Paul Raymond, D.C.
Occupational Health Chiropractor · Houston, TX 77031 · NPI 1457348997
29%of Medicare
BCBSTX pays Paul Raymond, D.C. $28.20 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 occupational health chiropractors |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $28.20 | $96.33 | 29% | above 0% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $59.99 | $137.41 | 44% | above 11% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $252.85 | $317.92 | 80% | not typically billed by occupational health chiropractors |
| 72148MRI lumbar spine, without contrast | $151.55 | $192.38 | 79% | not typically billed by occupational health chiropractors |
| 77067Screening mammography, bilateral | $28.12 | $126.38 | 22% | not typically billed by occupational health chiropractors |
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 Paul Raymond, D.C. performs these services, and they are kept out of the benchmark above.