Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Ohio (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Advanced Medical Equipment, LLC (NPI 1538128293)

Field	Value
Entity Type	Organization
Organization	Advanced Medical Equipment, LLC
Address	426 Alexandersville Rd
City	Miamisburg
State	OH
ZIP	45342
Taxonomy	Customized Equipment (DME)
NPI Enumerated	March 21, 2006

Payer Source	Total Paid
Medicaid	$58.4M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file and all reported federal revenue is from Medicaid, totaling $58.4M. That concentration means its revenue, market exposure, and payer negotiations are driven almost entirely by Medicaid policy and contracts in Ohio rather than any Medicare business mix.

Revenue concentration is high within a few product lines: the precomputed top three Medicaid codes (E0465, B4161, B4035) account for 37.5% of the provider's total Medicaid revenue. Specifically, E0465 accounts for $8.4M (17.1%), B4161 for $6.3M (12.8%), and B4035 for $3.7M (7.6%), indicating a few high‑impact codes drive more than one‑third of Medicaid revenue.

The code mix indicates a DME focus on complex respiratory support and enteral nutrition: major revenue items include home ventilators (E0465, E0466), ventilator accessories and moisture exchangers (A4483, A7521/A7520), oxygen concentrators and portable oxygen (E1390, E0431), and multiple enteral formulas and supplies (B4161, B4160, B4149, B4035). This combination of ventilatory equipment, tracheostomy supplies, and pediatric/formula products points to a business model serving chronic ventilator‑dependent and enterally fed populations.

State competitive standing is strong and concentrated: multiple codes rank at the top statewide, e.g., E0465 ranks #1 of 18 providers (100th percentile), B4161 ranks #2 of 27 (96th percentile), and B4035 ranks #3 of 46 (96th percentile). Several other items are #1 in‑state at the 100th percentile (for example B9998, A4606, A4217, A4624, A7526), which together indicate the provider is a dominant supplier in Ohio for several respiratory and enteral supply categories.

Claim volume patterns show a mix of high‑volume consumables and fewer higher‑unit‑value devices: the provider reports very large claim counts for supply items such as B9998 (57.1K claims), A4606 (50.1K claims), and B4035 (33K claims), while device claims such as E0465 (14.7K claims at $571 avg paid/claim) and E0466 (3.9K claims at $673 avg paid/claim) generate large dollar revenue per claim. This suggests operational strengths in both high‑throughput distribution of disposables and in provision of capital respiratory devices.

Several codes are explicitly flagged as statistical outliers or notably above typical state volume, which signals unusual concentration in particular supply lines: B9998 is labeled an "extreme outlier" (rank #1 of 30), A4217 is an "extreme outlier" (rank #1 of 39), and A4624 and A7526 are also "extreme outlier" items at the 100th percentile. Other high‑revenue codes such as E0465 and A4483 are described as "notably above typical state volume," underscoring a pattern of above‑average market share in select DME categories.

Clinical and patient‑mix implications are clear from the product mix: the presence of pediatric hydrolyzed/amino‑acid formulas (B4161), nutritionally complete dense pediatric formulas (B4160), and blenderized formulas (B4149) indicates a substantive pediatric enteral population, while the high volumes of home ventilator and tracheostomy codes (E0465, E0466, A7521, A7520, A7526) point to a significant population of ventilator‑dependent and tracheostomy patients. Payers and care management teams should view this provider as a specialized supplier for complex respiratory and enteral needs rather than a general‑purpose DME vendor.

The provider has a long operational tenure: the NPI was enumerated on 2006‑03‑21 (~20 years ago), suggesting established presence and sustained service delivery in Ohio. Coupled with the high volumes and numerous #1 statewide rankings, this tenure reinforces that the organization is a mature, high‑volume Medicaid supplier in its core product lines.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

133 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	14,690	$570	$8.4M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	11,640	$540	$6.3M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	33,040	$110	$3.7M
B9998	Noc for enteral supplies	57,100	$50	$2.7M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	33,840	$80	$2.6M
A4483	Moisture exchanger, disposable, for use with invasive mechanical ventilation	10,590	$250	$2.6M
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	3,870	$670	$2.6M
E0445	Oximeter device for measuring blood oxygen levels non-invasively	6,780	$300	$2M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	7,580	$240	$1.8M
A7521	Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each	10,360	$170	$1.8M

Showing 1–10 of 133

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.

Claims Volume vs. Ohio Distribution

Advanced Medical Equipment, LLC — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

133 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	1	20	2,040	$590	$2.1M
E2617	Custom fabricated wheelchair back cushion, any size, including any type mounting hardware	16	20	580	$880	$1.9M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	2	30	3,220	$390	$1.5M
K0108	Wheelchair component or accessory, not otherwise specified	8	30	5,260	$160	$790.2K
K0005	Ultralightweight wheelchair	10	10	350	$1,320	$720.7K
T2029	Specialized medical equipment, not otherwise specified, waiver	18	40	950	$130	$709.9K
Y2032	N/A	1	10	2,790	$270	$696.7K
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	6	40	2,610	$120	$677.4K
A4483	Moisture exchanger, disposable, for use with invasive mechanical ventilation	1	10	1,740	$210	$673.8K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	3	50	4,010	$80	$640.4K

Showing 1–10 of 133

Nearby Providers

Other providers in the same ZIP code as Advanced Medical Equipment, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kettering Medical Center	OH	General Acute Care Hospital	$0	$20M
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$18.4M
Kettering Independent Medical Group Inc	OH	Orthopaedic Surgery Physician	$0	$8.4M
Stateline Medical Equipment, Inc	OH	Durable Medical Equipment & Medical Supplies	$0	$7.9M
Chacko Alappatt	OH	Rheumatology Physician	$3.3M	$6.4K
Miami Valley Fire District	OH	Ambulance	$401.1K	$1.4M
Isis Medical, Incorporated	OH	Physiological Laboratory	$712.6K	$220.3K
Paul Obeng-okyere	OH	Cardiovascular Disease Physician	$371.8K	$0
Rachel Boggus	OH	Pain Medicine (Anesthesiology) Physician	$272.6K	$0
Michael Welker	OH	Orthopaedic Surgery Physician	$184.4K	$0

Advanced Medical Equipment, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References