Physician

Paul R Garcia, MD

According to 2025 Medicare claims, Paul Garcia, MD (NPI: 1144731498) practices family practice in the Janesville-Beloit, WI market, with the plurality of this provider's patient population coming from Rock, WI. This provider's primary affiliated billing organization is DEAN HEALTH SYSTEMS, INC (NPI: 1053358846; TIN: 391128616) and primary practice location at 53546-2343. Garcia is affiliated with the Mercy Health Corporation (ACO ID: A2097), SSM WI ACO LLC (ACO ID: A5124), and Ascension Care Management Health Partners Wisconsin, LLC (ACO ID: A5329), participating under the MSSP model.

Garcia's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 403 traditional Medicare patients, billed 1,171 HCPCS/CPT codes, and received $85,226 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 9,362 prescription claims across 817 beneficiaries totaling $749,424 in drug costs, led by Eliquis (Apixaban). DME data shows 170 claims. No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has risen steadily, from $2,885 to $85,226. Similarly, Part D prescription costs have moved sharply higher in recent years, from $3,371 to $749,424. In contrast, DME billing represents a smaller volume and moved sharply higher in recent years, from $267 to $14,459.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	33	55	$2,885
2019	153	344	$19,062
2020	92	305	$14,192
2021	169	443	$19,441
2022	126	694	$19,780
2023	325	808	$58,478
2024	403	1,171	$85,226

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	26	42	$3,371
2018	109	401	$28,756
2019	309	1,353	$72,344
2020	307	2,064	$112,425
2021	325	2,575	$154,377
2022	348	2,801	$192,605
2023	628	3,555	$355,196
2024	817	9,362	$749,424

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	N/R	24	$2,917
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	32	170	$11,764

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	216	216	$122
90653	Influenza vaccine, inactivated	28	28	$82
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	249	350	$78
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	172	189	$44
G0008	Administration of influenza virus vaccine	31	32	$30

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	145	7,725	$150,052
Ozempic	Semaglutide	93	3,934	$125,058
Trulicity	Dulaglutide	57	1,684	$57,399
Jardiance	Empagliflozin	28	1,921	$37,915
Xarelto	Rivaroxaban	37	1,731	$31,259

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	N	N/R	23	$8,002
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	21	$1,358
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Y	N/R	20	$1,136
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	N	20	53	$727
Q0513	Pharmacy dispensing fee for inhalation drug(s); per 30 days	N	N/R	16	$362

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Paul R. Garcia, MD?

Tedicare shows public-source Medicare data for Paul R. Garcia, MD (NPI 1144731498), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Paul R. Garcia, MD have ACO affiliation data?

Paul R. Garcia, MD is shown with ACO affiliation data for Mercy Health Corporation (MSSP, ACO ID A2097), SSM WI ACO LLC (MSSP, ACO ID A5124), and Ascension Care Management Health Partners Wisconsin, LLC (MSSP, ACO ID A5329).

What billing organization is linked to Paul R. Garcia, MD?

Paul R. Garcia, MD is linked to DEAN HEALTH SYSTEMS, INC (billing NPI 1053358846) in the available physician profile data.

Does Paul R. Garcia, MD have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.