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NPI 1033705934 · Toledo, OH · Ambulance
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Mercy Health - Life Flight Network LLC is a ambulance provider located in Toledo, Ohio. This profile covers 9 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Mercy Health - Life Flight Network LLC |
| Address | 2200 Jefferson Ave Fl 5b |
| City | Toledo |
| State | OH |
| ZIP | 43604 |
| Taxonomy | Ambulance |
| NPI Enumerated | December 15, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.3M |
| Medicaid | $3.2M |
The provider’s code mix is characteristic of a combined air-and-ground ambulance operator: high-revenue rotary wing transports (A0431) appear alongside very large ground-mileage billing (A0425) and both basic and advanced life support transports (A0428, A0427, A0426). Presence of A0436 (rotary wing air mileage) and A0434 (specialty care transport) further indicates a service line that supports long-distance air missions and higher-acuity interfacility transfers in addition to routine ground movements. This pattern suggests operational capability across both emergency air rescue and high-volume ground transport.
Medicare revenue is highly concentrated in three codes: A0431, A0425, and A0428 together account for 71.3% of the provider’s total Medicare revenue, with A0431 contributing 27.7%, A0425 25.1%, and A0428 18.5% individually. That concentration shows the business is driven primarily by rotary-wing air transports and extensive ground mileage plus routine BLS non-emergency trips under Medicare. Analysts should treat changes to these specific code lines as having outsized impact on Medicare revenue.
On Medicaid the top three codes (A0431, A0425, A0428) account for 60.6% of total Medicaid revenue, with individual shares of 22.5%, 20.3%, and 17.8% respectively. Medicaid revenue is slightly less concentrated than Medicare but follows the same service-line mix: air transport, high ground mileage, and BLS non-emergency work are the primary drivers. This mirrored mix across payers indicates consistent operational focus rather than payer-specific service variation.
Payer mix is effectively balanced: lifetime Medicare revenue is $3.3M while lifetime Medicaid revenue is $3.2M, putting this provider at near-parity between the two programs. Because both payers contribute similar scale-dollar revenue, payer-specific policy or network changes in either program could materially affect overall revenue and utilization mix.
Competitively this provider is an outlier on ground-mileage billing nationally for Medicare: A0425 ranks #108 of 8934 providers (99th percentile) and is labeled an "extreme outlier," indicating far higher-than-typical mileage volume versus national peers. The provider also shows unusually high national standing on ALS non-emergency Medicare billing: A0426 ranks #31 of 1568 (98th percentile) and is marked "notably above typical." At the same time, many other Medicare codes (for example A0431 at the 87th percentile and A0428 at the 92nd percentile) are within ranges described as typical or unremarkable, so the competitive strength is concentrated in specific service areas.
In-state competitive position on Medicaid is mixed: ground mileage (A0425) is strong within Ohio—rank #56 of 675 (92nd percentile)—while rotary-wing air transport (A0431) sits near the median of in-state peers at rank #8 of 15 (50th percentile). Basic life support non-emergency (A0428) is above median in-state (70th percentile) but not dominant, so the provider appears to be a significant Medicaid mileage provider while its air-transport share is middling among in-state ambulance services.
The provider exhibits explicit statistical flags that are operationally meaningful: the Medicare A0425 ground-mileage line is an "extreme outlier" in national volume and the Medicare A0426 ALS non-emergency line is "notably above typical." These labels point to unusually high utilization of mileage-based billing and above-typical ALS non-emergency activity compared with peers, and they should guide audit, pricing, and network-contracting attention toward those code families.
This entity has been enumerated since 2020-12-15 (~6 years ago) yet shows substantial lifetime activity (e.g., 116.7K Medicare claims billed for A0425 and 15.6K Medicaid claims billed for A0425), suggesting rapid scale-up or sustained high-volume operations in mileage-driven services over a relatively short tenure. Tenure-plus-volume profile means this is a mid‑life-cycle operator that already exerts material utilization impact in both Medicare and Medicaid within its service lines.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 200 | $4,540 | $898.5K |
| A0425 | Ground mileage, per statute mile | 116,660 | $10 | $816.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,090 | $200 | $601.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 760 | $380 | $288K |
| A0436 | Rotary wing air mileage, per statute mile | 8,860 | $30 | $274.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 850 | $240 | $204.5K |
| A0434 | Specialty care transport (sct) | 120 | $650 | $79.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 190 | $320 | $58.8K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $550 | $25.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 530 | $1,340 | $707.5K |
| A0425 | Ground mileage, per statute mile | 15,570 | $40 | $638.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 7,920 | $70 | $562K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,470 | $130 | $464.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,960 | $100 | $201.4K |
| A0436 | Rotary wing air mileage, per statute mile | 520 | $310 | $162.3K |
| A0130 | Non-emergency transportation: wheelchair van | 7,710 | $20 | $154.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,500 | $100 | $150.3K |
| S0209 | Wheelchair van, mileage, per mile | 7,710 | $10 | $77K |
| A0434 | Specialty care transport (sct) | 180 | $190 | $32.9K |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 8 | 20 | 530 | $2,040 | $2.6M |
| A0436 | Rotary wing air mileage, per statute mile | 6 | 20 | 270 | $520 | $618.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 39 | 130 | 3,720 | $50 | $544.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 91 | 510 | 1,080 | $120 | $365.4K |
| A0434 | Specialty care transport (sct) | 17 | 20 | 660 | $190 | $317.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 186 | 480 | 880 | $90 | $260K |
| A0130 | Non-emergency transportation: wheelchair van | 47 | 150 | 3,580 | $20 | $208K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 15 | 80 | 380 | $80 | $132.1K |
| A0425 | Ground mileage, per statute mile | 56 | 680 | 2,020 | $10 | $98.4K |
| S0209 | Wheelchair van, mileage, per mile | 47 | 150 | 3,580 | $10 | $73.5K |
Other providers in the same ZIP code as Mercy Health - Life Flight Network LLC, ranked by combined Medicare and Medicaid revenue.
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