Sebastian Ochoa Gonzalez, M.D.
Allergy & Immunology (Internal Medicine) Physician · Houston, TX 77030 · NPI 1356736763
121%of Medicare
BCBSTX pays Sebastian Ochoa Gonzalez, M.D. $116.53 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 allergy & immunology (internal medicine) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $116.53 | $96.33 | 121% | above 94% of 17 Houston allergy & immunology (internal medicine) physicians |
| 99214Office visit, established patient, moderate complexity | $123.69 | $137.41 | 90% | above 69% of 17 Houston allergy & immunology (internal medicine) physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by allergy & immunology (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 Sebastian Ochoa Gonzalez, M.D. performs these services, and they are kept out of the benchmark above.