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NPI 1306801113 · Saint Paul, MN · Ambulance
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Allina Health System is a ambulance provider located in Saint Paul, Minnesota. This profile covers 7 Medicare and 12 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 | Allina Health System |
| Address | 167 Grand Ave |
| City | Saint Paul |
| State | MN |
| ZIP | 55102 |
| Taxonomy | Ambulance |
| NPI Enumerated | April 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $118M |
| Medicare | $9M |
The provider’s code mix is consistent with an ambulance-centric operation focused on advanced life support emergency transport and high mileage billing. Medicare and Medicaid top-line drivers are A0427 (ALS emergency transport), A0425 (ground mileage), and A0428 (BLS non-emergency), which together indicate primary revenue is generated from emergency ALS responses and extensive patient transport rather than ancillary clinical services. Claim-level averages and code descriptions point to routine billing for both emergency and non-emergency ground transports. This operational profile aligns with an organization running sizable fleet-based transport services.
Revenue is highly concentrated in a very small set of codes on both payers: the top 3 Medicare codes account for 94.8% of Medicare revenue and the top 3 Medicaid codes account for 96.0% of Medicaid revenue. That concentration means financial performance is tightly tied to volume and reimbursement for A0427, A0425, and A0428, leaving the provider exposed to rate or utilization changes for these specific transport services. Monitoring these code lines will capture most of the provider’s payer revenue exposure.
Payer mix is strongly skewed toward Medicaid in scale: total Medicaid revenue is $118M versus total Medicare revenue of $9M, indicating the entity is effectively Medicaid-dominant by revenue. Analysts should treat Medicaid payment policies and state network relationships as the primary determinants of near-term revenue trends. Medicare activity is present but represents a much smaller portion of the revenue base.
On Medicare the provider is a national-level outlier for key ALS and mileage codes: A0427 generates $5.9M (14.5K claims) and ranks #10 of 6841 providers nationally (100th percentile; extreme outlier), while A0425 generates $1.8M (254.9K claims) and ranks #27 of 8934 providers nationally (100th percentile; extreme outlier). A0428 contributes $914.4K and ranks #153 of 2772 (95th percentile; typical). These national ranks indicate the provider’s Medicare volumes for ALS emergency transport and mileage are far above typical peers at a national scale, with BLS non-emergency transport at a high but more typical level.
In Medicaid the provider is a dominant in-state player for the same transport lines: A0427 accounts for $83.4M (168.8K claims) and ranks #1 of 60 providers in-state (100th percentile; extreme outlier), A0425 accounts for $21.2M (230.2K claims) and ranks #1 of 107 (100th percentile; extreme outlier), and A0428 accounts for $8.7M (45.7K claims) and ranks #1 of 25 (100th percentile; extreme outlier). This combination of top ranks and extreme-outlier status signals market leadership within the state for both ALS emergency and mileage-based ground transport services.
Operational scale evidence supports heavy utilization of mileage-based billing and ALS responses: Medicare A0425 shows 254.9K claims while Medicaid A0425 shows 230.2K claims, and Medicaid A0427 shows 168.8K claims versus Medicare A0427 at 14.5K claims. Those claim-level volumes, combined with the dollar revenues reported for each code, indicate continuous high-frequency transport activity and a substantial Medicaid caseload driving the majority of trips. Analysts should interpret high mileage counts as indicative of either broad geographic coverage, many long-distance transports, or high trip frequency.
The provider has a long tenure on file, with NPI enumerated 2006-04-18 (~20 years ago), which supports that these billing patterns are likely established operations rather than a short-lived surge. Longevity combined with the concentrated code mix and dominant in-state ranks suggests sustained specialization in ground ambulance services. This history strengthens the relevance of historical claims patterns for forecasting near-term activity.
Given the extreme-outlier ranks and concentrated reliance on A0427/A0425/A0428 (top 3 codes account for 94.8% of Medicare revenue and 96.0% of Medicaid revenue), these patterns warrant targeted review for contract negotiations, utilization management, and payer-provider alignment. High concentration and top-in-state positioning for Medicaid mean changes to state policy or reimbursement for these specific codes could materially affect revenue. Analysts should prioritize these codes when benchmarking reimbursement rates and when evaluating network capacity for emergency and non-emergency ground transport.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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) | 14,450 | $410 | $5.9M |
| A0425 | Ground mileage, per statute mile | 254,930 | $10 | $1.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4,270 | $210 | $914.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 720 | $260 | $186.5K |
| A0433 | Advanced life support, level 2 (als 2) | 220 | $580 | $127.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 330 | $340 | $111.9K |
| A0434 | Specialty care transport (sct) | 70 | $700 | $46.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 168,790 | $490 | $83.4M |
| A0425 | Ground mileage, per statute mile | 230,230 | $90 | $21.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 45,690 | $190 | $8.7M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6,890 | $270 | $1.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,860 | $490 | $905.3K |
| A0433 | Advanced life support, level 2 (als 2) | 840 | $790 | $660.5K |
| A0130 | Non-emergency transportation: wheelchair van | 22,320 | $20 | $490.9K |
| S0209 | Wheelchair van, mileage, per mile | 22,280 | $20 | $423.2K |
| A0434 | Specialty care transport (sct) | 450 | $850 | $378.7K |
| S0215 | Non-emergency transportation; mileage, per mile | 1,820 | $10 | $20K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota median
12 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) | 1 | 60 | 780 | $470 | $5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 18 | 80 | 410 | $430 | $2.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1 | 30 | 420 | $220 | $1.1M |
| A0425 | Ground mileage, per statute mile | 1 | 110 | 870 | $80 | $971K |
| S0215 | Non-emergency transportation; mileage, per mile | 85 | 140 | 3,950 | $20 | $852K |
| T2003 | Non-emergency transportation; encounter/trip | 165 | 240 | 7,020 | $30 | $803.5K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 10 | 560 | $790 | $714.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 20 | 130 | $290 | $438.3K |
| S0209 | Wheelchair van, mileage, per mile | 17 | 90 | 2,310 | $30 | $321.5K |
| A0434 | Specialty care transport (sct) | 4 | 10 | 230 | $690 | $297.6K |
Showing 1–10 of 12
Other providers in the same ZIP code as Allina Health System, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Independent School District 625 | MN | Local Education Agency (LEA) | $0 | $43.1M |
| City Of St Paul | MN | Land Ambulance | $2M | $40.9M |
| United Family Practice Health Center | MN | Family Medicine Physician | $0 | $17.7M |
| Ramsey County | MN | Public Health or Welfare Agency | $0 | $9.8M |
| Serenity Home Health Care System Inc | MN | Home Health Agency | $0 | $4.6M |
| West Side Community Health Services, Inc | MN | Federally Qualified Health Center (FQHC) | $0 | $4.5M |
| Healtheast St Josephs Hospital | MN | General Acute Care Hospital | $0 | $4.3M |
| Mark Palmer | MN | Radiation Oncology Physician | $563.7K | $0 |
| Ryan Youland | MN | Radiation Oncology Physician | $543.4K | $0 |
| Prasanthi Meagher | MN | Rheumatology Physician | $531.1K | $0 |
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