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NPI 1225633092 · Donnellson, IA · Land Ambulance
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Lee County Auditor is a land ambulance provider located in Donnellson, Iowa. This profile covers 6 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 | Lee County Auditor |
| Address | 315 S Main St |
| City | Donnellson |
| State | IA |
| ZIP | 52625 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | December 1, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.1M |
| Medicare | $854.8K |
Provider is an active Land Ambulance operator (NPI enumerated 2020-12-01 (~6 years ago)) with both Medicare and Medicaid activity: lifetime Medicare revenue is $854.8K while lifetime Medicaid revenue is $1.1M, making Medicaid the larger single payer by scale for this entity. The existence of substantial billing to both programs suggests ongoing mixed-payer ground-ambulance operations rather than a single-payer specialty.
Top Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes (A0427, A0425, A0429) account for 91.1% of total Medicare revenue, with A0427 alone representing $396.3K (46.5%) and A0425 contributing $269K (31.6%). This concentration around ALS emergency transports and ground mileage indicates the business model is driven by emergency ground-transport services rather than ancillary supply billing.
Top Medicaid revenue is even more concentrated around a small set of codes: the precomputed top 3 Medicaid codes (A0999, A0427, A0425) account for 91.7% of total Medicaid revenue, led by A0999 at $663.5K (62.8%). Heavy reliance on A0999 (Unlisted ambulance service) for Medicaid suggests a substantial portion of state revenue is attributed to unlisted or catch‑all ambulance billing rather than narrowly coded ALS/BLS descriptors.
Medicare competitive standing for leading codes is in the upper national percentiles but characterized in the data as typical: A0427 ranks #714 of 6841 (90th percentile, typical, unremarkable volume) and A0425 ranks #703 of 8934 (92th percentile, typical, unremarkable volume). Those ranks indicate the provider posts above‑median national volumes for core emergency transport and mileage codes but is not positioned as a dominant national provider.
In-state competitive standing on Medicaid shows modest market presence: A0999 ranks #21 of 57 (64th percentile, typical), A0427 ranks #21 of 92 (78th percentile, typical), and A0425 ranks #24 of 157 (85th percentile, typical). These percentiles suggest the provider is a mid-tier Medicaid biller in-state—active on key transport codes but not a statewide leader.
Payment patterns across payers reveal notable per-claim differences for the same service codes: for example A0427 shows Medicare avg paid/claim $380 versus Medicaid avg paid/claim $68, and A0429 shows Medicare avg paid/claim $319 versus Medicaid avg paid/claim $52. These discrepancies reflect payer-level reimbursement differences for ALS/BLS emergency transports and will materially affect per-transport revenue even when claim volumes are similar.
Operational profile implied by claim counts and code mix points to frequent mileage billing and routine emergency responses: Medicare shows 29.9K claims for A0425 (ground mileage) contributing $269K and 1K claims for A0427 contributing $396.3K, indicating many runs with substantial mileage component and a smaller number of higher‑paid ALS emergency transports. Combined with the Medicaid pattern (5.1K A0425 claims and 2.8K A0427 claims), the dataset describes a volume model that relies on high mileage and a mix of ALS/BLS emergency transports.
Coding and revenue-concentration implications: reliance on a single unlisted Medicaid code (A0999 at 62.8% of Medicaid revenue) plus heavy weighting to three codes per payer (91.1% Medicare, 91.7% Medicaid) concentrates financial performance in a narrow set of transport services. For financial planning or contract negotiations this concentration signals limited service-line diversification and identifies specific codes to prioritize for pricing, utilization review, or targeted operational audits.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,040 | $380 | $396.3K |
| A0425 | Ground mileage, per statute mile | 29,890 | $10 | $269K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 350 | $320 | $110.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 120 | $240 | $29.4K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $550 | $29.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 90 | $200 | $17.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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 |
|---|---|---|---|---|
| A0999 | Unlisted ambulance service | 1,010 | $660 | $663.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,800 | $70 | $190.1K |
| A0425 | Ground mileage, per statute mile | 5,060 | $20 | $116.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,400 | $50 | $72.7K |
| A0398 | Als routine disposable supplies | 1,340 | $10 | $6.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 110 | $50 | $5.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 140 | $10 | $1.7K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 30 | $40 | $1.2K |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0999 | Unlisted ambulance service | 21 | 60 | 600 | $990 | $2.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 21 | 90 | 570 | $80 | $180.2K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 21 | 90 | 170 | $70 | $134.3K |
| A0425 | Ground mileage, per statute mile | 24 | 160 | 730 | $20 | $60.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 23 | 30 | 350 | $50 | $49.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 11 | 20 | 150 | $80 | $44K |
| A0398 | Als routine disposable supplies | 3 | 20 | 490 | $1 | $3.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 4 | 10 | 160 | $10 | $1.5K |
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