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NPI 1568563278 · Denver, CO · Ambulance
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Denver Health And Hospital Authority is a ambulance provider located in Denver, Colorado. This profile covers 4 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 | Denver Health And Hospital Authority |
| Address | 777 Bannock St |
| City | Denver |
| State | CO |
| ZIP | 80204 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $46.3M |
| Medicare | $3.4M |
DENVER HEALTH AND HOSPITAL AUTHORITY is an ambulance taxonomy provider with an NPI enumerated on 2006-09-26 (~20 years ago), indicating long tenure in Medicare/Medicaid billing and likely established operational infrastructure for emergency ground transport services. The code mix (A0427, A0429, A0425, A0433) is consistent with an ambulance/EMS operation focused on emergency transports and mileage-billed ground service rather than non-transport or ancillary ambulance services.
Medicaid revenue dwarfs Medicare revenue for this entity: lifetime Medicaid revenue is $46.3M versus lifetime Medicare revenue of $3.4M, showing the provider is heavily Medicaid-facing in scale and effectively operates with Medicaid as the primary payer population. This large disparity suggests the provider’s business model or service area produces substantially more Medicaid transports than Medicare.
Revenue concentration is highly focused in a small set of codes for both payers: the top 3 Medicare codes account for 98.1% of the provider’s Medicare revenue, and the top 3 Medicaid codes account for 98.3% of the provider’s Medicaid revenue. This indicates that emergency ALS/BLS transports and ground mileage are the dominant revenue drivers and that other codes contribute negligibly to total payer revenue.
For Medicare, A0427 (ALS 1 emergency), A0429 (BLS emergency) and A0425 (ground mileage) together produce the large majority of revenue (the precomputed top-3 share of 98.1%), with A0427 alone representing $2.1M (62.6% of Medicare revenue) and A0429 contributing $977.2K (28.7%). The Medicare profile shows high concentration in emergency transport services, implying routine billing of ALS and BLS emergency runs.
In Medicaid, the provider is a statewide dominant outlier on its top transport codes: A0427 generated $27.5M and A0429 generated $15.5M, together making up roughly 92.7% of Medicaid revenue and the precomputed top-3 share is 98.3%. Both A0427 and A0429 rank #2 in-state (99th percentile) and are described as extreme outliers, signaling the provider is one of the largest Medicaid ambulance billers in Colorado by volume.
Competitive standing differs by payer and code: nationally the provider ranks in the 98th percentile for Medicare A0427 and A0429 volumes (rank #120), indicating notably above-typical national volume for those emergency transport codes; in-state, the provider is even more dominant for Medicaid, ranking #2 of providers on A0427, A0429, and A0425 (100th percentile for A0425), which supports characterization as a major Medicaid ambulance provider in Colorado.
Operational profile implied by unit-level details: Medicare shows 5.2K claims for A0427 with an average paid/claim of $408 and 2.8K claims for A0429 at $343, while Medicaid shows substantially larger claim counts (e.g., 167.4K for A0427 at $164 and 113.3K for A0429 at $137). The disparity in claim counts and average paid/claim between payers suggests different reimbursement rates and potentially different utilization patterns or payer populations served under Medicaid versus Medicare.
Mileage billing is present but comparatively small in revenue share: A0425 accounts for $230.3K (6.8% of Medicare revenue) and $2.6M (5.5% of Medicaid revenue), indicating ground mileage is billed consistently but is not a primary revenue source compared with ALS/BLS transport codes. The A0425 ranks are typical to strong (Medicare 93rd percentile, Medicaid 100th in-state) which means mileage is a steady, routine component of trips rather than an unusual driver.
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) | 5,230 | $410 | $2.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,850 | $340 | $977.2K |
| A0425 | Ground mileage, per statute mile | 32,910 | $10 | $230.3K |
| A0433 | Advanced life support, level 2 (als 2) | 110 | $600 | $66K |
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 167,390 | $160 | $27.5M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 113,340 | $140 | $15.5M |
| A0425 | Ground mileage, per statute mile | 285,460 | $10 | $2.6M |
| A0433 | Advanced life support, level 2 (als 2) | 4,310 | $190 | $810.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 20 | $50 | $850 |
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
5 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) | 2 | 130 | 750 | $140 | $957.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 120 | 700 | $120 | $843.2K |
| A0425 | Ground mileage, per statute mile | 2 | 280 | 990 | $20 | $636.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 19 | 20 | 110 | $330 | $516.1K |
| A0433 | Advanced life support, level 2 (als 2) | 2 | 20 | 120 | $170 | $183.3K |
Other providers in the same ZIP code as Denver Health And Hospital Authority, ranked by combined Medicare and Medicaid revenue.
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