 | 2.2% | 2,338 | $128K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.8% | 1,695 | $106K |
| 99000 | 1.2% | 9,337 | $72K | |
| 99203 | Doctor's office visit, new patient (routine) | 1.1% | 1,336 | $61K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,253 | $57K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 711 | $57K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 7,038 | $48K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 790 | $45K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 5,466 | $35K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 740 | $27K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,261 | $22K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 295 | $21K |
| 99421 | <1% | 1,169 | $20K | |
| 99422 | <1% | 801 | $17K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,049 | $14K |
| 81003 | <1% | 13,590 | $12K | |
| 93000 | <1% | 1,361 | $11K | |
| 80061 | Lipid panel | <1% | 3,591 | $11K |
| 0001A | <1% | 427 | $10K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,583 | $10K |
| 90461 | <1% | 1,677 | $9K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,856 | $9K |
| 72100 | <1% | 369 | $9K | |
| 0002A | <1% | 336 | $8K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 157 | $8K |
| 82947 | <1% | 9,129 | $8K | |
| 74018 | <1% | 280 | $5K | |
| 83013 | <1% | 139 | $5K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 239 | $4K |
| 72070 | <1% | 181 | $4K | |
| 90658 | <1% | 976 | $4K | |
| 73560 | <1% | 185 | $4K | |
| 87807 | <1% | 346 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 495 | $3K |
| 81002 | <1% | 1,474 | $3K | |
| 84703 | <1% | 584 | $3K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 2,725 | $2K |
| 73620 | <1% | 139 | $2K | |
| 97170 | <1% | 139 | $2K | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 6,592 | $2K |
| 97169 | <1% | 79 | $2K | |
| 72040 | <1% | 88 | $2K | |
| 99091 | <1% | 60 | $2K | |
| 99381 | <1% | 26 | $2K | |
| 73610 | <1% | 65 | $1K | |
| 82044 | <1% | 743 | $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 | <1% | 901 | $1K |
| 73130 | <1% | 54 | $1K | |
| 99454 | <1% | 1,002 | $1K | |
| 76881 | <1% | 12 | $1K | |
| 99382 | <1% | 13 | $1K | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 3,958 | $984.25 |
| 0003A | <1% | 32 | $920.00 | |
| 76770 | <1% | 13 | $910.78 | |
| 99457 | <1% | 1,040 | $884.84 | |
| 76536 | <1% | 13 | $850.26 | |
| 90715 | <1% | 461 | $790.85 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 99 | $775.52 |
| 0013A | <1% | 29 | $760.00 | |
| 0011A | <1% | 28 | $760.00 | |
| 99458 | <1% | 926 | $740.05 | |
| 0012A | <1% | 26 | $720.00 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 12 | $663.53 |
| 73030 | <1% | 27 | $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 | <1% | 290 | $564.24 |
| 0072A | <1% | 21 | $560.00 | |
| 83014 | <1% | 125 | $528.00 | |
| 99384 | <1% | 13 | $510.07 | |
| 86580 | <1% | 66 | $421.11 | |
| 0071A | <1% | 13 | $400.00 | |
| J2010 | Injection, lincomycin hcl, up to 300 mg | <1% | 28 | $390.61 |
| 90674 | <1% | 18 | $317.79 | |
| 90734 | <1% | 800 | $290.04 | |
| 90620 | <1% | 264 | $290.03 | |
| 83655 | <1% | 27 | $271.42 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 47 | $253.96 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 956 | $205.15 |
| 94150 | <1% | 44 | $161.57 | |
| 90732 | <1% | 14 | $101.51 | |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 296 | $98.37 |
| 82570 | <1% | 265 | $92.49 | |
| 84030 | <1% | 13 | $74.10 | |
| 90662 | <1% | 215 | $54.58 | |
| 99496 | <1% | 47 | $44.54 | |
| 99407 | <1% | 160 | $22.47 | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 483 | $18.21 |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,635 | $15.13 |
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | <1% | 134 | $15.00 |
| 94760 | <1% | 29 | $6.53 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 86 | $3.78 |
| 90650 | <1% | 75 | $0.03 | |
| 1160F | 0% | 12,180 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 21,104 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 18,202 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 15,695 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 15,661 | $0.00 |
| 3078F | 0% | 6,221 | $0.00 | |
| 90710 | 0% | 583 | $0.00 | |
| 90670 | 0% | 869 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 4,522 | $0.00 |
| 3077F | 0% | 1,203 | $0.00 | |
| 90633 | 0% | 543 | $0.00 | |
| 0521F | 0% | 14,965 | $0.00 | |
| 90648 | 0% | 798 | $0.00 | |
| 91300 | 0% | 29 | $0.00 | |
| 90700 | 0% | 95 | $0.00 | |
| 1159F | 0% | 400 | $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 | 0% | 13 | $0.00 |
| 90649 | 0% | 56 | $0.00 | |
| 99490 | Ccm add 20min | 0% | 162 | $0.00 |
| 84439 | 0% | 86 | $0.00 | |
| 90685 | 0% | 22 | $0.00 | |
| 96160 | 0% | 12 | $0.00 | |
| 99453 | 0% | 25 | $0.00 | |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | 0% | 39 | $0.00 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 0% | 18 | $0.00 |
| 3075F | 0% | 3,718 | $0.00 | |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 0% | 16,870 | $0.00 |
| 3079F | 0% | 4,435 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 13,194 | $0.00 |
| 3074F | 0% | 6,432 | $0.00 | |
| 1036F | 0% | 33,248 | $0.00 | |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 536 | $0.00 |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 1,049 | $0.00 |
| 1126F | 0% | 13,948 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 288 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 19,066 | $0.00 |
| 3080F | 0% | 659 | $0.00 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 3,156 | $0.00 |
| 90723 | 0% | 565 | $0.00 | |
| 90680 | 0% | 508 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 353 | $0.00 |
| 2000F | 0% | 34,494 | $0.00 | |
| 1125F | 0% | 6,266 | $0.00 | |
| 1111F | 0% | 902 | $0.00 | |
| 1000F | 0% | 289 | $0.00 | |
| 99439 | 0% | 163 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 112 | $0.00 |
| G8422 | Bmi not documented, documentation the patient is not eligible for bmi calculation | 0% | 306 | $0.00 |
| 0001F | 0% | 164 | $0.00 | |
| 90696 | 0% | 213 | $0.00 | |
| 3008F | 0% | 45 | $0.00 | |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 17 | $0.00 |
| 91301 | 0% | 55 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 0% | 13 | $0.00 |
| 1101F | 0% | 14 | $0.00 | |
| 90657 | 0% | 15 | $0.00 | |
| 1170F | 0% | 22 | $0.00 | |
| 1034F | 0% | 13 | $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.
From NPPES
Who's on the registration
Authorized officialPEREZ, MONICA (PRACTICE ADMINISTRATOR)
Parent organizationHIRAM L. GARCIA, M.D., P.A.