This provider's $6.7M in total Medicare payments ranks in the 99th percentile of Internal Medicine providers nationally.
Their average markup ratio of 11.31x is significantly above the specialty median of 2.9x.
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 | $1.3K | $71.25 | 18.76x | $1.3K | $676.5K | 10.6K | 6.2K |
| 2015 | $1.3K | $74.65 | 17.63x | $1.2K | $798.6K | 13.2K | 7.2K |
| 2016 | $1.0K | $71.70 | 14.34x | $956.43 | $723.9K | 12.5K | 7.1K |
| 2017 | $988.25 | $63.61 | 15.54x | $924.64 | $613.9K | 11.5K | 6.5K |
| 2018 | $868.40 | $59.53 | 14.59x | $808.87 | $660.8K | 11.5K | 6.5K |
| 2019 | $949.90 | $72.57 | 13.09x | $877.33 | $667.1K | 10.1K | 5.6K |
| 2020 | $1.1K | $75.73 | 14.91x | $1.1K | $582.2K | 8.8K | 4.6K |
| 2021 | $399.45 | $80.35 | 4.97x | $319.10 | $600.5K | 8.4K | 4.5K |
| 2022 | $324.61 | $73.33 | 4.43x | $251.28 | $676.4K | 10.3K | 5.5K |
| 2023 | $300.54 | $75.62 | 3.97x | $224.92 | $670.0K | 9.5K | 5.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 16.8K | $1.2M | $73.84 | 11.81x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 6.1K | $917.5K | $149.55 | 9.94x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 7.0K | $393.4K | $55.87 | 10.29x |
| 99231 | Subsequent hospital inpatient care, typically 15 minutes per day | 12.5K | $387.1K | $30.89 | 11.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.3K | $369.3K | $50.37 | 14.15x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 1.9K | $330.0K | $169.34 | 9.39x |
| 99238 | Hospital discharge day management, 30 minutes or less | 4.7K | $266.3K | $56.57 | 9.59x |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 2.2K | $248.7K | $114.66 | 2.14x |
| G0181 | Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of c | 2.8K | $225.4K | $80.65 | 14.77x |
| 93306 | Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function | 1.9K | $201.8K | $106.21 | 13.44x |
| 99239 | Hospital discharge day management, more than 30 minutes | 2.1K | $169.2K | $81.73 | 11.53x |
| 99220 | Hospital observation care typically 70 minutes per day | 1.2K | $167.2K | $137.84 | 17.47x |
| 93880 | Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck | 1.3K | $144.0K | $112.93 | 16.87x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 2.8K | $140.1K | $50.42 | 9.79x |
| 99236 | Hospital observation or inpatient care high severity, 55 minutes per day | 596 | $98.0K | $164.47 | 13.51x |
| 99496 | Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge | 529 | $94.7K | $179.07 | 5.65x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 528 | $84.3K | $159.71 | 1.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 709 | $69.0K | $97.31 | 14.62x |
| 96374 | Injection of drug or substance into a vein for therapy, diagnosis, or prevention | 2.0K | $67.8K | $33.98 | 15.62x |
| 99217 | Hospital observation care discharge | 1.2K | $65.8K | $55.11 | 19.23x |
This provider submits charges 11.31 times higher than what Medicare actually pays.
A markup ratio of 11.31x means for every $100 Medicare pays, this provider initially charges $1131. 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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