Joshua Fullerton
Certified Registered Nurse Anesthetist · Houston, TX 77030 · NPI 1285171264
69%of Medicare
BCBSTX pays Joshua Fullerton $66.02 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 certified registered nurse anesthetists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $66.02 | $96.33 | 69% | above 31% of 970 Houston certified registered nurse anesthetists |
| 99214Office visit, established patient, moderate complexity | $140.45 | $137.41 | 102% | above 70% of 970 Houston certified registered nurse anesthetists |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 72148MRI lumbar spine, without contrast | $426.00 | $192.38 | 221% | not typically billed by certified registered nurse anesthetists |
| 74177CT abdomen and pelvis, with contrast | $426.00 | $300.72 | 142% | not typically billed by certified registered nurse anesthetists |
| 77067Screening mammography, bilateral | $161.89 | $126.38 | 128% | not typically billed by certified registered nurse anesthetists |
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 Joshua Fullerton performs these services, and they are kept out of the benchmark above.