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 Nebraska for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nebraska 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. Nebraska (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.

Bluestem Health (NPI 1932156114)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bluestem Health
Address	1021 N 27th St
City	Lincoln
State	NE
ZIP	68503
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$12.6M
Medicare	$0

BLUESTEM HEALTH is effectively a Medicaid-centered operation: there is no Medicare billing on file and reported lifetime Medicaid revenue is $12.6M, so payer mix is single-payer in practice and the organization’s financial footprint is driven almost exclusively by Medicaid activity. This concentration will shape contracting and utilization analyses because Medicare-based benchmarks are not available for cross-payer comparison.

Revenue is highly concentrated in three codes: the precomputed top-3 codes account for 87.5% of this provider’s total Medicaid revenue, led by T1015 ($4.9M, 40.1%), 99213 ($3.6M, 29.5%), and 99214 ($2.2M, 18.0%). This concentration indicates that a very small set of encounter and E/M services drive the vast majority of billed Medicaid dollars and should be the focus for any revenue-risk or reimbursement-negotiation work.

The code mix and FQHC taxonomy indicate a primary-care–centric, comprehensive clinic model: T1015 (clinic visit/encounter, all-inclusive) is the single largest revenue line and the high volumes of 99213 and 99214 reflect routine established-patient E/M work. Complementary codes such as preventive visits for children and adults (99392, 99393, 99391, 99396), vaccines (90686, 90471), and chronic-care management (G0511) further support an integrated primary care and population-health service line typical of a Federally Qualified Health Center.

Competitive standing is mixed by code: BLUESTEM ranks #3 of 44 for T1015 (95th percentile) and is described as notably above typical state volume for that code, which positions the provider as a leading FQHC-level clinic for bundled visits in-state. By contrast, 99213 (rank #20 of 696, 97th percentile) and 99214 (rank #29 of 596, 95th percentile) are high-volume but characterized as typical, unremarkable volumes for those E/M codes, so the provider is a strong but not uniquely dominant statewide player on routine office E/M services.

Service diversification beyond core E/M is evident in dental, behavioral health, and ancillary diagnostics. High claim counts and elevated in-state ranks for dental codes (D1206: 11.7K claims, rank 14 of 317, 96th percentile; D2391: 2.7K claims, rank 8 of 118, 94th percentile) and routine dental prophylaxis and evaluations (D1120, D0120) show a sizeable dental program, while psychotherapy codes (90837, 90834, 90832) and G0511 (2K claims, $85.2K, rank #1 of 5, 100th percentile) indicate embedded behavioral-health and chronic-care management services.

BLUESTEM demonstrates substantial vaccination and respiratory testing throughput: 90471 appears as an extreme outlier with 18.2K claims (98th percentile, far above typical state volume), and 90686 records 8.3K claims ($107.7K). Multiplex respiratory testing and COVID/influenza assays (87637: 680 claims, rank #3 of 20; 87428: 1.6K claims, rank #4 of 35) further show operational capacity for high-volume immunization campaigns and on-site infectious-disease testing.

The provider has an established operational tenure: NPI was enumerated on 2006-05-31 (~20 years ago), signaling long-term presence in the market. Given that longevity together with the concentrated Medicaid revenue base and top-code rankings, BLUESTEM is a longstanding, Medicaid-focused FQHC with strong local penetration on bundled clinic encounters and broad primary-care service lines that include pediatric and dental care.

Medicaid: Complete Services Breakdown

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

97 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	42,710	$110	$4.9M
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…	21,570	$170	$3.6M
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…	13,520	$160	$2.2M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,450	$90	$127.2K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	8,280	$10	$107.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	770	$140	$104.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,310	$80	$102.2K
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…	640	$150	$96.5K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	1,980	$40	$85.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	570	$150	$83.2K

Showing 1–10 of 97

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Bluestem Health — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

97 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	40	1,930	$230	$2.3M
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…	20	700	660	$70	$305.1K
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…	29	600	610	$70	$251.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22	70	360	$80	$234.7K
D1355	N/A	2	10	19,550	$10	$226.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	18	70	230	$90	$222.7K
90834	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…	254	510	450	$100	$168.1K
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…	208	510	440	$140	$155.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	3	20	50	$140	$102.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12	70	100	$100	$100.9K

Showing 1–10 of 97

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centerpointe, Inc.	NE	Addiction (Substance Use Disorder) Counselor	$0	$4.3M
Tr Hepburn Inc	NE	Assisted Living Facility (Mental Illness)	$0	$3.7M
Heartland Optical Inc.	NE	Optometrist	$0	$3.5M
Lincoln Endoscopy Center, LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$612.5K
Centerpointe, Inc.	NE	Mental Illness Community Based Residential Treatment Facility	$0	$2.1M
Renal Treatment Centers-illinois Inc.	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$970.8K
Gastroenterology Specialties, P.C.	NE	Specialist	$0	$960.3K
Youniq Health LLC	NE	Psychiatric/Mental Health Nurse Practitioner	$0	$804.4K
Gregory Utecht	NE	Dentist	$0	$527.9K
Nebraska Specialty Network, LLC	NE	Cardiovascular Disease Physician	$0	$361.2K

Bluestem Health — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$6.8M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$3.6M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$1.3M