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NPI 1245614403 · Denver, CO · Ambulance
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Apex Paramedics, LLC. is a ambulance provider located in Denver, Colorado. 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 | Apex Paramedics, LLC. |
| Address | 1873 W 52nd Ave |
| City | Denver |
| State | CO |
| ZIP | 80221 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 16, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $10.2M |
| Medicare | $1.5M |
APEX PARAMEDICS, LLC. operates as an ambulance service specializing in both basic and advanced life support transports; the billing mix centers on ground-ambulance CPT/HCPCS codes such as A0428, A0429, A0426, A0427 and mileage code A0425, which together define a traditional transport-focused operation handling both emergency and non-emergency runs. The presence of substantial volumes across BLS and ALS codes suggests the organization runs mixed-level crews and a sizable transport fleet rather than being a niche specialty provider.
Revenue is highly concentrated by code for both payers: the provider’s top 3 Medicare codes account for 98.6% of Medicare revenue and the top 3 Medicaid codes account for 96.7% of Medicaid revenue. This indicates financial dependence on a small set of transport services and mileage-based reimbursement streams.
Payer mix is heavily weighted toward Medicaid, with total Medicaid revenue of $10.2M versus total Medicare revenue of $1.5M, making Medicaid the dominant source of reported billing revenue. While Medicare is present, the scale disparity suggests the organization primarily serves Medicaid-covered transport volume in its market.
Medicare billing is dominated by A0428, which generated $977.3K (65.7% of Medicare revenue) across 4.5K claims at $218 avg paid/claim and ranks #147 of 2772 nationally (95th percentile; typical, unremarkable volume). The provider also reports A0426 activity ($148.5K, 569 claims, $261 avg paid/claim) that ranks #70 of 1568 nationally (96th percentile; notably above typical national volume), indicating stronger-than-typical ALS non-emergency billing relative to national peers.
On the Medicaid side, A0429 is the single largest driver at $5.8M (56.9% of Medicaid revenue) across 29.7K claims at $196 avg paid/claim and ranks #6 of 116 in-state (96th percentile; typical, unremarkable volume), showing dominant in-state emergency BLS activity. Complementary Medicaid drivers include A0425 mileage ($2.2M from 45.8K claims, $49 avg paid/claim; ranks #11 of 279, 96th percentile) and A0427 ALS emergency ($1.8M from 6.8K claims, $267 avg paid/claim; ranks #19 of 125, 85th percentile), together accounting for meaningful shares of Medicaid revenue and reflecting both high trip volume and significant emergency ALS utilization.
Competitive standing is mixed: for Medicare the provider posts high-percentile ranks on major codes (e.g., A0428 at the 95th percentile and A0426 at the 96th percentile) but the dataset labels these volumes as "typical, unremarkable" for A0428 and "notably above typical" for A0426, which points to a modest-to-strong niche nationally in ALS non-emergency transports. In-state Medicaid ranks (A0429 #6/116, A0425 #11/279, A0428 #4/52) place the provider among the larger ambulance operators regionally, especially for emergency BLS and mileage-driven billing.
Operational implications from claims counts are clear: very high mileage and trip counts (A0425: 48.6K Medicare claims and 45.8K Medicaid claims) coupled with large BLS emergency volumes (A0429: 29.7K Medicaid claims) suggest a high-frequency transport model with extensive road coverage and substantial distance-based reimbursement. These patterns imply fleet and logistics scale are central to the business model and to managing unit economics across payers.
The provider’s NPI was enumerated on 2015-07-16 (~11 years ago), indicating an established presence in the market during the period reported; combined lifetime revenues of $1.5M (Medicare) and $10.2M (Medicaid) reflect a sustained Medicaid-centric operating footprint with meaningful, but smaller, Medicare activity. Tenure plus concentrated code-level revenue should be considered when assessing network contracting, capacity planning, or competitive threat in the region.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,480 | $220 | $977.3K |
| A0425 | Ground mileage, per statute mile | 48,630 | $10 | $340.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 570 | $260 | $148.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 50 | $410 | $20.5K |
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) | 29,650 | $200 | $5.8M |
| A0425 | Ground mileage, per statute mile | 45,800 | $50 | $2.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,780 | $270 | $1.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 8,280 | $30 | $265.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 740 | $60 | $40.7K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 2,930 | $10 | $35.1K |
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4 | 50 | 360 | $130 | $5.6M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 19 | 130 | 750 | $140 | $957.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 120 | 700 | $120 | $843.2K |
| A0425 | Ground mileage, per statute mile | 11 | 280 | 990 | $20 | $636.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 20 | 110 | $330 | $516.1K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 9 | 40 | 170 | $30 | $81.1K |
Other providers in the same ZIP code as Apex Paramedics, LLC., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Rocky Mountain Medical Equipment LLC | CO | Oxygen Equipment & Supplies (DME) | $0 | $34.8M |
| Mile High Homecare LLC | CO | In Home Supportive Care Agency | $0 | $22.4M |
| Clinica Campesina Family Health Services | CO | Federally Qualified Health Center (FQHC) | $0 | $22.3M |
| Goldstar Learning Options, Inc | CO | Attendant Care Provider | $0 | $9.7M |
| Goldstar Learning Options, Inc | CO | Behavior Analyst | $0 | $4.2M |
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