Medicare Enrolled
Dr. George Manoukian, M.D.
Internal Medicine · Shenandoah, TX
Practice pattern: Remote & Electrophysiology
— Practice combining remote and electrophysiology services
Consulting-driven
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Manoukian from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Manoukian
Dr. George Manoukian is an internal medicine specialist in Shenandoah, TX, with 14 years of NPI registration. Based on federal Medicare data, Dr. Manoukian performed 1,615 Medicare services across 1,049 unique beneficiaries.
Between the years covered by Open Payments, Dr. Manoukian received a total of $235,494 from 26 pharmaceutical and/or device companies across 1519 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. The majority of payments are for consulting, which typically reflects recognized clinical expertise sought by manufacturers. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Manoukian is Very High — reflecting how much public federal data is available about this provider. This is not a quality rating. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 14 years in practice
▲ Top 23% volume in TX
$235,494 industry payments
Medicare Practice Summary
Medicare Utilization ↗1,615
Medicare services
Top 23% in TX for internal medicine
1,049
Unique beneficiaries
$141
Avg. Medicare payment
Medicare patients only (65+ / disabled) · Not a quality rating · How to read this →
~115 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
304 | $95 | $274 |
| Remote monitoring of implantable heart device, up to 30 days Remote evaluation of an implanted heart or blood vessel monitoring system over a period of up to 30 days. |
262 | $19 | $75 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
166 | $66 | $182 |
| Remote pacemaker monitoring, 90 days Remote assessment of a pacemaker system, including single, dual, multiple lead, or leadless devices, performed up to 90 days apart. |
94 | $22 | $125 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
83 | $128 | $430 |
| Remote evaluation of implantable defibrillator system Remote assessment of a single, dual, or multiple lead implantable defibrillator system within 90 days of the previous evaluation. |
81 | $28 | $205 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
79 | $133 | $350 |
| Heart rhythm stimulator programming after drug infusion Adjustment of a heart rhythm stimulation device following a drug infusion. This procedure involves reprogramming the device settings to ensure proper function after the medication has been administered. |
68 | $63 | $375 |
| Heart catheterization to identify abnormal heart rhythm A tube is inserted into the heart chambers to record electrical activity and locate the source of an irregular heartbeat. |
67 | $207 | $1,140 |
| Heart chamber tissue destruction via catheter A procedure that destroys tissue in the upper heart chamber using a tube to treat abnormal heart rhythm. |
60 | $236 | $825 |
| Atrial fibrillation ablation with pulmonary vein isolation A procedure to treat atrial fibrillation by mapping the heart's electrical activity and destroying tissue causing irregular contractions. This is done by isolating the pulmonary veins using catheter-based destruction. |
52 | $728 | $2,875 |
| Catheter ablation for abnormal heart rhythm A procedure where catheters are inserted to destroy tissue causing irregular heartbeats. |
49 | $232 | $1,250 |
| Sedation by physician, initial 15 minutes Administration of a drug to induce depression of consciousness by the physician performing a procedure. This code covers the initial 15 minutes of sedation for patients aged 5 years or older. |
