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

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

Evelyn Lilly (NPI 1447546213)

Evelyn Lilly is a dermatology physician provider located in Boston, Massachusetts. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Evelyn Lilly
Address	55 Fruit St
City	Boston
State	MA
ZIP	02114
Taxonomy	Dermatology Physician
NPI Enumerated	June 21, 2011

Payer Source	Total Paid
Medicare	$90.1K
Medicaid	$0

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

14 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…	350	$70	$24.5K
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…	190	$100	$18K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	150	$80	$11.8K
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…	80	$90	$6.6K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	140	$40	$5.6K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	60	$90	$4.7K
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…	30	$130	$4.4K
11103	The provider biopsies an additional skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. Report +11103 for each separate lesion…	80	$50	$3.6K
11104	The provider biopsies a skin lesion using a punch technique with a sharp hollow instrument; punch biopsies are commonly performed for deeper circular skin lesions.	30	$100	$2.9K
11602	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the trunk, arms, or legs.	20	$140	$2.3K

Showing 1–10 of 14

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	4,995	15,410	110	$80	$15.6K
17000	371	640	170	$40	$10.7K
11102	218	600	110	$70	$10.6K
17110	393	600	90	$80	$10.3K
99213	1,364	13,700	70	$60	$8.8K
99204	2,872	5,870	30	$120	$5.6K
17003	378	590	490	$10	$4.2K
99203	859	4,290	30	$80	$4.1K
11602	120	170	20	$110	$3.7K
11601	5	10	20	$110	$3.5K

Evelyn Lilly — Billing Profile & Reimbursement Data

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Evelyn Lilly — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References