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NPI 1194833939 · San Diego, CA · Ambulance
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American Medical Response Ambulance Service Inc is a ambulance provider located in San Diego, California. This profile covers 7 Medicare and 19 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 | American Medical Response Ambulance Service Inc |
| Address | 8808 Balboa Ave Ste 150 |
| City | San Diego |
| State | CA |
| ZIP | 92123 |
| Taxonomy | Ambulance |
| NPI Enumerated | August 29, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $65.4M |
| Medicare | $9.6M |
This provider is Medicaid-dominant in scale: Total Medicare revenue is $9.6M while Total Medicaid revenue is $65.4M, indicating the bulk of billed volume and revenue comes from Medicaid rather than Medicare. Both payers are active, but the provider’s Medicaid footprint is materially larger in absolute dollars.
The code mix and taxonomy identify a ground ambulance operator focused on both advanced and basic life support transports: high-revenue codes include A0427 (advanced life support, emergency) and A0428/A0429 (basic life support variants), with substantial ground mileage billing via A0425. The presence of A0434 (Specialty care transport) and large mileage counts supports an operational model that combines emergency ALS/BLS responses with longer-distance or specialty transfers.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes account for 85.8% of this provider’s Total Medicare revenue, driven by A0427 ($3.7M, 38.4% of Medicare revenue), A0428 ($3M, 30.8%), and A0425 ($1.6M, 16.7%). This concentration shows Medicare billing is dominated by a small set of transport/mileage services rather than a broad mix of ancillary procedures.
Medicaid revenue is even more concentrated: the precomputed top three Medicaid codes account for 88.9% of Total Medicaid revenue, led by A0427 ($37.1M, 56.5%), A0429 ($12M, 18.3%), and A0425 ($9.3M, 14.1%). These three lines (ALS emergency, BLS emergency, and ground mileage) drive nearly all Medicaid receipts, indicating core competency and dependency on emergency and mileage-based reimbursement.
The provider is a major outlier nationally on Medicare for core ambulance codes: A0427 ranks #56 of 6841 (99th percentile; extreme outlier), A0428 ranks #32 of 2772 (99th percentile; extreme outlier), and A0425 ranks #35 of 8934 (100th percentile; extreme outlier). Those national ranks place the organization far above typical peers on volume for these transport and mileage codes, signaling a high-volume national standing for Medicare-billed ambulance services.
Within California Medicaid, the provider is also a leading player on the same core services: A0427 ranks #4 of 248 (99th percentile; extreme outlier) and A0429 ranks #10 of 386 (98th percentile; notably above typical state volume). Additionally, A0425 ranks #6 of 580 (99th percentile; labelled as typical/unremarkable in the comparator), and A0999 (Unlisted ambulance service) ranks #1 of 99 (100th percentile; extreme outlier), which together imply dominant in-state activity across both standard and unlisted ambulance billing.
Operationally, claim counts are very large for mileage and ALS: reported claims include A0425 with 229K Medicare claims and 343.4K Medicaid claims, and A0427 with 8.4K Medicare claims and 228.7K Medicaid claims. Those absolute volumes, together with average paid/claim differentials such as A0427 ($442 Medicare vs $162 Medicaid), suggest high-frequency transport operations with payer-specific reimbursement patterns that impact cash flow per claim.
The provider has long tenure in the registry, with an NPI enumerated on 2006-08-29 (~20 years ago), indicating an established operation; combined with its outlier ranks and concentrated revenue mix, this longevity supports a sustained, high-volume ambulance service presence in both Medicare and California Medicaid markets.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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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) | 8,350 | $440 | $3.7M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,560 | $240 | $3M |
| A0425 | Ground mileage, per statute mile | 229,030 | $10 | $1.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,870 | $370 | $697.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,130 | $280 | $322.1K |
| A0434 | Specialty care transport (sct) | 370 | $770 | $286.4K |
| A0433 | Advanced life support, level 2 (als 2) | 90 | $640 | $58K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
View: State1 / 2
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.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 228,710 | $160 | $37.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 61,020 | $200 | $12M |
| A0425 | Ground mileage, per statute mile | 343,420 | $30 | $9.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 45,640 | $80 | $3.4M |
| A0434 | Specialty care transport (sct) | 6,660 | $220 | $1.4M |
| A0999 | Unlisted ambulance service | 137,780 | $10 | $1.2M |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 39,250 | $10 | $549.5K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 27,290 | $10 | $245.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,590 | $80 | $201.7K |
| A0433 | Advanced life support, level 2 (als 2) | 1,110 | $130 | $141.8K |
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How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
19 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) | 4 | 250 | 2,420 | $220 | $3.7M |
| T2005 | Non-emergency transportation; stretcher van | 120 | 130 | 1,560 | $140 | $1.9M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10 | 390 | 1,270 | $220 | $1.5M |
| A0380 | Bls mileage (per mile) | 276 | 310 | 7,380 | $40 | $1.1M |
| A0425 | Ground mileage, per statute mile | 6 | 580 | 3,120 | $30 | $963.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6 | 190 | 2,470 | $80 | $674.3K |
| A0434 | Specialty care transport (sct) | 3 | 60 | 700 | $350 | $672.4K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 51 | 760 | 1,930 | $20 | $196K |
| J3490 | Unclassified drugs | 1,354 | 1,390 | 670 | $20 | $159.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 9 | 80 | 280 | $130 | $148.2K |
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Other providers in the same ZIP code as American Medical Response Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
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