Zahra Malik
Primary Care Nurse Practitioner · Houston, TX 77049 · NPI 1417520537 · 1 payer file
61%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Zahra Malik $58.95 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 90 contract rows for this clinician and code, from $45.85 to $81.59; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston primary care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $58.95median of 90 rows · $45.85–$81.59 | $96.33 | 61% | above 12% of 34 Houston primary care nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $88.78median of 90 rows · $67.55–$118.37 | $137.41 | 65% | above 32% of 35 Houston primary care nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston primary care nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $55.81median of 36 rows · $49.24–$66.55 | $82.68 | 68% | not typically billed by primary care nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $98.26median of 24 rows · $86.70–$115.61 | $138.62 | 71% | not typically billed by primary care nurse practitioners |
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 Zahra Malik performs these services, and they are kept out of the benchmark above.