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

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

Sydney Lillard (NPI 1619082336)

Sydney Lillard is a surgery physician provider located in Kalispell, Montana. This profile covers 13 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	Sydney Lillard
Address	1333 Surgical Services Way
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Surgery Physician
NPI Enumerated	August 20, 2006

Payer Source	Total Paid
Medicare	$34.7K
Medicaid	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	20	$530	$7.9K
49505	The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it.	10	$490	$6.4K
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…	100	$50	$4.5K
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	$60	$4.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	50	$60	$2.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$140	$1.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10	$110	$1.5K
11606	The provider excises a cancerous (malignant) lesion, including margins, over 4.0 cm in diameter, from the skin of the trunk, arms, or legs.	10	$130	$1.4K
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	$90	$1.4K
38900	The provider injects a nonradioactive dye into the tissues surrounding the lymph nodes. The provider examines the lymph nodes during the procedure to detect the presence of disease and identify the…	10	$110	$1.2K

Showing 1–10 of 13

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,731	1,810	100	$70	$12.4K
99232	357	560	70	$60	$8K
47562	4	10	10	$480	$7.7K
99213	769	1,730	90	$50	$7.2K
99223	375	410	30	$130	$7K
49505	2	10	10	$430	$5.5K
99204	628	780	30	$100	$4.8K
99222	298	390	20	$100	$3.3K
99203	122	700	30	$70	$3.1K
99212	514	540	30	$30	$1.8K

Sydney Lillard — Billing Profile & Reimbursement Data

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Sydney Lillard — 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