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.

James Rice (NPI 1568499697)

Field	Value
Entity Type	Individual
Organization	James Rice
Address	3500 Comanche Rd Ne Ste G
City	Albuquerque
State	NM
ZIP	87107
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	June 26, 2006

Payer Source	Total Paid
Medicare	$210.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	810	$60	$50.4K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	260	$180	$46.5K
77002	The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…	200	$80	$16.6K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	80	$200	$16K
62321	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)…	80	$190	$15.2K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	30	$400	$10.9K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	180	$50	$8.6K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	40	$160	$6.4K
99203	The provider sees a new 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 provider…	70	$70	$5.5K
99458	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.…	180	$30	$5.5K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

James Rice — 5 of 18 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

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
64635	27	40	40	$360	$21.2K
64483	11	40	50	$190	$13.9K
64493	26	50	40	$180	$13.7K
62323	3	30	40	$150	$11.8K
99213	45	2,440	60	$50	$7.3K
99457	16	30	80	$30	$7.3K
64636	26	30	50	$130	$7.2K
99458	5	20	100	$30	$6.8K
62321	3	20	30	$160	$6.6K
99454	23	30	110	$30	$6.2K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peter Pacheco	NM	Physician Assistant	$114.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bernalillo County Health Care Corporation	NM	Land Ambulance	$4.4M	$80M
Alianza Family Services, LLC	NM	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$60.9M
Csi Aviation, Inc.	NM	Air Ambulance	$2.2M	$50.9M
Albuquerque Health Services	NM	Methadone Clinic	$195.8K	$35.4M
Native American Professional Parent Resources (nappr), Inc.	NM	Community/Behavioral Health Agency	$0	$14.6M
Courageous Transformations, Inc	NM	Methadone Clinic	$0	$13.6M
Unm Medically Fragile Case Management Program	NM	Case Management Registered Nurse	$0	$10.2M
Functional Aquatics Therapy	NM	Rehabilitation Clinic/Center	$0	$6M
Roswell Home Medical Inc	NM	Durable Medical Equipment & Medical Supplies	$0	$5.5M
Unm Focus Program	NM	Case Manager/Care Coordinator	$0	$4.9M

James Rice — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References