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 1437508314)

Field	Value
Entity Type	Organization
Organization	Bluestone Health Association, Inc.
Address	324 Oakvale Rd Ste 12
City	Princeton
State	WV
ZIP	24740
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 10, 2016

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	16,600	$100	$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…	10,980	$10	$98.8K
3008F	No Summary found for this code	4,520	$10	$27.1K
1111F	No Summary found for this code	2,770	$10	$19.4K
1160F	No Summary found for this code	3,590	$10	$17.9K
1159F	No Summary found for this code	3,430	$10	$17.1K
1031F	The provider treats a patient who presents with a diagnosis of asthma. The provider interviews the patient or their primary care giver regarding tobacco use and exposure to secondhand smoke within…	2,140	$10	$17.1K
3074F	No Summary found for this code	2,540	$10	$15.3K
3078F	No Summary found for this code	2,070	$10	$14.5K
1033F	A provider determines that a patient who presents with a diagnosis of asthma does not use tobacco and has no exposure to a passive smoking environment. The provider then does not need to discuss…	1,000	$10	$10K

Showing 1–10 of 48

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. — 0 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	111	390	4,610	$130	$2.2M
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…	203	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…	632	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…	252	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…	72	80	2,480	$10	$112.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	200	330	790	$10	$64.1K
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…	67	100	940	$20	$62.4K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	157	200	490	$30	$57.7K
99203	The provider sees a new 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 provider…	218	440	110	$60	$57.2K
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,…	132	540	320	$20	$43.2K

Showing 1–10 of 48

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
Privia Medical Group, LLC	VA	Internal Medicine Physician	$0	$81.2M
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Robert Brennan	VA	Infectious Disease Physician	$15.9M	$0
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Adebowale Prest	MD	Family Medicine Physician	$2.8M	$0
Joseph Baisden	WV	Radiation Oncology Physician	$1.9M	$0
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
Enrico Giangeruso	VA	Anatomic Pathology & Clinical Pathology Physician	$1.4M	$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
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
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
Inas Al-attar	WV	Pediatric Infectious Diseases Physician	$0	$3.9M
Brandon M Lingenfelter Do Phd	WV	Obstetrics & Gynecology Physician	$0	$3.9M

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