Anthony Igbadumhe
Hospitalist Physician · Houston, TX 77030 · NPI 1205210739 · 1 payer file
75%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Anthony Igbadumhe $72.04 for a 99213 — Office visit, established patient, low complexity. Medicare pays $96.33 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare. The file lists 80 contract rows for this clinician and code, from $61.45 to $92.56; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospitalist physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $72.04median of 80 rows · $61.45–$92.56 | $96.33 | 75% | above 22% of 304 Houston hospitalist physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $107.29median of 80 rows · $89.93–$137.83 | $137.41 | 78% | above 29% of 304 Houston hospitalist physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hospitalist physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $65.34median of 12 rows · $57.64–$76.87 | $82.68 | 79% | not typically billed by hospitalist physicians |
A payer’s file carries a rate for every code in the contract’s fee class, whether or not the clinician will ever bill it. These rows are real, and they are how the fee class shows through — but they are not evidence that Anthony Igbadumhe performs these services, and they are kept out of the benchmark above.