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NPI 1114926151 · Caldwell, ID · Ambulance
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Canyon County Ambulance District is a ambulance provider located in Caldwell, Idaho. This profile covers 7 Medicare and 8 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 | Canyon County Ambulance District |
| Address | 6116 Graye Lane |
| City | Caldwell |
| State | ID |
| ZIP | 83607 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 20, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.4M |
| Medicare | $950.5K |
Medicaid dominates this provider's pay mix: the provider reports Total Medicare revenue of $950.5K versus Total Medicaid revenue of $7.4M, indicating the business is primarily sustained by Medicaid billing rather than Medicare. This scale difference suggests operational focus and revenue risk are more closely tied to state Medicaid policy and contracts than to Medicare volume.
The service mix is clearly emergency-focused ambulance transport: the top codes for both payers are A0427 (advanced life support, emergency), A0429 (basic life support, emergency) and A0425 (ground mileage), which together reflect a business model built around emergency ALS/BLS transports and substantial mileage billing. The presence of both high-volume emergency transport codes and heavy mileage reporting implies regular inter-facility or long-distance responses in addition to scene-to-hospital work.
Revenue is highly concentrated in a few codes on both payers: the precomputed top three Medicare codes account for 89.7% of this provider's total Medicare revenue, and the precomputed top three Medicaid codes account for 91.6% of its total Medicaid revenue. This concentration means a small set of service lines (emergency ALS, emergency BLS, and mileage) drive the overwhelming majority of billed revenue and would be the primary targets for contract negotiations or utilization reviews.
On Medicare, A0427 is the single largest code (59.8% of Medicare revenue) but the provider ranks as a typical national participant for this code (ranks #470 of 6841 providers nationally, 93rd percentile; labeled typical, unremarkable volume). A0429 and A0425 also contribute materially to Medicare revenue (18.5% and 11.4%, respectively) with national percentile placements described as typical, so the provider is not an extreme national outlier in Medicare ALS/BLS volume despite the high share of A0427 in its own Medicare mix.
On Medicaid, the provider is a major statewide participant for its top services: A0427 represents 58.2% of Medicaid revenue and ranks #2 of 31 providers in-state (97th percentile; notably above typical state volume), while A0425 (ground mileage) ranks #2 of 48 in-state (98th percentile; notably above typical state volume). These state-ranked positions indicate the provider is a leading ambulance vendor in the local Medicaid market, particularly for emergency ALS and mileage billing.
Payer-level payment patterns differ materially by code: for A0427 the avg paid/claim is $372 on Medicare versus $232 on Medicaid, while for A0425 the avg paid/claim is $7 on Medicare versus $30 on Medicaid. Those payer-by-code rate differences suggest the provider receives meaningfully different reimbursement profiles for the same service depending on payer, which will affect margins by payer and should be considered in pricing or contract strategy.
The provider bills specialty care transport (A0434) on both payers, accounting for 5.1% of Medicare revenue and 2.8% of Medicaid revenue; nationally the Medicare A0434 rank is #199 of 591 (66th percentile; typical), while in-state Medicaid A0434 billing ranks #1 of 2 providers (100th percentile). This indicates a smaller but distinct SCT capability that gives the provider unique in-state positioning for that service line despite it representing a modest share of total revenue.
This NPI has been enumerated since 2005-07-20 (~21 years ago), indicating long tenure in the market; combined with the heavy Medicaid revenue footprint and strong in-state ranks on core codes, the provider appears to be a well-established, Medicaid-focused ambulance operator with concentrated service lines that drive most of its billing. Continuity of operations and market position are likely dependent on maintaining state Medicaid relationships and capacity for ALS emergency and mileage-intensive transports.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,530 | $370 | $569.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 570 | $310 | $176.6K |
| A0425 | Ground mileage, per statute mile | 15,480 | $10 | $108.3K |
| A0434 | Specialty care transport (sct) | 80 | $640 | $49K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $540 | $26.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 60 | $240 | $13.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 50 | $200 | $8.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 18,500 | $230 | $4.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,500 | $210 | $1.6M |
| A0425 | Ground mileage, per statute mile | 30,400 | $30 | $911.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,690 | $120 | $206.3K |
| A0434 | Specialty care transport (sct) | 410 | $500 | $205.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 960 | $160 | $157.4K |
| A0433 | Advanced life support, level 2 (als 2) | 140 | $350 | $49.9K |
| A0999 | Unlisted ambulance service | 660 | $1 | $2K |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
8 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) | 2 | 30 | 480 | $220 | $663.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 30 | 570 | $180 | $428.6K |
| A0999 | Unlisted ambulance service | 2 | 10 | 800 | $480 | $388.3K |
| A0434 | Specialty care transport (sct) | 1 | 10 | 340 | $540 | $181.5K |
| A0425 | Ground mileage, per statute mile | 2 | 50 | 960 | $40 | $166.8K |
| A0433 | Advanced life support, level 2 (als 2) | 2 | 10 | 140 | $400 | $64.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 10 | 260 | $80 | $54.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 10 | 120 | $160 | $40.5K |
Other providers in the same ZIP code as Canyon County Ambulance District, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Vallivue School District #139 | ID | Local Education Agency (LEA) | $0 | $17M |
| Smiles 4 Kids Caldwell | ID | Pediatric Dentistry | $0 | $8.5M |
| Patrick Waite | ID | General Practice Dentistry | $0 | $1.1M |
| Southwest District Health | ID | Public Health or Welfare Agency | $0 | $809.5K |
| Canyon Creek Developmental Services | ID | Local Education Agency (LEA) | $0 | $791K |
| Mobilitycares LLC | ID | Optometrist | $0 | $492.2K |
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