Providers
All 23 in CA
RODOLFO M GARCIA, M.D.
NPI 1073619805, individual, Los Banos, CA, Family Medicine
1
Evidence tier
documented action, then payment
- Listed on the CA Medicaid exclusion list since May 10, 2019.
- Medicaid still paid claims in 1 later month, $288 in total.
score 92 of 100, rank 425, $288 at stake
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026) | Exact NPI, name verified | May 10, 2019 | still open | 1 | Jun 2019 | Jun 2019 | $288 | $1K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RODOLFO M GARCIA, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | September 16, 2006, last updated June 25, 2018 |
| Practice location | 808 IOWA AVE, Los Banos, CA 93635, 209-710-4124 |
| Specialties | Family Medicine (207Q00000X, primary, license A39112 CA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $2K | 96% | $4.84 | $44 (top 5% from $110) | 8th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $77 | 4% | $2.49 | $60 (top 5% from $133) | too few months to rank |
In this area
23 providers in Merced County, CA carry an indicator in the public record, with $30.2M at stake between them. The most common is more hours than a day holds, on 21 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BRISTOL HOSPICE - CALIFORNIA, LLC Merced, CA, ranked 1211 | $338K |
|
| 3 | AVALON CARE CENTER-MERCED FRANCISCAN LLC Merced, CA, ranked 4649 | $0 |
|
| 4 | MIRANDA FURIE Merced, CA, ranked 7284 | $7.6M |
|
| 4 | PRIYANKA JAIN Merced, CA, ranked 7905 | $634K |
|
| 4 | ABHILASHA SHARMA Merced, CA, ranked 7961 | $423K |
|
| 4 | KARTHIKEYA DEVIREDDY Los Banos, CA, ranked 8509 | $3.4M |
|
| 4 | GEORGE ALKHOURI Merced, CA, ranked 8725 | $2.0M |
|
| 4 | ELLEN PIERNOT Merced, CA, ranked 8971 | $1.0M |
|
Recent enforcement in CA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.