Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or West Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to West Virginia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. West Virginia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Bluestone Health Association, Inc. (NPI 1346266848)

Field	Value
Entity Type	Organization
Organization	Bluestone Health Association, Inc.
Address	3997 Beckley Rd
City	Princeton
State	WV
ZIP	24740
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 15, 2006

Payer Source	Total Paid
Medicaid	$12.1M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

102 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	100,830	$110	$11.4M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	61,200	$10	$306K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	3,940	$10	$39.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	9,430	$1	$37.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,090	$20	$25.1K
1111F	No Summary found for this code	11,460	$1	$22.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	10,890	$1	$21.8K
3074F	No Summary found for this code	10,760	$1	$21.5K
3008F	No Summary found for this code	21,250	$1	$21.2K
3078F	No Summary found for this code	8,820	$1	$17.6K

Showing 1–10 of 102

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. West Virginia Distribution

Bluestone Health Association, Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

102 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	7	390	4,610	$130	$2.2M
H0038	Self‑help/peer services, per 15 minutes	52	60	3,310	$110	$1.6M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	19	1,270	1,240	$30	$245K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	89	1,030	890	$50	$221K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	134	310	740	$80	$178.2K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	65	80	2,480	$10	$112.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	124	140	1,090	$20	$104.5K
Q3014	Telehealth originating site facility fee	76	80	580	$20	$104.1K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	290	340	140	$90	$97.5K
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	67	70	1,910	$10	$77K

Showing 1–10 of 102

Related Providers

Other providers that share a Tax Identification Number (TIN) with Bluestone Health Association, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.8M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
Randy Brodnik	WV	Obstetrics & Gynecology Physician	$7.2K	$26.5K
Jenine Ward	WV	Nurse Practitioner	$230	$0

Nearby Providers

Other providers in the same ZIP code as Bluestone Health Association, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Southern Highlands Community Mental Health Center, Inc.	WV	Community/Behavioral Health Agency	$0	$44.2M
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M
Bluefield Gastroenterology PLLC	WV	Specialist	$0	$4M

Bluestone Health Association, Inc. — Billing Profile & Reimbursement Data

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Bluestone Health Association, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References