Mallory Cook
Acute Care Nurse Practitioner · Houston, TX 77030 · NPI 1730781907
54%of Medicare
BCBSTX pays Mallory Cook $51.98 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 acute care nurse practitioners |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 82% of 485 Houston acute care nurse practitioners |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 3% of 484 Houston acute care nurse practitioners |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by acute 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 Mallory Cook performs these services, and they are kept out of the benchmark above.