49 | $10 | $150 |
| Ultrasound of heart blood vessels with radiologist review An ultrasound exam that evaluates blood vessels within the heart, including a review of the results by a radiologist. |
35 | $57 | $265 |
| 30-day continuous ECG with patient-triggered event transmission and review This procedure involves continuous electrocardiogram monitoring for up to 30 days, including the transmission of patient-triggered events. A healthcare professional reviews the data and provides a report. |
34 | $630 | $2,100 |
| Repair of left upper heart chamber with implant A surgical procedure to repair the left upper chamber of the heart using an implanted device, with review by a radiologist. |
24 | $593 | $5,000 |
| Continuous ECG monitoring, up to 30 days Continuous heart rhythm monitoring for up to 30 days, including professional review and reporting of the results. |
23 | $20 | $100 |
| Insertion of implantable defibrillator system A surgical procedure to place an implantable cardioverter-defibrillator (ICD) device into the body. The device is connected to the heart to monitor heart rhythm and deliver shocks if dangerous arrhythmias occur. |
20 | $708 | $2,700 |
| Radiofrequency ablation for supraventricular tachycardia A procedure to locate and destroy abnormal heart tissue in the upper chambers of the heart that causes a rapid heart rate. |
20 | $643 | $2,457 |
| Insertion of left lower heart electrode for pacemaker or defibrillator A procedure to place an electrode in the lower part of the left side of the heart. This electrode is used to connect a pacemaker or defibrillator to help regulate the heart's rhythm. |
15 | $355 | $1,343 |
| Permanent leadless pacemaker insertion A small, self-contained pacemaker is placed directly into the heart without using wires. The procedure is guided by imaging to ensure correct positioning. |
15 | $353 | $1,760 |
| Pacemaker programming, dual lead system Adjustment and configuration of a dual-lead pacemaker device to ensure proper operation and settings. |
15 | $29 | $112 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
34.4% high complexity
2.2% medium
63.4% routine
Industry Payment Transparency
Open Payments through 2024 ↗$235,494
Total received (2018-2024)
Avg $33,642/year across 7 years
Top 1% in TX for internal medicine
26
Companies
1,519
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Consulting
Expert advisory fees, typically reflecting recognized clinical expertise
$173,432 (73.6%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$32,869 (14.0%)
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$29,160 (12.4%)
Other
Charitable contributions, space rental, and other categories
$33 (0.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$109,415
2023
$54,598
2022
$29,127
2021
$10,363
2020
$4,118
2019
$7,588
2018
$20,285
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Abbott Laboratories
$175,387
Boston Scientific Corporation
$24,505
Biosense Webster, Inc.
$7,494
Medical Device Business Services, Inc.
$6,000
Medtronic, Inc.
$5,328
Impulse Dynamics (USA) Inc.
$4,648
BIOTRONIK INC.
$4,635
SANOFI-AVENTIS U.S. LLC
$3,701
BOSTON SCIENTIFIC CORPORATION
$1,040
Medtronic Vascular, Inc.
$989
CARDIVA MEDICAL, INC.
$521
Janssen Pharmaceuticals, Inc
$427
Baxter Healthcare
$154
iRhythm Technologies, Inc.
$137
Boehringer Ingelheim Pharmaceuticals, Inc.
$91
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$83
ABIOMED
$70
Kestra Medical Technology Services, Inc.
$69
G Medical Diagnostic Services, Inc.
$47
Aziyo Biologics, Inc.
$38
Stryker Corporation
$29
Bardy Diagnostics, Inc.
$27
Terumo Medical Corporation
$23
Itamar Medical Inc
$22
Lundbeck LLC
$15
Amgen Inc.
