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NPI 1134185648 · Portland, ME · Land Ambulance
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City Of Portland is a land ambulance provider located in Portland, Maine. This profile covers 4 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 | City Of Portland |
| Address | 380 Congress St |
| City | Portland |
| State | ME |
| ZIP | 04101 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.4M |
| Medicare | $740.2K |
This entity is overwhelmingly Medicaid-funded by scale: reported lifetime Medicaid revenue is $5.4M compared with $740.2K in Medicare revenue, making Medicaid the dominant payer for this provider’s billed services. The gap in absolute revenue indicates the provider’s operational footprint is concentrated in the state Medicaid market rather than in Medicare.
Revenue is highly concentrated in a narrow set of ambulance codes for both payers: the top three Medicare codes account for 99.1% of the provider’s Medicare revenue, and the top three Medicaid codes account for 100.0% of the provider’s Medicaid revenue. The dominant codes in both payers are A0427, A0429, and A0425, indicating most revenue comes from emergency transport and mileage line items.
Business/service-line mix is clearly land ambulance emergency transport: Medicare and Medicaid top codes are A0427 (ALS 1 emergency), A0429 (BLS emergency), and A0425 (ground mileage). These codes and the reported claim counts and revenues (for example, Medicare A0427 $409.4K and A0429 $292K; Medicaid A0429 $3M and A0427 $2.2M) show the organization primarily bills for emergency ALS/BLS transports plus mileage and routine disposable supplies.
Medicare billing shows modest national presence by volume across key codes: Medicare A0427 appears with 1K claims and $409.4K revenue and ranks #744 of 6841 providers nationally (89th percentile; typical, unremarkable volume), while A0429 has 864 claims and $292K revenue and ranks #627 of 7808 (92th percentile; typical, unremarkable volume). These figures suggest the provider participates in the national Medicare ambulance market but does not stand out as an extreme national outlier for these codes.
By contrast, the provider is a major statewide actor in Medicaid ambulance billing: A0429 has 16.9K claims and $3M revenue and ranks #1 of 96 providers in-state (100th percentile; extreme outlier), and A0427 has 12.7K claims and $2.2M revenue and ranks #2 of 103 providers in-state (99th percentile; extreme outlier). Those in-state ranks and the descriptor “extreme outlier” indicate this provider is one of the largest Medicaid ambulance billers in Maine.
Claim volume patterns show much higher utilization in Medicaid than Medicare: examples include 16.9K Medicaid claims for A0429 versus 864 Medicare claims for the same code, and 29.7K Medicaid claims for A0425 versus 4.7K Medicare claims. This disparity in claim counts reinforces that the provider’s operational activity and patient transports are heavily weighted toward Medicaid beneficiaries.
Average paid-per-claim differs materially between payers for comparable services: Medicare average paid/claim for A0427 is $401 and for A0429 is $338, while Medicaid average paid/claim is reported as $177 for A0427 and $175 for A0429. The provider therefore realizes substantially higher per-claim payments from Medicare even though Medicaid generates the larger aggregate revenue through higher claim volumes.
The provider has long tenure in the NPI registry (NPI enumerated 2006-04-24, ~20 years ago), which aligns with the large cumulative Medicaid billing totals and in-state dominance for core ambulance codes; this longevity is consistent with an established municipal or regional EMS operation rather than a recent entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,020 | $400 | $409.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 860 | $340 | $292K |
| A0425 | Ground mileage, per statute mile | 4,690 | $10 | $32.8K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $590 | $6.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16,930 | $180 | $3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 12,690 | $180 | $2.2M |
| A0425 | Ground mileage, per statute mile | 29,670 | $10 | $207.7K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 270 | $1 | $270 |
| A0398 | Als routine disposable supplies | 2,540 | $0 | $0 |
| A4556 | Electrodes, (e.g., apnea monitor), per pair | 1,810 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine 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) | 2 | 100 | 670 | $200 | $363.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 100 | 660 | $180 | $316.3K |
| A0425 | Ground mileage, per statute mile | 4 | 140 | 1,400 | $50 | $201.8K |
| A0398 | Als routine disposable supplies | 1 | 10 | 2,540 | $1 | $800 |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 2 | 10 | 1,080 | $1 | $70 |
| A4556 | Electrodes, (e.g., apnea monitor), per pair | 1 | 10 | 1,810 | $1 | $40 |
Other providers in the same ZIP code as City Of Portland, ranked by combined Medicare and Medicaid revenue.
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