Sylvie EL Hage, O.D.
Optometrist · Houston, TX 77056 · NPI 1801287727
44%of Medicare
BCBSTX pays Sylvie EL Hage, O.D. $42.66 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 optometrists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $42.66 | $96.33 | 44% | above 0% of 476 Houston optometrists |
| 99214Office visit, established patient, moderate complexity | $65.75 | $137.41 | 48% | above 0% of 476 Houston optometrists |
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 optometrists |
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 Sylvie EL Hage, O.D. performs these services, and they are kept out of the benchmark above.