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NPI 1306946371 · Claremore, OK · Land Ambulance
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Pafford Ems Of Oklahoma Inc is a land ambulance provider located in Claremore, Oklahoma. This profile covers 7 Medicare and 10 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 | Pafford Ems Of Oklahoma Inc |
| Address | 817 N J M Davis Blvd |
| City | Claremore |
| State | OK |
| ZIP | 74018 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | September 22, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $25.7M |
| Medicare | $5.4M |
Payer mix and scale: PAFFORD EMS OF OKLAHOMA INC reports $5.4M in lifetime Medicare revenue and $25.7M in lifetime Medicaid revenue, indicating a substantially larger Medicaid footprint relative to Medicare in absolute dollars. This provider is not effectively single-payer — both payers are active — but Medicaid dominates the revenue picture.
Revenue concentration: The provider’s Medicare revenue is heavily concentrated, with its top three Medicare codes accounting for 89.9% of Medicare revenue, and its top three Medicaid codes accounting for 79.5% of Medicaid revenue. Those top codes are ambulance service and mileage codes, which together drive the bulk of dollars on both payers.
Medicare service profile and implications: Medicare billing is dominated by A0427 (7.1K claims, $2.7M revenue) and A0425 (218K claims, $1.7M revenue) with A0429 (1.5K claims, $472.6K revenue) also contributing material revenue; the mix (ALS emergency, ground mileage, BLS emergency) indicates a high-volume emergency/transport operation that bills both ALS and mileage intensively. A0427 and A0425 are flagged as “extreme outlier” volumes nationally, which suggests the provider operates at a scale for those ambulance services well above typical national peers.
Medicaid service profile and implications: Medicaid billing is likewise concentrated in emergency and mileage codes with A0427 (48.3K claims, $10.6M revenue), A0425 (73.4K claims, $6.8M revenue), and A0429 (13.9K claims, $3M revenue) as the top three contributors; these three codes account for 79.5% of Medicaid revenue. The Medicaid mix also shows meaningful specialty and air transport activity (A0434, A0431, A0436), indicating the provider bills for ALS emergency, BLS emergency, specialty care transport, and rotary-wing services.
Competitive standing — Medicare: For Medicare the provider is a national outlier on key ambulance codes: A0427 ranks #82 of 6841 (99th percentile, described as an “extreme outlier”) and A0425 ranks #38 of 8934 (100th percentile, “extreme outlier”), while A0429 sits at #286 of 7808 (96th percentile, a more typical volume). These ranks indicate the provider is a dominant national-volume performer for certain ALS and mileage codes.
Competitive standing — Medicaid: In-state, PAFFORD EMS ranks among the top performers on its leading Medicaid codes: A0427, A0425, and A0429 each rank #3 in-state at the 98th percentile and A0434 ranks #1 of 6 providers in-state (100th percentile). Those placements characterize the provider as a major statewide operator for both emergency ALS and high-mileage ground transport and as a leading provider for specialty care transport.
Operational complexity: The presence of high-volume ALS emergency codes (A0427), high ground-mileage billing (A0425), BLS emergency and non-emergency codes (A0429, A0428), plus material specialty care transport and rotary-wing air codes (A0434, A0431, A0436) points to a multi-modal operation that provides emergency response, long-distance ground transfers, specialty care transport, and air transport. This breadth suggests operational capacity and logistical complexity beyond a single-service ambulance provider.
Tenure and monitoring implications: The NPI was enumerated on 2006-09-22 (~20 years ago), showing long-term presence in the market and a sustained billing footprint across both Medicare and Medicaid. Given the concentration of revenue in a few transport codes and multiple codes flagged as “extreme outlier” or “notably above typical,” these patterns warrant targeted operational and contracting review as part of payer oversight and network evaluation.
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) | 7,120 | $380 | $2.7M |
| A0425 | Ground mileage, per statute mile | 218,040 | $10 | $1.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,480 | $320 | $472.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,310 | $200 | $257K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 670 | $240 | $160.4K |
| A0433 | Advanced life support, level 2 (als 2) | 150 | $550 | $79.6K |
| A0434 | Specialty care transport (sct) | 90 | $640 | $57.7K |
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 48,320 | $220 | $10.6M |
| A0425 | Ground mileage, per statute mile | 73,400 | $90 | $6.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13,910 | $220 | $3M |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 470 | $3,880 | $1.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,630 | $110 | $1.2M |
| A0436 | Rotary wing air mileage, per statute mile | 460 | $2,140 | $983K |
| A0434 | Specialty care transport (sct) | 1,160 | $470 | $547.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,910 | $170 | $499.7K |
| A0433 | Advanced life support, level 2 (als 2) | 540 | $350 | $186.7K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 3,430 | $10 | $44.6K |
How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oklahoma median
10 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) | 3 | 90 | 1,320 | $240 | $1.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 80 | 760 | $210 | $554.1K |
| A0425 | Ground mileage, per statute mile | 3 | 110 | 2,080 | $60 | $501.9K |
| A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | 3 | 20 | 180 | $2,580 | $495.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 4 | 50 | 370 | $120 | $286.5K |
| A0436 | Rotary wing air mileage, per statute mile | 2 | 20 | 160 | $1,440 | $260.1K |
| A0433 | Advanced life support, level 2 (als 2) | 4 | 10 | 100 | $340 | $187.8K |
| A0434 | Specialty care transport (sct) | 1 | 10 | 170 | $450 | $169.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 40 | 90 | $160 | $132.4K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 1 | 10 | 980 | $10 | $17.8K |
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