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NPI 1619021813 · Hillsboro, OR · Ambulance
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Metro West Ambulance, Inc is a ambulance provider located in Hillsboro, Oregon. 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 | Metro West Ambulance, Inc |
| Address | 5475 Ne Dawson Creek Dr |
| City | Hillsboro |
| State | OR |
| ZIP | 97124 |
| Taxonomy | Ambulance |
| NPI Enumerated | January 23, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $22.8M |
| Medicare | $2.4M |
This provider is highly Medicaid-dominant in scale: lifetime Medicaid revenue is $22.8M versus total Medicare revenue of $2.4M, indicating Medicaid receipts are an order of magnitude larger than Medicare for this entity. The disparity suggests the organization’s operational focus and revenue risk profile are principally tied to state Medicaid contracts and utilization rather than Medicare volume.
Medicare revenue is concentrated in a very small set of codes: the precomputed top three Medicare codes account for 87.2% of the provider’s total Medicare revenue, led by A0427 (64.1% of Medicare revenue), A0425 (15.6%), and A0429 (7.5%). This concentration points to a Medicare business that is dominated by emergency ambulance dispatches and mileage rather than a broadly diversified CPT mix.
Medicaid revenue is even more concentrated: the precomputed top three Medicaid codes account for 95.8% of the provider’s total Medicaid revenue, with A0427 representing 75.4% of Medicaid revenue, A0434 13.6%, and A0429 6.8%. Such a high single-payer code concentration implies that Medicaid reimbursement for ALS emergency transports and specialty care transport are the primary drivers of the provider’s financial performance.
The code mix and unit-level metrics portray a heavy advanced-life-support (ALS) and specialty-transport operational model: A0427 (ALS emergency) dominates both payers (Medicare: 3.6K claims, $1.5M revenue; Medicaid: 72.1K claims, $17.2M revenue) and A0434 (specialty care transport) is a material Medicaid contributor (2.1K claims, $3.1M revenue with $1496 avg paid/claim). Ground mileage (A0425) is also a meaningful volume driver (Medicaid: 91.2K claims, $638.5K; Medicare: 52.5K claims, $367.8K), consistent with long-distance or high-frequency transport operations rather than a purely short-trip EMS service.
On Medicare competitive standing this provider is a strong national outlier for ALS emergency transports: A0427 ranks #185 of 6841 providers nationally (97th percentile) and is described as notably above typical national volume, while A0425 ranks in the 96th percentile nationally. Even though total Medicare receipts are modest at $2.4M, these ranks indicate unusually high national activity for specific ambulance services.
On Medicaid competitive standing the provider is a major statewide player: A0427 ranks #2 of 88 in-state (99th percentile) and is described as notably above typical state volume, and A0425 is also an elevated state outlier (rank #3 of 105, 98th percentile). These standings support interpretation that the provider is one of Oregon’s leading suppliers of ALS emergency transport and high-mileage ambulance services under Medicaid.
The provider has an established tenure in claims data with an NPI enumerated on 2007-01-23 (~19 years ago), indicating a long-running operation that aligns with the large cumulative claim counts shown (for example, 72.1K Medicaid A0427 claims). Longevity plus concentrated, high-volume code lines suggest an entrenched operational niche in ambulance and specialty transport services.
Several codes are statistical outliers and present both strategic concentration and monitoring points: A0427 is flagged as notably above typical volume in both Medicare and Medicaid, and A0425 also appears as notably above typical volume in Medicaid. Given that the precomputed top-three shares are 87.2% (Medicare) and 95.8% (Medicaid), the business is highly dependent on a narrow set of ambulance services, which amplifies the impact of payer policy changes, reimbursement reviews, or contract shifts affecting those specific codes.
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) | 3,630 | $420 | $1.5M |
| A0425 | Ground mileage, per statute mile | 52,540 | $10 | $367.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 500 | $350 | $176.6K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 670 | $220 | $147.6K |
| A0434 | Specialty care transport (sct) | 130 | $740 | $95.8K |
| A0433 | Advanced life support, level 2 (als 2) | 80 | $610 | $48.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 40 | $250 | $9.9K |
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) | 72,080 | $240 | $17.2M |
| A0434 | Specialty care transport (sct) | 2,080 | $1,500 | $3.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 9,110 | $170 | $1.6M |
| A0425 | Ground mileage, per statute mile | 91,220 | $10 | $638.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6,030 | $40 | $253.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 650 | $40 | $25.4K |
| A0998 | Ambulance response and treatment, no transport | 100 | $230 | $22.3K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $190 | $8.4K |
| S0215 | Non-emergency transportation; mileage, per mile | 680 | $10 | $4.1K |
| A0130 | Non-emergency transportation: wheelchair van | 310 | $10 | $3.1K |
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon 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) | 2 | 90 | 2,490 | $240 | $2M |
| A0130 | Non-emergency transportation: wheelchair van | 17 | 20 | 32,690 | $20 | $1.7M |
| A0434 | Specialty care transport (sct) | 4 | 20 | 530 | $670 | $850.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7 | 70 | 1,600 | $170 | $661.9K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 410 | $240 | $238.9K |
| A0998 | Ambulance response and treatment, no transport | 14 | 20 | 230 | $200 | $212.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 30 | 340 | $70 | $141.2K |
| A0425 | Ground mileage, per statute mile | 3 | 110 | 2,790 | $10 | $134.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 20 | 270 | $100 | $56.5K |
| S0215 | Non-emergency transportation; mileage, per mile | 7 | 10 | 580 | $1 | $47K |
Other providers in the same ZIP code as Metro West Ambulance, Inc, ranked by combined Medicare and Medicaid revenue.
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