This provider's $7.5M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 4081% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 335% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $148.12 | $77.66 | 1.91x | $70.46 | $101.7K | 1.3K | 12 |
| 2015 | $121.71 | $60.48 | 2.01x | $61.23 | $91.3K | 1.5K | 8 |
| 2016 | $215.84 | $83.14 | 2.60x | $132.70 | $106.9K | 1.3K | 10 |
| 2017 | $109.57 | $37.39 | 2.93x | $72.18 | $44.1K | 1.2K | 9 |
| 2018 | $161.53 | $56.60 | 2.85x | $104.93 | $191.6K | 3.4K | 19 |
| 2019 | $168.29 | $62.23 | 2.70x | $106.06 | $265.3K | 4.3K | 18 |
| 2020 | $157.13 | $59.89 | 2.62x | $97.24 | $534.3K | 8.9K | 17 |
| 2021 | $133.37 | $51.69 | 2.58x | $81.68 | $374.9K | 7.3K | 13 |
| 2022 | $155.16 | $59.41 | 2.61x | $95.75 | $1.5M | 25.1K | 14 |
| 2023 | $157.02 | $60.17 | 2.61x | $96.85 | $4.3M | 70.6K | 12 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 58.6K | $3.1M | $52.83 | 2.56x |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 18.3K | $1.8M | $98.33 | 2.60x |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 14.8K | $447.1K | $30.28 | 2.66x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 9.2K | $393.0K | $42.92 | 2.72x |
| 99496 | Transitional care management services for problem of high complexity | 1.6K | $276.5K | $177.46 | 2.68x |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 6.4K | $253.4K | $39.41 | 2.65x |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 2.4K | $226.2K | $93.44 | 2.71x |
| 99344 | Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes | 1.0K | $131.3K | $125.43 | 2.87x |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 939 | $125.2K | $133.30 | 2.65x |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 3.3K | $116.5K | $35.28 | 2.67x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 1.4K | $71.0K | $52.48 | 2.01x |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | 1.7K | $68.5K | $41.35 | 3.04x |
| 99345 | New patient home visit, typically 75 minutes | 409 | $66.6K | $162.87 | 2.69x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 693 | $56.9K | $82.17 | 2.41x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 799 | $56.2K | $70.30 | 1.96x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 746 | $41.9K | $56.13 | 2.79x |
| 99495 | Transitional care management services for problem of at least moderate complexity | 236 | $29.1K | $123.14 | 2.95x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 168 | $26.4K | $156.88 | 2.69x |
| 99239 | Hospital discharge day management, more than 30 minutes | 318 | $26.0K | $81.83 | 2.65x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 184 | $23.9K | $129.88 | 2.01x |
This provider submits charges 2.6 times higher than what Medicare actually pays.
A markup ratio of 2.6x means for every $100 Medicare pays, this provider initially charges $260. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Internal Medicine providers in TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Owen Ellington, M.D, J.D. | Humble, TX | $34.4M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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