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NPI 1437159613 · Durham, NC · Land Ambulance
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County Of Durham Finance Dept is a land ambulance provider located in Durham, North Carolina. This profile covers 4 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 | County Of Durham Finance Dept |
| Address | 402 Stadium Dr |
| City | Durham |
| State | NC |
| ZIP | 27704 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | July 28, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $11.3M |
| Medicare | $2.4M |
The provider’s code mix and taxonomy (Land Ambulance) indicate a core operation focused on emergency transport services: Medicare billing is led by A0427 (3.9K claims, $1.5M revenue) and A0429 (1.9K claims, $599.1K revenue), with high-volume ground mileage reporting in A0425 (36K claims, $252.2K revenue), consistent with an active ground ambulance fleet performing many transports and accruing statute mileage. The presence of A0433 on Medicare (157 claims, $86.8K) also shows use of higher-acuity ALS level-of-care on a subset of calls, reinforcing an ALS-capable operation rather than a BLS-only service.
Revenue is heavily concentrated in a small set of transport codes for both payers: the top 3 Medicare codes account for 96.4% of this provider’s Medicare revenue, and the top 3 Medicaid codes account for 98.9% of its Medicaid revenue. This concentration means the business’s financial performance is closely tied to volume and reimbursement for A0427, A0429, and the relevant mileage or higher-level ALS codes.
The provider’s payer mix is Medicaid-dominant: reported Medicaid revenue is $11.3M compared with $2.4M in Medicare revenue, so Medicaid accounts for the majority of lifetime public-payer receipts on file. Claim volumes echo that scale difference — for example, A0427 appears 49.5K times in Medicaid data versus 3.9K times in Medicare data — indicating day-to-day operational reliance on Medicaid-covered transports.
On national Medicare measures the entity is a high-volume outlier for emergency transport codes: A0427 ranks #172 of 6841 providers (98th percentile) and A0429 ranks #215 of 7808 (97th percentile), while A0433 also ranks highly at #74 of 1632 (96th percentile). Even the mileage code A0425 is above typical national volume (rank #580 of 8934, 94th percentile), so this provider performs transport volumes well above most peers nationally for these services.
Within North Carolina Medicaid activity the provider is a dominant in-state performer on emergency transports: both A0427 (49.5K claims, $6.7M) and A0429 (31.2K claims, $4.2M) rank #6 in-state (97th percentile), and A0433 ranks #7 of 28 (78th percentile). The provider’s high in-state ranks for A0427 and A0429 indicate it is among the largest ambulance service billers in the state for those emergency transport categories.
Payment patterns show materially different average paid-per-claim between payers for the same service: Medicare average paid/claim on A0427 is $379 and on A0429 is $319, while Medicaid average paid/claim on A0427 is $135 and on A0429 is $136. Those per-claim differences suggest unit reimbursement for the same code is substantially higher on Medicare than on Medicaid, which will affect margin dynamics by payer for identical transport activity.
Medicaid billing includes modest volumes of ancillary and non-transport activity: A0998 (ambulance response and treatment, no transport) appears 981 times for $15.7K revenue and ranks #5 of 29 in-state (86th percentile), while supply codes A0398 and A0382 are present but contribute negligible revenue ($936 and $0 respectively). This pattern indicates limited additional revenue streams beyond primary transport services and occasional billed responses without transport.
The provider’s NPI was enumerated 2005-07-28 (~21 years ago), indicating long tenure in the market. Coupled with the high national and in-state ranks on core transport codes and the Medicaid-weighted revenue base, this tenure supports interpretation of an established, high-volume county ambulance operation with entrenched regional market presence.
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 |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,910 | $380 | $1.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,880 | $320 | $599.1K |
| A0425 | Ground mileage, per statute mile | 36,030 | $10 | $252.2K |
| A0433 | Advanced life support, level 2 (als 2) | 160 | $550 | $86.8K |
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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 49,540 | $140 | $6.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 31,160 | $140 | $4.2M |
| A0433 | Advanced life support, level 2 (als 2) | 1,530 | $160 | $237.9K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 15,600 | $10 | $78K |
| A0425 | Ground mileage, per statute mile | 30,730 | $1 | $30.7K |
| A0998 | Ambulance response and treatment, no transport | 980 | $20 | $15.7K |
| A0398 | Als routine disposable supplies | 310 | $1 | $940 |
| A0382 | Bls routine disposable supplies | 180 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
8 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) | 6 | 170 | 2,470 | $140 | $1.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6 | 140 | 2,410 | $110 | $686.8K |
| 99199 | Use this code to report other medicine services or procedures for which there is no specific code available. | 1,260 | 2,850 | 10,910 | $10 | $330.3K |
| A0433 | Advanced life support, level 2 (als 2) | 7 | 30 | 280 | $140 | $100K |
| A0425 | Ground mileage, per statute mile | 15 | 220 | 3,930 | $10 | $86.1K |
| A0998 | Ambulance response and treatment, no transport | 5 | 30 | 150 | $10 | $3.6K |
| A0398 | Als routine disposable supplies | 1 | 10 | 190 | $1 | $100 |
| A0382 | Bls routine disposable supplies | 2 | 10 | 130 | $0 | $0 |
Other providers in the same ZIP code as County Of Durham Finance Dept, ranked by combined Medicare and Medicaid revenue.
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