This provider averages 127 services per working day
Based on 318.5K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Averaging 127 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 993% from 2014 to 2023.
69% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 4176% in 2023
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 | $139.63 | $65.95 | 2.12x | $73.68 | $312.9K | 4.7K | 15 |
| 2015 | $146.37 | $70.01 | 2.09x | $76.36 | $307.1K | 4.4K | 16 |
| 2016 | $134.41 | $74.05 | 1.82x | $60.36 | $239.9K | 3.2K | 13 |
| 2017 | $121.19 | $69.99 | 1.73x | $51.20 | $255.2K | 3.6K | 7 |
| 2018 | $96.83 | $53.16 | 1.82x | $43.67 | $161.2K | 3.0K | 9 |
| 2019 | $91.28 | $50.86 | 1.79x | $40.42 | $102.9K | 2.0K | 8 |
| 2020 | $93.03 | $50.75 | 1.83x | $42.28 | $100.1K | 2.0K | 13 |
| 2021 | $90.81 | $49.84 | 1.82x | $40.97 | $64.5K | 1.3K | 5 |
| 2022 | $26.81 | $16.60 | 1.62x | $10.21 | $80.0K | 4.8K | 9 |
| 2023 | $12.21 | $11.82 | 1.03x | $0.39 | $3.4M | 289.3K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 292.8K | $3.4M | $11.76 | 1.02x |
| 99308 | Follow-up nursing facility visit per day, typically 15 minutes | 7.7K | $393.0K | $50.82 | 1.77x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 6.5K | $357.1K | $54.77 | 2.20x |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 5.0K | $339.3K | $67.41 | 1.78x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 665 | $101.3K | $152.32 | 1.91x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 780 | $61.6K | $79.02 | 2.28x |
| 99239 | Hospital discharge day management, more than 30 minutes | 753 | $61.4K | $81.58 | 1.68x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 431 | $43.9K | $101.84 | 1.62x |
| 99306 | Initial nursing facility visit, typically 45 minutes per day | 327 | $41.4K | $126.70 | 1.66x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 323 | $33.1K | $102.59 | 2.30x |
| 99305 | Initial nursing facility visit per day, typically 35 minutes | 298 | $29.1K | $97.72 | 1.69x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 234 | $23.0K | $98.21 | 2.29x |
| 99220 | Hospital observation care typically 70 minutes per day | 121 | $17.0K | $140.36 | 1.92x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 500 | $16.8K | $33.55 | 1.79x |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 307 | $9.7K | $31.51 | 2.61x |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 245 | $9.5K | $38.87 | 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 | 255 | $9.5K | $37.26 | 2.50x |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 164 | $8.1K | $49.50 | 2.46x |
| 99318 | Nursing facility annual assessment, typically 30 minutes | 100 | $7.2K | $72.23 | 2.46x |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 147 | $6.2K | $42.12 | 2.58x |
This provider submits charges 1.31 times higher than what Medicare actually pays.
A markup ratio of 1.31x means for every $100 Medicare pays, this provider initially charges $131. This is lower 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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