This provider averages 66 services per working day
Based on 164.8K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 66 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 51% in 2019
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 | $97.46 | $43.91 | 2.22x | $53.55 | $427.6K | 12.4K | 8.2K |
| 2015 | $81.50 | $41.96 | 1.94x | $39.54 | $447.4K | 13.2K | 8.8K |
| 2016 | $104.29 | $43.64 | 2.39x | $60.65 | $427.7K | 12.4K | 8.2K |
| 2017 | $121.75 | $45.71 | 2.66x | $76.04 | $479.9K | 14.7K | 9.8K |
| 2018 | $130.81 | $46.32 | 2.82x | $84.49 | $537.3K | 15.2K | 9.9K |
| 2019 | $114.07 | $42.60 | 2.68x | $71.47 | $810.7K | 22.7K | 13.5K |
| 2020 | $103.56 | $43.48 | 2.38x | $60.08 | $790.4K | 22.4K | 11.6K |
| 2021 | $87.83 | $39.46 | 2.23x | $48.37 | $807.2K | 21.3K | 10.7K |
| 2022 | $98.30 | $43.82 | 2.24x | $54.48 | $694.5K | 15.9K | 9.3K |
| 2023 | $106.16 | $45.91 | 2.31x | $60.25 | $595.1K | 14.6K | 9.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 29.9K | $1.5M | $51.37 | 2.51x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 20.4K | $1.4M | $69.92 | 2.39x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 6.6K | $776.1K | $117.25 | 1.33x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 17.2K | $562.2K | $32.74 | 1.74x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.4K | $331.3K | $97.83 | 2.02x |
| 87426 | Coronavirus ag ia | 3.1K | $131.9K | $43.05 | 1.76x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 2.6K | $131.2K | $51.34 | 2.50x |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 749 | $114.8K | $153.24 | 1.09x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $74.8K | $66.09 | 2.93x |
| 36415 | Insertion of needle into vein for collection of blood sample | 19.9K | $69.1K | $3.47 | 4.32x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 654 | $62.5K | $95.49 | 2.60x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 376 | $62.2K | $165.34 | 1.42x |
| 86328 | Ia nfct ab sarscov2 covid19 | 1.2K | $56.5K | $45.23 | 1.66x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 323 | $53.6K | $165.85 | 1.33x |
| 93000 | Routine EKG using at least 12 leads including interpretation and report | 5.5K | $52.3K | $9.56 | 3.86x |
| 99211 | Established patient office or other outpatient visit, typically 5 minutes | 2.6K | $41.7K | $16.13 | 2.65x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 243 | $36.6K | $150.49 | 2.62x |
| 81002 | Urinalysis, manual test | 10.3K | $35.0K | $3.42 | 5.43x |
| 90674 | Vaccine for influenza for administration into muscle, 0.5 ml dosage | 1.2K | $29.6K | $25.11 | 1.19x |
| 87804 | Detection test for influenza virus | 1.4K | $22.5K | $16.27 | 2.79x |
This provider submits charges 2.25 times higher than what Medicare actually pays.
A markup ratio of 2.25x means for every $100 Medicare pays, this provider initially charges $225. 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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