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NPI 1114193844 · Smithfield, NC · Land Ambulance
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Johnston County is a land ambulance provider located in Smithfield, North Carolina. This profile covers 5 Medicare and 6 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 | Johnston County |
| Address | 120 South Third Street |
| City | Smithfield |
| State | NC |
| ZIP | 27577 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | May 2, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.9M |
| Medicare | $2.4M |
JOHNSTON COUNTY operates as a front-line ambulance provider focused on emergency transport services, as reflected by its revenue mix concentrated in ambulance transport and mileage codes: A0427 (advanced life support, emergency transport), A0425 (ground mileage), and A0429 (basic life support, emergency transport). The presence of high-volume ALS and mileage codes on both payers indicates routine emergency response and long-run transport activity rather than sporadic or non-transport services in SMITHFIELD, NC.
Medicare revenue is concentrated in a very small set of services: the precomputed top 3 Medicare codes account for 97.3% of this provider's total Medicare revenue. In particular A0427 generated $1.6M (65.4% of Medicare revenue) across 4.1K claims, A0425 produced $504.1K (21.1%) across 63K claims, and A0429 produced $259.7K (10.9%) across 814 claims, indicating near-total reliance on these transport-related codes for Medicare billing.
Medicaid revenue is even more concentrated, with the precomputed top 3 Medicaid codes accounting for 99.1% of this provider's total Medicaid revenue. A0427 dominates Medicaid billing with $5.9M (73.8% of Medicaid revenue) over 34.1K claims, followed by A0429 at $1.9M (23.7%) and A0425 at $131.6K (1.7%), which shows the provider’s Medicaid business is overwhelmingly driven by emergency ALS and BLS transports.
The payer mix is Medicaid-dominant in scale: total Medicaid revenue of $7.9M substantially exceeds total Medicare revenue of $2.4M, so Medicaid patients and contracts are the principal revenue source for the entity. This imbalance implies strategic exposure to state program rules and reimbursement trends more than to Medicare policy shifts.
On competitive standing for Medicare, the provider is a high-volume national outlier for several transport codes: A0427 ranks #163 of 6841 providers (98th percentile) and A0425 ranks #289 of 8934 providers (97th percentile), both described as notably above typical national volume. By contrast, its Medicare A0429 volume (rank #673 of 7808, 91th percentile) is characterized as typical and unremarkable, so the provider’s national prominence is concentrated specifically in ALS emergency transports and mileage reporting.
Within North Carolina Medicaid comparisons, A0427 ranks #9 of 168 providers (95th percentile) yet is labeled typical/unremarkable in the dataset’s language, while A0429 and A0425 sit at #19 of 144 (87th percentile) and #18 of 222 (92th percentile) respectively, each described as typical. Those in-state rankings show the provider is among the larger Medicaid ambulance billers for core transport services, even though the qualitative labels provided treat volumes as generally within expected operational ranges.
Operationally, the extraordinarily high claim counts for mileage on Medicare (A0425 at 63K claims) alongside large Medicaid mileage counts (26.3K claims) point to sustained, high-frequency ground transport activity and longer-distance or numerous short-mileage trips. This pattern, together with heavy A0427 utilization across both payers, suggests a business model centered on emergency response and frequent patient transports rather than ancillary or specialty non-transport services.
The NPI tenure (enumerated 2008-05-02, ~18 years ago) indicates a long-standing presence in the market, which, combined with the Medicaid-heavy revenue profile and high percentile ranks on key transport codes, suggests established operational scale and entrenched payer relationships that underpin its current billing patterns. Continued monitoring of ALS (A0427) and mileage (A0425) trends will be critical given their outsized contribution to revenue on both payers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,100 | $380 | $1.6M |
| A0425 | Ground mileage, per statute mile | 63,010 | $10 | $504.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 810 | $320 | $259.7K |
| A0433 | Advanced life support, level 2 (als 2) | 100 | $560 | $55K |
| A0434 | Specialty care transport (sct) | 10 | $660 | $8.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 34,140 | $170 | $5.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13,360 | $140 | $1.9M |
| A0425 | Ground mileage, per statute mile | 26,330 | $10 | $131.6K |
| A0433 | Advanced life support, level 2 (als 2) | 210 | $320 | $67.7K |
| A0998 | Ambulance response and treatment, no transport | 60 | $50 | $2.5K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 330 | $10 | $1.6K |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 9 | 170 | 2,470 | $140 | $1.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 19 | 140 | 2,410 | $110 | $686.8K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 2,440 | 2,850 | 10,910 | $10 | $330.3K |
| A0433 | Advanced life support, level 2 (als 2) | 18 | 30 | 280 | $140 | $100K |
| A0425 | Ground mileage, per statute mile | 18 | 220 | 3,930 | $10 | $86.1K |
| A0998 | Ambulance response and treatment, no transport | 23 | 30 | 150 | $10 | $3.6K |
Other providers in the same ZIP code as Johnston County, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Johnston Health Services Corporation | NC | General Acute Care Hospital | $0 | $37.8M |
| Sunshine Pediatrics, PA | NC | Pediatrics Physician | $0 | $11.5M |
| Johnston County Schools | NC | Local Education Agency (LEA) | $0 | $8.5M |
| Carolina Outreach, LLC | NC | Mental Health Counselor | $0 | $7.8M |
| Johnston County Public Health Department | NC | State or Local Public Health Clinic/Center | $0 | $7.6M |
| Franklin Wefald | NC | Cardiovascular Disease Physician | $665.3K | $0 |
| Mateen Akhtar | NC | Cardiovascular Disease Physician | $551.4K | $0 |
| Bessaliea Griffin | NC | Foot & Ankle Surgery Podiatrist | $411.9K | $49.2K |
| Jason Moyer | NC | Optometrist | $169.7K | $259.3K |
| Octavio Cieza | NC | Infectious Disease Physician | $163.7K | $117.1K |
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