BLUESTONE HEALTH ASSOCIATION, INC.

$1.79M

Total Medicaid Paid

48,769

Total Claims

44,177

Beneficiaries

48

Codes Billed

2018-01

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic service	17,926	15,941	$1.63M
99213		12,321	11,162	$100K
99212		1,246	1,160	$9K
G0467	Fqhc visit, estab pt	4,409	3,800	$6K
3008F		1,851	1,777	$6K
1111F		1,216	1,148	$4K
1160F		1,450	1,376	$4K
3074F		1,010	976	$3K
36415		293	267	$3K
3078F		824	795	$3K
90837		200	172	$3K
1031F		524	505	$3K
1159F		1,292	1,226	$2K
90853		166	145	$2K
1033F		153	147	$2K
96372		269	240	$2K
99203		103	99	$2K
99214		833	743	$2K
90471		274	262	$2K
87804		148	132	$1K
G0511	Ccm/bhi by rhc/fqhc 20min mo	169	167	$1K
87880		83	68	$794.64
90686		110	107	$655.20
3725F		28	28	$375.76
3079F		244	239	$356.82
99408		25	25	$187.88
1034F		91	85	$93.94
4000F		271	252	$93.94
99211		35	32	$79.39
81025		20	12	$68.99
81001		24	21	$32.79
J1885	Ketorolac tromethamine inj	25	22	$19.66
J0696	Ceftriaxone sodium injection	18	15	$7.48
J1100	Dexamethasone sodium phos	53	51	$6.52
1032F		81	76	$0.00
3077F		17	14	$0.00
87811		20	20	$0.00
90832		87	77	$0.00
80305		338	300	$0.00
1090F		26	23	$0.00
Q2039	Influenza virus vaccine, nos	16	16	$0.00
3351F		204	192	$0.00
96127		21	20	$0.00
3075F		89	88	$0.00
H0049	Alcohol/drug screening	64	55	$0.00
1101F		39	36	$0.00
G0008	Admin influenza virus vac	16	16	$0.00
99406		47	47	$0.00

Medicaid Provider Spending