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NPI 1437188398 · Johnson, VT · Ambulance
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Lamoille Ambulance Service,inc. is a ambulance provider located in Johnson, Vermont. This profile covers 5 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 | Lamoille Ambulance Service,inc. |
| Address | 93 Lower Main West |
| City | Johnson |
| State | VT |
| ZIP | 05656 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.4M |
| Medicare | $613.8K |
LAMOILLE AMBULANCE SERVICE,INC. operates as an ambulance/ground-transport provider (taxonomy: Ambulance) with its NPI enumerated on 2006-07-02 (~20 years ago), indicating long tenure in the market. The billing mix — dominated by A0428, A0425 and A0426 on Medicare and A0425, A0428 and T2002 on Medicaid — is consistent with an organization focused on scheduled non-emergency basic life support and mileage-based ground transport rather than high-volume emergency ALS runs.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 98.0% of this provider's total Medicare revenue, led by A0428 (50.8%) and A0425 (39.9%) with A0426 contributing 7.3%. This concentration implies that a small set of non-emergency transport and mileage codes drive nearly all Medicare receipts for this entity, making Medicare revenue streams sensitive to changes in reimbursement or utilization for those specific services.
Medicaid revenue is similarly concentrated: the top 3 Medicaid codes account for 94.4% of this provider's total Medicaid revenue, with A0425 at 55.4%, A0428 at 33.8%, and T2002 at 5.1%. This shows Medicaid business is largely dependent on ground mileage and BLS non-emergency transports, with a modest additional contribution from per diem non-emergency transportation (T2002).
Payer mix by scale shows Medicaid is the larger payer for this provider: total Medicare revenue is $613.8K versus total Medicaid revenue of $1.4M. The underlying claim profiles are strikingly different across payers for the same codes — for example, A0425 appears with 34.2K Medicare claims at $7 avg paid/claim and 6.9K Medicaid claims at $113 avg paid/claim — highlighting substantial payer rate and reimbursement structure differences for mileage and how that translates into revenue.
National competitive standing on Medicare is mixed: A0425 (ground mileage) ranks #622 of 8934 providers nationally (93th percentile), indicating a relatively strong national presence for mileage billing, while A0428 (BLS non-emergency) ranks #479 of 2772 providers nationally (83th percentile) and A0426 ranks #353 of 1568 providers nationally (77th percentile), both described as typical, unremarkable volume. These rankings suggest the provider is a modest-to-strong national participant for mileage and a typical-volume operator for BLS and ALS 1 non-emergency transports.
State-level competitive standing on Medicaid points to market leadership in BLS non-emergency transport: A0428 ranks #1 of 16 providers in-state (100th percentile; notably above typical state volume) and A0425 ranks #10 of 60 providers in-state (85th percentile). T2002 is recorded as #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), so while that per-diem line exists, the clearest in-state dominance is for A0428 BLS non-emergency transports.
Emergency transport activity is limited relative to peers: Medicare emergency codes A0427 and A0429 are at very low national percentiles (A0427 ranks #6597 of 6841 providers nationally (3th percentile) and A0429 ranks #7642 of 7808 providers nationally (1th percentile)), and Medicaid emergency codes A0427 and A0429 sit at mid-to-low state percentiles (34th and 18th respectively). This pattern reinforces that the provider’s operational emphasis is on non-emergency and mileage services rather than emergency ambulance response.
Operational scale signals: high claim counts for mileage and BLS on Medicare (e.g., 34.2K claims for A0425 and 1.5K claims for A0428) and substantial Medicaid volumes (e.g., 6.9K claims for A0425 and 5.2K claims for A0428) indicate steady utilization of routine transport routes and scheduling, which aligns with a ground-transport business model reliant on repeat, scheduled non-emergency trips rather than episodic emergency work.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,510 | $200 | $305.5K |
| A0425 | Ground mileage, per statute mile | 34,220 | $10 | $239.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 150 | $300 | $44K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 20 | $470 | $7.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 10 | $380 | $4.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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 |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 6,910 | $110 | $781.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5,240 | $90 | $476.4K |
| T2002 | Non-emergency transportation; per diem | 420 | $170 | $72.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 270 | $190 | $50.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 140 | $200 | $28.9K |
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 33 | 40 | 580 | $190 | $370.2K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 32 | 50 | 590 | $220 | $265.7K |
| A0425 | Ground mileage, per statute mile | 10 | 60 | 1,570 | $50 | $160.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1 | 20 | 690 | $100 | $151.9K |
| T2002 | Non-emergency transportation; per diem | 1 | 10 | 420 | $170 | $72.2K |
Other providers in the same ZIP code as Lamoille Ambulance Service,inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Mark Ferriman | VT | Mental Health Counselor | $0 | $236.8K |
| A3b Acceptance Believing Bonding And Belonging Inc | VT | Family Medicine Physician | $0 | $228.5K |
| Barbara Rosenthal | VT | Family Medicine Physician | $0 | $103.1K |
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