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

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

J Richard Lilly Md Shaaron R Towns Md And Associates PC (NPI 1336135821)

J Richard Lilly Md Shaaron R Towns Md And Associates PC is a general practice physician provider located in Hyattsville, Maryland. This profile covers 0 Medicare and 102 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	J Richard Lilly Md Shaaron R Towns Md And Associates PC
Address	5804 Baltimore Ave
City	Hyattsville
State	MD
ZIP	20781
Taxonomy	General Practice Physician
NPI Enumerated	September 21, 2005

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

102 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	45,690	$100	$4.5M
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…	13,610	$80	$1.1M
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	3,040	$120	$355.3K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	2,620	$130	$333K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,880	$120	$216.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,990	$100	$207.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,700	$50	$143K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,340	$110	$141.1K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	4,930	$20	$108.5K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	11,450	$10	$103.1K

Showing 1–10 of 102

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maryland Distribution

J Richard Lilly Md Shaaron R Towns Md And Associates PC — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

102 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	27	3,670	680	$90	$310K
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…	195	3,280	610	$80	$296.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	117	330	800	$110	$228.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	138	290	730	$100	$212.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	89	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	59	320	290	$120	$128K
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…	644	1,000	200	$120	$96.3K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	11	90	240	$10	$88.5K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	9	90	100	$20	$87.8K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	15	90	370	$10	$83.1K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eduardo Flores	MD	Internal Medicine Physician	$169.9K	$0
Elizabeth Vebangsi	DC	Family Nurse Practitioner	$86.5K	$870
Prudence Mancho	MD	Family Nurse Practitioner	$63.4K	$0
Rosalee Townsend	DC	Nurse Practitioner	$14.1K	$0

J Richard Lilly Md Shaaron R Towns Md And Associates PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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