This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
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 | $212.85 | $63.25 | 3.37x | $149.60 | $369.4K | 6.8K | 2.8K |
| 2015 | $199.56 | $59.40 | 3.36x | $140.16 | $418.2K | 7.5K | 3.0K |
| 2016 | $214.41 | $47.75 | 4.49x | $166.66 | $488.7K | 12.6K | 6.6K |
| 2017 | $209.53 | $50.24 | 4.17x | $159.29 | $499.9K | 14.7K | 7.5K |
| 2018 | $186.18 | $35.97 | 5.18x | $150.21 | $487.1K | 15.9K | 8.5K |
| 2019 | $213.18 | $42.47 | 5.02x | $170.71 | $451.8K | 13.9K | 7.8K |
| 2020 | $176.41 | $41.14 | 4.29x | $135.27 | $396.0K | 11.5K | 6.9K |
| 2021 | $174.42 | $43.87 | 3.98x | $130.55 | $403.6K | 12.0K | 6.9K |
| 2022 | $142.58 | $38.88 | 3.67x | $103.70 | $375.6K | 12.7K | 6.9K |
| 2023 | $270.61 | $45.04 | 6.01x | $225.57 | $362.9K | 10.9K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 21.8K | $1.2M | $56.73 | 3.12x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 9.5K | $755.0K | $79.48 | 3.32x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 3.5K | $181.4K | $51.80 | 3.02x |
| G0482 | Drug test def 15-21 classes | 664 | $127.2K | $191.57 | 5.02x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 622 | $112.2K | $180.31 | 2.31x |
| 80053 | Blood test, comprehensive group of blood chemicals | 8.2K | $95.4K | $11.61 | 8.50x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.9K | $91.6K | $31.90 | 3.28x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 713 | $82.6K | $115.85 | 3.35x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 1.4K | $78.4K | $55.75 | 3.97x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 8.7K | $76.1K | $8.78 | 11.82x |
| 93924 | Ultrasound study of arteries of both legs at rest and exercise | 564 | $70.0K | $124.12 | 2.21x |
| 82575 | Creatinine clearance measurement to test for kidney function | 6.3K | $62.2K | $9.87 | 10.50x |
| 99490 | Chronic care management services at least 20 minutes per calendar month | 2.0K | $60.3K | $29.91 | 3.34x |
| G0483 | Drug test def 22+ classes | 245 | $59.3K | $242.18 | 6.22x |
| 80307 | Testing for presence of drug | 841 | $52.8K | $62.74 | 13.80x |
| 99495 | Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge | 336 | $47.1K | $140.26 | 2.91x |
| G0008 | Administration of influenza virus vaccine | 2.1K | $46.9K | $22.18 | 1.85x |
| 87633 | Detection test for multiple types of respiratory virus | 108 | $45.4K | $419.93 | 2.26x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 382 | $43.7K | $114.37 | 1.60x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 279 | $43.0K | $154.14 | 2.88x |
This provider submits charges 4.27 times higher than what Medicare actually pays.
A markup ratio of 4.27x means for every $100 Medicare pays, this provider initially charges $427. 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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