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NPI 1699889915 · Rio Grande, PR · Land Ambulance
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Raul Medina is a land ambulance provider located in Rio Grande, Puerto Rico. This profile covers 2 Medicare and 4 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 | Raul Medina |
| Address | Km 27.0 |
| City | Rio Grande |
| State | PR |
| ZIP | 00745 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | August 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.6M |
| Medicare | $9.7K |
This provider is effectively Medicaid-dominant: lifetime Medicaid revenue is $4.6M versus only $9.7K in Medicare revenue, so the bulk of operating scale and financial exposure is on the Medicaid side rather than Medicare. The asymmetry means payor-specific policy or contract changes at the state level will have outsized impact on total revenue.
Revenue is highly concentrated within a very small set of codes on both payers: the precomputed top 3 Medicare codes by revenue account for 100.0% of Medicare revenue, and the precomputed top 3 Medicaid codes by revenue account for 97.3% of Medicaid revenue. For Medicaid the top three contributors are A0429 (55.3%), A0427 (27.9%), and A0425 (14.1%), which together dominate the provider’s Medicaid receipts.
The code mix and volumes indicate a land-ambulance operation focused on emergency transports and extensive ground mileage. High Medicaid claim counts for emergency basic life support and advanced life support—A0429 with 17.3K claims and A0427 with 7.1K claims—combined with large A0425 mileage volume (26.2K claims) point to a business model that emphasizes frequent emergency response and significant transport distances. A0428 (1.7K Medicaid claims) appears only as a small portion of Medicaid revenue.
State-level competitive standing is concentrated and extreme for several Medicaid codes: A0429 ranks #2 of 186 in-state (99th percentile; extreme outlier, far above typical state volume), A0427 ranks #3 of 64 (97th percentile; notably above typical state volume), and A0425 ranks #2 of 226 (100th percentile; extreme outlier, far above typical state volume). These ranks indicate the provider is a dominant in-state supplier for emergency ambulance services and mileage for Medicaid patients.
By contrast, the provider’s Medicare footprint is modest and unremarkable: A0428 generates $7.6K (78.1% of the provider’s Medicare revenue) but ranks #2242 of 2772 nationally (19th percentile), and A0425 generates $2.1K (21.9% of Medicare revenue) and ranks #8417 of 8934 nationally (6th percentile). The combination of very low aggregate Medicare revenue ($9.7K) and low national percentiles suggests Medicare is a minor, lower-volume payor for this operation.
Operational interpretation: the dominance of emergency transport codes (A0429 and A0427) plus very high mileage claims (A0425) implies routine handling of high-frequency emergency calls and long or numerous transports rather than primarily local non-emergency runs. This mix has implications for staffing, vehicle utilization, and reimbursement sensitivity to mileage and emergent-transport policy changes.
The provider has a long tenure in the NPI file (enumerated 2006-08-17, ~20 years ago), which, coupled with the extreme in-state Medicaid volumes, suggests an established operational role in the state Medicaid ambulance network rather than a recent entrant. That longevity may reflect sustained contracts or referral pathways within the service area.
Because revenue is concentrated in a small set of high-volume Medicaid codes (top 3 = 97.3%) and Medicare revenue is nearly negligible in scale relative to Medicaid, any policy, rate, or utilization review changes affecting A0429, A0427, or A0425 could materially alter overall revenue. Analysts should prioritize monitoring reimbursement rules and state contract terms for those specific codes when assessing financial and operational risk.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 17,330 | $150 | $2.6M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7,080 | $180 | $1.3M |
| A0425 | Ground mileage, per statute mile | 26,180 | $30 | $654.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,690 | $70 | $124.8K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
4 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) | 3 | 60 | 250 | $200 | $232.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 190 | 300 | $150 | $137.9K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 13 | 50 | 390 | $60 | $124.2K |
| A0425 | Ground mileage, per statute mile | 2 | 230 | 480 | $30 | $52.1K |
Other providers in the same ZIP code as Raul Medina, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Centro De Diagnostico Y Tratamiento De Rio Grande | PR | Emergency Care Clinic/Center | $0 | $4.7M |
| Laboratorio Clinico Chegar Inc | PR | Clinical Medical Laboratory | $8.8K | $1.9M |
| Fajardo Imaging Mri Csp | PR | Mammography Clinic/Center | $0 | $1.1M |
| Centro De Medicina Fisica Y Rehabilitacion Rio Grande,inc | PR | Physical Therapy Clinic/Center | $0 | $680.3K |
| Walgreen Co. | PR | Pharmacy | $129K | $0 |
| Aracelis Mendoza | PR | Clinical Medical Laboratory | $0 | $2.5K |
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