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.

Marvin Vaughan (NPI 1194705152)

Marvin Vaughan is a internal medicine physician provider located in Rochester, Minnesota. This profile covers 18 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	Marvin Vaughan
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 18, 2006

Payer Source	Total Paid
Medicare	$76K
Medicaid	$0

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

18 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…	250	$80	$20.1K
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…	150	$120	$18.2K
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	60	$160	$9.8K
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…	140	$60	$8.1K
51705	In this procedure, the provider performs a simple removal of a tube that he previously places into a patient’s bladder and replaces it with a new tube through the same incision.	50	$70	$3.5K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	10	$280	$3.4K
91322	This code represents a SARS–CoV–2 vaccine product administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 50 mcg/0.5 mL.	10	$140	$2K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	30	$70	$2K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	40	$50	$1.9K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	10	$130	$1.7K

Showing 1–10 of 18

Marvin Vaughan — Billing Profile & Reimbursement Data

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Marvin Vaughan — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
91322	666	830	30	$140	$12.8K
99214	870	10,100	70	$80	$8.1K
G0439	2,139	2,290	40	$120	$6.9K
99215	215	4,060	30	$120	$5.9K
90677	535	730	20	$280	$5.6K
90662	470	940	30	$70	$5K
99213	1,223	9,120	50	$50	$4K
90480	1,097	1,380	30	$40	$3.5K
G0438	9	490	20	$160	$3.3K
99490	91	160	40	$40	$3K