Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or New Mexico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Mexico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. New Mexico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Lance Rudolph (NPI 1376502997)

Field	Value
Entity Type	Individual
Organization	Lance Rudolph
Address	300 Oak St Ne
City	Albuquerque
State	NM
ZIP	87106
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 22, 2006

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

Revenue is highly concentrated in a small set of Medicare line items: the precomputed top 3 Medicare codes account for 87.2% of this provider’s total Medicare revenue, with J0897 generating $853.2K (65.4%), J3111 generating $240.2K (18.4%), and 99213 generating $45.1K (3.5%). This concentration indicates the provider’s Medicare book is dominated by a few services rather than a broad mix of office-based care.

The service-line mix points to a bone-health/osteoporosis-focused operation: J0897 (denosumab) and J3111 (romosozumab) are the two largest revenue drivers, and imaging and bone-density services such as 77080 (DXA) with $23.9K and 77089 (trabecular bone score) with $11.5K are also present. High-volume administration/injection activity (96372 with 937 claims and 96365 present) supports an on-site injectable/infusion capability consistent with delivering biologic osteoporosis therapies.

Competitive standing for the top drug code is extreme: J0897 ranks #21 of 10057 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), identifying this provider as a nationally unusual high-volume biller for denosumab. By contrast, J3111 ranks #168 of 970 providers nationally (83th percentile; typical, unremarkable volume for this code), suggesting the denosumab activity is the clear national outlier while romosozumab billing is more typical among peers.

Although this provider is an Internal Medicine Physician with established office visit activity, evaluation-and-management codes contribute only a small share of Medicare revenue: 99213 produced $45.1K (3.5%), 99214 produced $41.1K (3.1%), and 99215 produced $17.1K (1.3%). These E/M codes appear at above-typical national ranks for volume (for example, 99213 ranks #11426 of 457151 providers nationally, 97th percentile; notably above typical national volume) but do not drive overall Medicare dollars relative to the drug-injection lines.

The payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $1.3M while Medicaid shows none on file, indicating negligible Medicaid exposure and that commercial/Medicare contracting and reimbursement dynamics will dominate revenue risk and growth opportunities. This profile reduces Medicaid-managed care relevance for competitive or network assessments and focuses analysis on Medicare and drug/administration reimbursement.

Operational throughput is supported by high procedural volumes on select ancillary services: 77080 (DXA) ranks #635 of 17308 providers nationally (96th percentile; notably above typical national volume) and 77089 ranks #21 of 348 providers nationally (94th percentile; notably above typical national volume), highlighting a capacity for repeated imaging assessments tied to osteoporosis care. Additionally, 96372 (injections) has 937 claims and ranks #456 of 58224 providers nationally (99th percentile; extreme outlier, far above typical national volume), reinforcing that injection administration is a major operational activity.

Tenure data indicates long-standing enrollment: the provider’s NPI was enumerated on 2006-03-22 (~20 years ago), showing sustained presence in Medicare billing that may reflect an established practice and patient panel able to support specialty medication delivery over time. This longevity combined with the drug- and imaging-focused code mix suggests a stable, niche service model rather than a new or transient billing pattern.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	47,400	$20	$853.2K
J3111	Injection, romosozumab-aqqg, 1 mg	30,030	$10	$240.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	780	$60	$45.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	500	$80	$41.1K
77080	The provider performs an imaging procedure, called dual–energy X–ray absorptiometry (DXA), of one or more bony areas on the trunk to determine the bone mineral density (BMD) and whether the patient…	680	$40	$23.9K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	140	$140	$19.3K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	140	$120	$17.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	160	$110	$17.1K
77089	The provider uses imaging data and software to calculate a patient’s trabecular bone score. The service includes an interpretation and report on the patient’s fracture risk.	480	$20	$11.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	940	$10	$9.4K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Lance Rudolph — 4 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3111	2	10	30,030	$10	$299.1K
J0897	2	50	3,150	$20	$113.2K
99214	190	2,700	90	$70	$12.9K
G0439	83	490	50	$120	$9.7K
90677	125	250	30	$280	$8.3K
99215	101	960	40	$110	$7.8K
99213	49	2,440	60	$50	$7.3K
96365	33	40	80	$40	$6K
77089	2	10	160	$20	$5.6K
77080	6	70	120	$20	$5K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lance Rudolph, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward Lewiecki	NM	Internal Medicine Physician	$1.8M	$0

Nearby Providers

Other providers in the same ZIP code as Lance Rudolph, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unm Hospital	NM	General Acute Care Hospital	$0	$462.9M
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Unm Medical Group Inc	NM	Multi-Specialty Clinic/Center	$0	$113.5M
Dungarvin New Mexico LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$84.6M
Perinatal Associates Of New Mexico, Ltd	NM	Maternal & Fetal Medicine Physician	$0	$62.6M
Optumcare New Mexico LLC	NM	Family Medicine Physician	$0	$23.6M
Unm Hospital	NM	Psychiatric Hospital Unit	$228.5K	$17.6M
Family Eye Care/children's Eye Center Of New Mexico, P.C.	NM	Ophthalmology Physician	$0	$13.3M
Pediatrix Medical Group Of New Mexico, P.C.	NM	Neonatal-Perinatal Medicine Physician	$0	$11.9M
Guardian Flight LLC	NM	Air Ambulance	$372.6K	$6.9M

Lance Rudolph — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References