This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Medicare payments to this provider grew 414% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 55% in 2016
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 | $176.10 | $91.48 | 1.93x | $84.62 | $177.3K | 2.5K | 1.4K |
| 2015 | $232.26 | $98.09 | 2.37x | $134.17 | $238.0K | 3.4K | 1.5K |
| 2016 | $250.49 | $93.83 | 2.67x | $156.66 | $369.5K | 5.5K | 2.2K |
| 2017 | $268.80 | $94.74 | 2.84x | $174.06 | $339.6K | 4.4K | 2.4K |
| 2018 | $268.01 | $109.16 | 2.46x | $158.85 | $495.4K | 5.5K | 3.2K |
| 2019 | $258.99 | $91.65 | 2.83x | $167.34 | $713.6K | 9.0K | 4.4K |
| 2020 | $259.34 | $99.53 | 2.61x | $159.81 | $899.0K | 10.9K | 4.9K |
| 2021 | $237.75 | $90.26 | 2.63x | $147.49 | $820.1K | 9.8K | 4.3K |
| 2022 | $254.34 | $96.84 | 2.63x | $157.50 | $813.6K | 9.8K | 4.3K |
| 2023 | $257.16 | $100.09 | 2.57x | $157.07 | $910.9K | 10.5K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 32.3K | $1.9M | $58.89 | 2.54x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 14.9K | $1.3M | $85.85 | 2.51x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 5.5K | $862.7K | $156.08 | 2.67x |
| 99239 | Hospital discharge day management, more than 30 minutes | 5.0K | $435.7K | $87.59 | 2.53x |
| 99220 | Hospital observation care typically 70 minutes per day | 2.1K | $312.7K | $146.26 | 2.60x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 2.8K | $306.7K | $108.05 | 2.59x |
| 99497 | Advance care planning by the physician or other qualified health care professional | 2.3K | $148.3K | $65.40 | 2.52x |
| 99236 | Hospital observation or inpatient care high severity, 55 minutes per day | 531 | $90.2K | $169.85 | 2.57x |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.4K | $81.0K | $58.70 | 2.55x |
| 99225 | Subsequent observation care, typically 25 minutes per day | 1.1K | $63.2K | $57.98 | 2.71x |
| 99219 | Hospital observation care typically 50 minutes | 571 | $60.4K | $105.76 | 2.64x |
| 99217 | Hospital observation care discharge | 1.0K | $58.6K | $57.67 | 2.71x |
| 99284 | Emergency department visit, problem of high severity | 373 | $35.5K | $95.28 | 2.72x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 345 | $26.8K | $77.81 | 2.85x |
| 99235 | Hospital observation or inpatient care moderate severity, 50 minutes per day' | 195 | $26.0K | $133.45 | 2.56x |
| 99285 | Emergency department visit for life threatening or functioning severity | 146 | $20.6K | $140.97 | 2.14x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 112 | $20.4K | $182.20 | 2.40x |
| 99226 | Subsequent observation care, typically 35 minutes per day | 246 | $20.1K | $81.54 | 2.69x |
| 99356 | Prolonged inpatient or observation hospital service first hour | 140 | $10.6K | $75.53 | 2.50x |
| 99358 | Prolonged patient service without direct patient contact first hour | 44 | $4.0K | $90.01 | 2.55x |
This provider submits charges 2.56 times higher than what Medicare actually pays.
A markup ratio of 2.56x means for every $100 Medicare pays, this provider initially charges $256. 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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