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

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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.

David Ridley (NPI 1659396000)

Field	Value
Entity Type	Individual
Organization	David Ridley
Address	2854 Highway 55 Ste 190
City	Eagan
State	MN
ZIP	55121
Taxonomy	Rheumatology Physician
NPI Enumerated	July 13, 2006

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

This provider reports $2.2M in lifetime Medicare revenue and has no Medicaid billing on file, making their public billing footprint effectively single-payer Medicare rather than a dual‑payer practice. The absence of Medicaid activity suggests limited billing exposure to state Medicaid populations and a business built primarily around Medicare patients.

Revenue is highly concentrated in a small set of biologic drug codes: the precomputed top 3 Medicare codes account for 67.3% of this provider's total Medicare revenue. Those top three are J0129 ($788.8K, 35.5%), J1745 ($380.9K, 17.2%), and J9312 ($324.5K, 14.6%), indicating the practice derives the bulk of its Medicare dollars from specific infused biologic therapies.

The mix of high-revenue drug codes (J0129, J1745, J9312, J1602, J3262) together with frequent infusion administration codes (for example 96365 with 861 claims and $43.1K revenue, and 96366 with 401 claims and $6.4K revenue) describes an operation that functions as an infusion‑center style rheumatology practice. The presence of J7050 (949 claims, $949 revenue) and other IV/infusion administration CPTs supports routine in‑office IV biologic delivery and associated nursing resources.

Competitive standing varies by product: J1745 (infliximab) is a clear national outlier for this provider, ranking #32 of 1352 providers and sitting in the 98th percentile with a labeled status of "notably above typical national volume," which signals unusually high infliximab use relative to peers. By contrast, J0129 (abatacept) and J9312 (rituximab) each generate large shares of revenue ($788.8K and $324.5K respectively) but are described as "typical, unremarkable volume" (J0129 rank #95 of 1221, 92th percentile; J9312 rank #66 of 317, 79th percentile), indicating strong revenue dependence without the same exceptional national dominance.

Clinical workload indicators reinforce a high-touch management model: 99214 has 897 claims, $86.1K revenue and ranks #14957 of 479517 (97th percentile; labeled "notably above typical national volume"), suggesting above‑typical mid‑level complexity office visits consistent with ongoing management of chronic rheumatic disease and infusion follow‑up. High relative ranks on infusion-related CPTs (96365 rank #124 of 8873, 99th percentile) further imply substantial visit throughput dedicated to infusion episodes.

While several biologic administration codes contribute meaningfully to revenue, other routine procedure codes are present at modest levels (for example 36415 with 529 claims and $2.6K revenue, and 77080 with 34 claims and $1.3K revenue), indicating the practice is focused on medical therapy and infusion rather than imaging or broad ambulatory procedure lines. This profile aligns with a specialty rheumatology practice that prioritizes infusion care over ancillary diagnostic service revenue.

The provider’s NPI was enumerated on 2006-07-13 (~20 years ago), indicating long tenure in the market. That sustained presence, combined with high national percentile placement on select biologics and infusion CPTs, suggests an established referral and operational model optimized for infusion biologic delivery to Medicare beneficiaries.

The absence of Medicaid billing poses strategic considerations: the practice is concentrated on Medicare revenue ($2.2M) with no recorded Medicaid activity, which reduces exposure to Medicaid managed care flows and state fee schedules but increases dependence on Medicare reimbursement patterns and the specific biologic drugs driving revenue. For payers and network planners this single‑payer concentration and the outsized role of a few biologic codes represent both points of leverage and potential cost drivers to monitor.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	23,200	$30	$788.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	14,650	$30	$380.9K
J9312	Injection, rituximab, 10 mg	5,070	$60	$324.5K
J1602	Injection, golimumab, 1 mg, for intravenous use	27,100	$10	$298.1K
J3262	Injection, tocilizumab, 1 mg	55,210	$10	$276K
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…	900	$100	$86.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	860	$50	$43K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	400	$20	$6.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	530	$10	$2.6K
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…	20	$120	$2.4K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

David Ridley — 11 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	20	5,330	$30	$242.9K
J9312	1	10	4,030	$60	$231.9K
J3262	2	20	26,440	$1	$147.6K
J1602	1	20	7,050	$10	$112K
J1745	1	60	1,540	$30	$76.7K
99214	15	10,100	70	$80	$8.1K
99213	7,591	9,120	50	$50	$4K
99204	1,847	3,340	20	$110	$3.6K
96365	1	260	30	$50	$3.2K
96375	99	140	120	$10	$2.2K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elvia Moreta Freire	MN	Rheumatology Physician	$638.6K	$0
Sumi Patel	MN	Rheumatology Physician	$364.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Respiratory Services, LLC	MN	Oxygen Equipment & Supplies (DME)	$0	$43.4M
People Incorporated	MN	Case Management Agency	$0	$22.2M
Summit Orthopedics Ltd	MN	Ambulatory Surgical Clinic/Center	$1.5M	$0
Eagan Orthopedic Surgery Center LLC	MN	Ambulatory Surgical Clinic/Center	$1M	$0
Kristoffer Breien	MN	Orthopaedic Surgery Physician	$143.6K	$0
Costco Wholesale Corporation	MN	Community/Retail Pharmacy	$92.1K	$0
Makenna Pechumer	MN	Gerontology Nurse Practitioner	$49.8K	$0
Sandra Kirksey	MN	Nurse Practitioner	$40.1K	$0
Bruce Thordal	MN	Cognitive & Behavioral Psychologist	$29.4K	$0
Robalee Wanderman	MN	Pain Medicine (Anesthesiology) Physician	$25.5K	$0

David Ridley — 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