Natalie Mondragon
Internal Medicine Physician · Houston, TX 77030 · NPI 1215432216
64%of Medicare
BCBSTX pays Natalie Mondragon $61.45 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston internal medicine physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $61.45 | $96.33 | 64% | above 50% of 1,057 Houston internal medicine physicians |
| 99214Office visit, established patient, moderate complexity | $130.73 | $137.41 | 95% | above 69% of 1,057 Houston internal medicine physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by internal medicine 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 Natalie Mondragon performs these services, and they are kept out of the benchmark above.