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NPI 1285639393 · Sanford, ME · Land Ambulance
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City Of Sanford is a land ambulance provider located in Sanford, Maine. This profile covers 3 Medicare and 5 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 Sanford |
| Address | 972 Main St |
| City | Sanford |
| State | ME |
| ZIP | 04073 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | June 15, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.8M |
| Medicare | $277.3K |
CITY OF SANFORD operates as a land ambulance service whose billing is dominated by emergency transport codes. On Medicare the top codes are A0427 (314 claims, $406 avg paid/claim, $127.5K; 46.0% of Medicare revenue), A0429 (368 claims, $341 avg paid/claim, $125.5K; 45.2%) and A0425 (2.4K claims, $10 avg paid/claim, $24.4K; 8.8%). On Medicaid the same three codes drive revenue with A0429 (4.7K claims, $192 avg paid/claim, $896.8K; 49.2%), A0427 (3.8K claims, $215 avg paid/claim, $812.7K; 44.6%) and A0425 (8.5K claims, $13 avg paid/claim, $110.5K; 6.1%), confirming a core business of BLS/ALS emergency transports plus mileage.
Revenue concentration is very high in both payers: the precomputed top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, and the precomputed top 3 Medicaid codes account for 99.9% of its total Medicaid revenue. This indicates that nearly all billed dollars come from a tight set of ambulance transport services rather than a broader mix of ancillary codes.
The provider’s payer mix is Medicaid-dominant in scale: total Medicaid revenue is $1.8M versus total Medicare revenue of $277.3K. That gap shows the organization’s economics and utilization are driven largely by Medicaid volume rather than Medicare.
Competitively on Medicare, volumes are typical rather than dominant: A0429 ranks #1518 of 7808 providers nationally (81th percentile; typical, unremarkable volume), A0427 ranks #2254 of 6841 (67th percentile; typical, unremarkable volume), and A0425 ranks #4909 of 8934 (45th percentile; typical, unremarkable volume). These positions indicate modest national presence for its highest-revenue Medicare codes rather than market leadership.
By contrast, the provider is comparatively strong in-state on Medicaid for core transport services. A0429 ranks #8 of 96 providers in-state (93th percentile; typical, unremarkable volume), A0427 ranks #17 of 103 (84th percentile; typical, unremarkable volume), and A0425 ranks #17 of 138 (88th percentile; typical, unremarkable volume), signaling it is a major Medicaid transport supplier in Maine for both BLS and ALS billing.
The near parity between A0429 and A0427 revenue shares on both payers (Medicare: 46.0% and 45.2%; Medicaid: 49.2% and 44.6%) suggests the operation fields both basic life support and advanced life support emergency responses at scale, rather than focusing on a single acuity level. Ground mileage (A0425) consistently contributes a smaller but nontrivial portion of revenue (Medicare 8.8%, Medicaid 6.1%), reflecting routine transport distance billing alongside the transport level charges.
Operational tenure is long-standing: the provider’s NPI was enumerated on 2005-06-15 (~21 years ago), indicating more than two decades of presence in the market which can support stable payer relationships and established service patterns. Analysts should view historical incumbency as a factor when assessing local contracting leverage or network role.
A small set of ancillary codes generate negligible revenue and appear low-volume in-state: A0998 (12 claims, $87 avg paid/claim, ~$1K; ranks #10 of 11 providers in-state, 0th percentile) and 0031A (15 claims, $25 avg paid/claim, $375; ranks #63 of 76, 12th percentile). These items are peripheral to the provider’s financial profile and do not materially change the primary picture of Medicaid-driven ambulance 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.
3 rows
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 4,670 | $190 | $896.8K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,780 | $220 | $812.7K |
| A0425 | Ground mileage, per statute mile | 8,500 | $10 | $110.5K |
| A0998 | Ambulance response and treatment, no transport | 10 | $90 | $1K |
| 0031A | N/A | 20 | $30 | $380 |
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
5 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) | 17 | 100 | 670 | $200 | $363.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 8 | 100 | 660 | $180 | $316.3K |
| A0425 | Ground mileage, per statute mile | 17 | 140 | 1,400 | $50 | $201.8K |
| A0998 | Ambulance response and treatment, no transport | 10 | 10 | 20 | $80 | $9.7K |
| 0031A | N/A | 63 | 80 | 30 | $10 | $1K |
Other providers in the same ZIP code as City Of Sanford, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Waypoint Maine, Inc. | ME | Case Management Agency | $0 | $110.5M |
| Great Bay Services | ME | Developmental Disabilities Clinic/Center | $0 | $7.1M |
| Milestones Family Services, LLC | ME | Case Management Agency | $0 | $2.8M |
| Montshire Sanford PC | ME | Pediatric Dentistry | $0 | $1.4M |
| Great Bay Services | ME | Developmental Disabilities Clinic/Center | $0 | $824.9K |
| Philip Russell | ME | Psychiatry Physician | $14.5K | $720.3K |
| City Of Sanford | ME | Local Education Agency (LEA) | $0 | $733.4K |
| Associated Eye Care, P.A. | ME | Optometrist | $0 | $687.3K |
| Children's Dentistry Of Sanford, LLP | ME | Pediatric Dentistry | $0 | $673.4K |
| Dana Graichen | ME | Ophthalmology Physician | $649.6K | $0 |
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