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Methodology•Download Data
  1. Home
  2. Providers
  3. Elvin Garcia
⚕️
MDIndividual

Elvin Garcia, M.D.

NPI: 1871547596
Mcallen, TX
10 years of data
Rheumatology
$7.1M
Total Payments
116.8K
Beneficiaries
226.7K
Services
2.03x
Markup Ratio

Peer Comparison

98th
percentile in specialty
This provider$7.1M
Specialty median$352.6K

📋 Key Findings

1Billed $7.1M over 10 years
22.03x markup ratio (above median)
398th percentile in Rheumatology by payments
491 services/day — unusually high
52 procedures with >3x markup

This provider averages 91 services per working day

Based on 226.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $7.1M in total Medicare payments ranks in the 98th percentile of Rheumatology providers nationally.

Averaging 91 services per working day raises questions about billing patterns.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$82.64$48.041.72x$34.60$923.1K30.5K15.7K
2015$63.95$32.351.98x$31.60$761.7K26.4K13.5K
2016$63.47$31.302.03x$32.17$762.0K26.2K13.1K
2017$79.99$42.301.89x$37.69$895.1K29.7K15.2K
2018$80.61$43.721.84x$36.89$733.5K24.8K13.7K
2019$63.65$30.582.08x$33.07$716.5K23.4K12.0K
2020$68.62$33.372.06x$35.25$656.3K20.5K11.1K
2021$69.17$35.141.97x$34.03$639.2K17.2K8.5K
2022$64.86$32.561.99x$32.30$528.8K15.1K7.6K
2023$63.37$30.382.09x$32.99$454.8K13.1K6.4K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutes
$2.3M
29.9K services$75.36/svc1.87x markup
96413Infusion of chemotherapy into a vein up to 1 hour
$972.7K
9.9K services$98.10/svc2.35x markup
20610Aspiration and/or injection of large joint or joint capsule
$479.4K
8.8K services$54.48/svc2.11x markup
99215Established patient office or other outpatient, visit typically 40 minutes
$422.8K
3.7K services$114.91/svc1.54x markup
J7321Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose
$300.3K
4.6K services$65.78/svc1.55x markup
96401Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle
$263.5K
4.8K services$55.33/svc1.61x markup
99204New patient office or other outpatient visit, typically 45 minutes
$243.1K
2.2K services$112.08/svc2.15x markup
20553Injections of trigger points in 3 or more muscles
$224.2K
5.0K services$44.71/svc1.98x markup
85025Complete blood cell count (red cells, white blood cell, platelets), automated test
$134.5K
14.4K services$9.35/svc2.67x markup
96375Injection of different drug or substance into a vein for therapy, diagnosis, or prevention⚠ 3.5x markup
$129.5K
9.3K services$13.95/svc3.50x markup
96415Infusion of chemotherapy into a vein
$123.5K
5.7K services$21.50/svc2.56x markup
J9310Injection, rituximab, 100 mg
$108.3K
167 services$648.40/svc1.36x markup
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
$107.4K
7.5K services$14.40/svc2.08x markup
20552Injections of trigger points in 1 or 2 muscles
$102.8K
2.8K services$36.09/svc2.13x markup
86140Measurement C-reactive protein for detection of infection or inflammation
$92.6K
14.9K services$6.21/svc2.42x markup
77080Bone density measurement using dedicated X-ray machine⚠ 3.1x markup
$86.5K
2.3K services$38.26/svc3.11x markup
99213Established patient office or other outpatient visit, typically 15 minutes
$84.1K
1.5K services$56.51/svc2.08x markup
85651Red blood cell sedimentation rate, to detect inflammation
$68.6K
15.3K services$4.48/svc2.23x markup
86235Measurement of antibody for assessment of autoimmune disorder
$58.0K
2.6K services$22.28/svc1.57x markup
J1745Injection infliximab, 10 mg
$56.1K
1.2K services$47.65/svc2.29x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes29.9K$2.3M$75.361.87x
96413Infusion of chemotherapy into a vein up to 1 hour9.9K$972.7K$98.102.35x
20610Aspiration and/or injection of large joint or joint capsule8.8K$479.4K$54.482.11x
99215Established patient office or other outpatient, visit typically 40 minutes3.7K$422.8K$114.911.54x
J7321Hyaluronan or derivative, hyalgan or supartz, for intra-articular injection, per dose4.6K$300.3K$65.781.55x
96401Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle4.8K$263.5K$55.331.61x
99204New patient office or other outpatient visit, typically 45 minutes2.2K$243.1K$112.082.15x
20553Injections of trigger points in 3 or more muscles5.0K$224.2K$44.711.98x
85025Complete blood cell count (red cells, white blood cell, platelets), automated test14.4K$134.5K$9.352.67x
96375Injection of different drug or substance into a vein for therapy, diagnosis, or prevention9.3K$129.5K$13.953.50x
96415Infusion of chemotherapy into a vein5.7K$123.5K$21.502.56x
J9310Injection, rituximab, 100 mg167$108.3K$648.401.36x
96372Injection beneath the skin or into muscle for therapy, diagnosis, or prevention7.5K$107.4K$14.402.08x
20552Injections of trigger points in 1 or 2 muscles2.8K$102.8K$36.092.13x
86140Measurement C-reactive protein for detection of infection or inflammation14.9K$92.6K$6.212.42x
77080Bone density measurement using dedicated X-ray machine2.3K$86.5K$38.263.11x
99213Established patient office or other outpatient visit, typically 15 minutes1.5K$84.1K$56.512.08x
85651Red blood cell sedimentation rate, to detect inflammation15.3K$68.6K$4.482.23x
86235Measurement of antibody for assessment of autoimmune disorder2.6K$58.0K$22.281.57x
J1745Injection infliximab, 10 mg1.2K$56.1K$47.652.29x

Markup Analysis

Charge-to-Payment Ratio

2.03x

This provider submits charges 2.03 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.03x means for every $100 Medicare pays, this provider initially charges $203. This is higher than the national average.

Location

Mcallen, TX

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Rheumatology providers in TX for peer comparison.

Elvin Garcia (you)
$7.1M
Constantine Saadeh, M.D.
$39.3M
Grace Makhlouf, M.D.
$34.2M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Constantine Saadeh, M.D.Amarillo, TX$39.3M✓ Clear
Grace Makhlouf, M.D.Sugar Land, TX$34.2M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

Believe this data is inaccurate? Dispute this data