Jenny Jiyoung Scaparra, PHARMD
Pharmacist · Houston, TX 77002 · NPI 1730558818 · 1 payer file
190%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Jenny Jiyoung Scaparra, PHARMD $183.05 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 12 contract rows for this clinician and code, from $132.80 to $194.01; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pharmacists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $183.05median of 12 rows · $132.80–$194.01 | $96.33 | 190% | above 91% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $228.00median of 8 rows · $196.42–$259.57 | $137.41 | 166% | above 92% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston pharmacists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $152.50median of 8 rows · $130.72–$174.29 | $82.68 | 184% | not typically billed by pharmacists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $285.29median of 8 rows · $244.54–$326.04 | $138.62 | 206% | not typically billed by pharmacists |
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 Jenny Jiyoung Scaparra, PHARMD performs these services, and they are kept out of the benchmark above.