Dalya Elhady, M.D.
Pain Medicine (Anesthesiology) Physician · Houston, TX 77098 · NPI 1871970814
84%of Medicare
BCBSTX pays Dalya Elhady, M.D. $80.69 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 pain medicine (anesthesiology) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $80.69 | $96.33 | 84% | above 74% of 44 Houston pain medicine (anesthesiology) physicians |
| 99214Office visit, established patient, moderate complexity | $118.20 | $137.41 | 86% | above 81% of 44 Houston pain medicine (anesthesiology) physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 72148MRI lumbar spine, without contrast | $390.50 | $192.38 | 203% | not typically billed by pain medicine (anesthesiology) physicians |
| 74177CT abdomen and pelvis, with contrast | $390.50 | $300.72 | 130% | not typically billed by pain medicine (anesthesiology) physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by pain medicine (anesthesiology) physicians |
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 Dalya Elhady, M.D. performs these services, and they are kept out of the benchmark above.