$12
Top 3 companies account for 88.1% of total payments
Associated products mentioned in payments ›
ADVISOR · AGILIS · AGILIS HISPRO · ALLURE QUADRA · AMPLATZER · AMPLATZER AMULET · AMPLATZER Occluders · AMPLATZER TORQVUE 45 X 45 · AMPLATZER TorqVue Delivery Systm · ASSURITY · AVEIR · Ablation Therapy Hardware · Accent Pacemaker · Advisor Catheter · Agilis NxT EP Introducer · Ampere RF Ablation Generator · Assure WCD · Assurity Pacemaker · BRK EP Transseptal Access · BodyGuardian · CARDIVA VASCADE 5F VCS · CARDIVA VASCADE MVP VVCS 6-12F · CARTO 3 · CONFIDENCE · CONFIRM RX · CRT-Ds · Cardiac Mapping System · Cardiac Monitoring Suite · CareLink · Carnation Ambulatory Monitor · Carto 3 · Carto 3 System · Carto Smarttouch · CartoSound · Cartoreplay · Claria MRI · Confidense · Confirm Rx · Connectivity and Remote care · Cool Point Irrigation Pump · Corlanor · DURATA · DecaNav · Durata Defibrillation ICD Lead · DxTerity · ECM · EMBLEM · EMBOSHIELD NAV6 · ENSITE · ENSITE PRECISION · EP Guiding Introducers · EP Transseptal Access · EP-4 Cardiac Stimulator · EP-WORKMATE · EP-WorkMate Claris System · EP-WorkMate Recording System · Ellipse ICD · EnSite Precision Cardiac Mapping System · EnSite Velocity System Expansion Modules · EnSite X · Ensite Cardiac Mapping System · FLEXABILITY · FlexAbility Ablation Catheter · Fortify Assura · GALLANT · GENERAL THERAPIES · General - Vascular Access · HeartMate 3 Left Ventricular Assist Device · Hillrom - Carnation Ambulatory Monitor · ICDs · Impella · Inquiry EP Diagnostic Catheters · Inquiry Steerable Catheters · Intracardiac Echocardiography (ICE) · Irrigated Ablation Catheters · JARDIANCE · JETI ALL IN ONE NON-STERILE KIT · JOT DX · LifeVest · Livewire Ablation Catheter · MERLIN@HOME · MICRA · MRI Ready Leads · MULTAQ · Merlin Connectivity and Remote · Micra · NA · NORTHERA · OCTARAY MAPPING CATHETER · OPTIMIZER · Optimizer · Optimizer Smart System · Pacing Leads · Pentaray · Pentaray Nav · QDOT MICRO Catheter · QUADRA ASSURA · QUARTET · Quadra Allure MP RF CRT Pacemkr · Quadra Assura CRT Defibrillator · Quartet CRT Lead · Quattrode Leads SCS Leads · REPROCESSED EP CATHETERS · Radiofrequency Therapy · Reflexion Circular Mapping Cath · Reveal LINQ · SELECTSECURE · SENSOR ENABLED · SYNERGY · Safire Ablation Catheter · SmartAblateTM System RF Generator · Smartablate · Soundstar · TACTICATH · TACTICATH ABLATION CATHETER · TENDRIL · TactiCath Quartz CFA Catheter · VADO · VALITUDE · VANTAGEVIEW · VIEWMATE · ViewFlex Xtra ICE Catheter · ViewMate Intracardiac Echo · Visia AF · WATCHMAN · WATCHMAN Access System · WATCHMAN FLX · WORKMATE CLARIS · WatchPAT · XARELTO · ZIO Patch · ZIO XT Patch · Zio monitor
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
The majority of payments (74%) are consulting fees, which typically reflect recognized clinical expertise sought by manufacturers. Total industry engagement is in the top 1% for internal medicine in TX.
Equivalent to $14,582 per 100 Medicare services performed
Geographic Context
Internal medicine physicians within 10 mi
711
Per 100K population
108.6
County median income
$97,266
Nearest hospital
HOUSTON METHODIST THE WOODLANDS HOSPITAL
4.2 mi
4.2 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This measures how much public data is available about a provider — not how good they are. How we calculate this →
Summary
Dr. Manoukian is a remote & electrophysiology specialist, with above-average Medicare volume (top 23% in TX), with consulting-driven industry engagement in the top 1% of TX peers.
This summary is auto-generated from federal data. It describes data availability and patterns — not clinical quality. Read our methodology →
Frequently Asked Questions
Is Dr. Manoukian experienced with office visit, established patient (30-39 min)?
Based on Medicare claims data, Dr. Manoukian performed 304 office visit, established patient (30-39 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Manoukian receive payments from pharmaceutical companies?
Yes. Dr. Manoukian received a total of $235,494 from 26 companies across 1,519 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Manoukian's costs compare to other internal medicine physicians in Shenandoah?
Dr. Manoukian's average Medicare payment per service is $141. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Manoukian) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. The Transparency Score measures data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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