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 South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Jon Grudem (NPI 1477649531)

Field	Value
Entity Type	Individual
Organization	Jon Grudem
Address	575 N Sioux Point Rd
City	North Sioux City
State	SD
ZIP	57049
Taxonomy	Neurology Physician
NPI Enumerated	October 5, 2006

Payer Source	Total Paid
Medicare	$402.6K
Medicaid	$0

Key Findings

This provider’s Medicare business is heavily concentrated: total Medicare revenue is $402.6K and the top 3 Medicare codes by revenue together account for 84.3% of that total. The single largest driver is J0585, which alone represents $329K (78.6% of Medicare revenue), indicating services are dominated by onabotulinumtoxina injections rather than general neurodiagnostic or routine evaluation & management care.

Clinical/service-line implication: the code mix (large volume of J0585 plus multiple botulinum toxin injection codes 64616, 64615, 64644 and the EMG/nerve conduction codes 95910, 95913, 95886, 95885, 95874) indicates a practice focused on procedural neurology with a strong emphasis on therapeutic chemodenervation and electrodiagnostic testing. This pattern suggests the provider operates largely as a procedure-oriented neurology practice treating movement disorders, spasticity, chronic migraine, or dystonia rather than a high-volume primary E/M clinic.

Revenue concentration risk/opportunity: dependence on one product code is pronounced — J0585 is 78.6% of Medicare revenue and the precomputed top-3 share is 84.3% — which creates operational sensitivity to changes in utilization, reimbursement, or supply for onabotulinumtoxina. From a payer or contracting perspective, this profile signals a narrowly specialized revenue stream that could be negotiated or managed differently than a diversified neurology practice.

Competitive standing on key procedures: for J0585 the provider ranks #45 of 3636 nationally (99th percentile) and is described as notably above typical national volume, identifying them as a high-volume national outlier for onabotulinumtoxina administration. For several electrodiagnostic and injection add-on codes (e.g., 95910 at the 92nd percentile, 95874 at the 93rd percentile) the provider also ranks well above peers, supporting the view that this clinician is a regional/national leader in procedural neurology services.

Other Medicare activity is modest and typical: evaluation & management codes such as 99204 and 99203 and routine follow-up 99213 contribute only small fractions of Medicare revenue (2.9%, 0.7%, and 0.3% respectively) and their national ranks are in ranges described as typical or unremarkable. Imaging and EEG activity (70553, 95819) are minor revenue contributors, consistent with a practice that refers some diagnostics out or performs them infrequently relative to injection and electrodiagnostic work.

Payer mix: this provider effectively operates as a single-payer (Medicare-focused) biller in the available records — total Medicare revenue is $402.6K and there is no Medicaid billing on file. Analysts should treat the entity as not participating in Medicaid or not billing state programs, which materially narrows the payer risk profile and local Medicaid market exposure.

Tenure and stability: the NPI was enumerated on 2006-10-05 (~20 years ago), indicating long-standing Medicare participation. That tenure, combined with highly concentrated procedural volume and high national ranks on key codes, suggests an established specialty practice with consistent service patterns over time.

Statistical outlier notes: several individual codes are explicitly flagged relative to national peers — J0585 is notably above typical national volume (99th percentile), 95910 and 95874 are high-percentile performers (92nd and 93rd percentiles respectively), while most other codes are described as typical or unremarkable. These descriptors support treating J0585 and a subset of procedural/diagnostic codes as the provider’s defining competitive strengths.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	65,800	$10	$329K
99204	The provider sees a new 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 provider…	100	$120	$12.2K
64616	The provider administers a chemical compound to the neck muscles on one side, avoiding the laryngeal muscles. The goal of this procedure is to paralyze the muscles. Providers may treat cervical…	90	$130	$11.6K
95910	In this procedure, the provider performs seven or eight nerve conduction studies, a diagnostic test to evaluate the function, especially the electrical conduction ability of the motor and sensory…	90	$130	$11K
95913	In this procedure, the provider performs 13 or more nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	50	$210	$9.4K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	120	$70	$8.4K
95874	In this add–on procedure, the provider uses needle electromyography guidance for a chemodenervation injection. Chemodenervation is a process of injecting a neurotoxin like ethyl alcohol or Botox®…	150	$60	$8.3K
64615	The provider bilaterally administers a chemical compound to the muscles innervated by the trigeminal, facial, cervical spinal, and accessory nerves. The goal of this procedure is to paralyze the…	80	$100	$7.7K
95885	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction studies. The provider performs…	120	$50	$5.8K
64644	The provider injects a chemical, such as Botox®, into 5 or more muscles of one extremity to relieve a patient's pain and spasms.	30	$120	$4K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Jon Grudem — 2 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	1	10	7,900	$1	$86.8K
95913	5	10	50	$170	$22.8K
95886	10	20	110	$50	$12K
70553	32	40	40	$90	$7.6K
64616	2	10	40	$110	$7K
99213	1,516	1,710	80	$50	$6.4K
64615	5	10	60	$80	$5.3K
99204	79	670	30	$100	$5.1K
95910	2	20	40	$100	$3.9K
64644	1	10	30	$120	$3.9K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trinity Regional Medical Center	IA	General Acute Care Hospital	$0	$12.3M
Northwest Iowa Hospital Corporation	IA	Emergency Medical Services (Emergency Medicine) Physician	$0	$7.9M
Trinity Regional Medical Center	IA	Rural Health Clinic/Center	$0	$5.7M
Trinity Regional Medical Center	IA	Emergency Medicine Physician	$0	$4.6M
Cnos PC	SD	Orthopaedic Surgery Physician	$0	$3.6M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Trinity Regional Medical Center	IA	Rural Health Clinic/Center	$0	$2.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dunes Dental 4 Kids, LLP	SD	Pediatric Dentistry	$0	$3.3M
Liem Som Oei Md PC	SD	Nephrology Physician	$0	$2.4M
Ear Nose And Throat Consultants And Hearing Services Plc	SD	Otolaryngology Physician	$0	$2.2M
Oral Surgery Assocates, P.C.	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$2.1M
Dunes Anesthesia PC	SD	Pain Medicine (Anesthesiology) Physician	$0	$1.1M
Midlands Clinic, P.C.	SD	Specialist	$0	$822.9K
Dunes Medical Laboratories	SD	Clinical Medical Laboratory	$303K	$416.6K
Beth Bruening	SD	Ophthalmology Physician	$704.9K	$2.2K
Neal Khurana	SD	Vascular & Interventional Radiology Physician	$704.3K	$0
Siouxland Surgery Center Limited Liability Partnership	SD	Special Hospital	$0	$658.3K

Jon Grudem — 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