Sairah Malik, O.D
Corneal and Contact Management Optometrist · Houston, TX 77027 · NPI 1992866909
44%of Medicare
BCBSTX pays Sairah Malik, 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 corneal and contact management optometrists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $42.66 | $96.33 | 44% | above 13% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $65.75 | $137.41 | 48% | above 13% 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 corneal and contact management 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 Sairah Malik, O.D performs these services, and they are kept out of the benchmark above.