Loading...
NPI 1720050826 · Rockford, IL · Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
City Of Rockford is a ambulance provider located in Rockford, Illinois. 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 | City Of Rockford |
| Address | 204 S 1st St |
| City | Rockford |
| State | IL |
| ZIP | 61104 |
| Taxonomy | Ambulance |
| NPI Enumerated | February 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $63.7M |
| Medicare | $1.3M |
City of Rockford is operating as an emergency ambulance provider: its Medicare and Medicaid revenue is concentrated in emergency transport codes A0427 and A0429 with ground mileage A0425 also present. On Medicare the top revenue drivers are A0427 (50.8% of Medicare revenue) and A0429 (40.9% of Medicare revenue), and on Medicaid the same two codes dominate with A0429 at 61.2% and A0427 at 37.3% of Medicaid revenue, indicating primary business activity is ALS/BLS emergency transport rather than ancillary services. The presence of A0425 in both payers (Medicare A0425 = 7.0% of Medicare revenue; Medicaid A0425 = 1.4% of Medicaid revenue) shows mileage is billed frequently but contributes only a small share of total revenue.
Revenue concentration is extreme across both payers: the top three Medicare codes account for 98.7% of Medicare revenue and the top three Medicaid codes account for 99.9% of Medicaid revenue. This concentration means reimbursement changes or policy shifts affecting A0427, A0429, or A0425 would materially alter overall revenue for this provider, because nearly all billed dollars come from that narrow code set.
The provider’s payer mix is heavily skewed toward Medicaid in scale: lifetime Medicaid revenue is $63.7M compared with $1.3M in lifetime Medicare revenue, indicating Medicaid is the dominant source of billed volume and dollars. Operational metrics (claim counts and avg paid/claim) reinforce the Medicaid emphasis: for example, Medicaid reports 40.4K claims for A0429 at $965 avg paid/claim (total $39M), while Medicare shows 1.6K claims for A0429 at $317 avg paid/claim (total $515.1K).
Competitive standing in-state for Medicaid BLS is a clear strength: A0429 ranks #5 of 339 providers in-state (99th percentile) and is explicitly labeled as "notably above typical state volume for this code," marking City of Rockford as a major Medicaid BLS provider locally. A0427 also posts large in-state ranks (A0427 ranks #6 of 362, 99th percentile) but is described as "typical, unremarkable volume for this code," suggesting very high counts that nonetheless fall within state norms for ALS emergency billing patterns.
On Medicare the provider shows solid national placement on the same ambulance codes but with labels indicating routine volumes: A0427 ranks #409 of 6841 providers (94th percentile) and A0429 ranks #256 of 7808 providers (97th percentile), each characterized as "typical, unremarkable volume for this code." In other words, City of Rockford is visible nationally on ALS/BLS codes but the data labels frame those volumes as within common national practice rather than exceptional outliers.
Payment level signals differ sharply by payer and may reflect payer-specific reimbursement policies: Medicaid avg paid/claim for A0429 is $965 (40.4K claims, $39M revenue) and for A0427 is $935 (25.4K claims, $23.8M revenue), whereas Medicare avg paid/claim for A0429 is $317 and for A0427 is $377. These per-claim differences, combined with far larger Medicaid claim counts, explain why Medicaid drives the revenue scale despite similar code mixes across payers.
The entity has long operational tenure that supports sustained market position: the NPI was enumerated on 2006-02-02 (~20 years ago), consistent with the large cumulative Medicaid and Medicare volumes reported. That longevity, paired with the concentrated code mix and high in-state Medicaid ranks, suggests an established municipal ambulance operation focused on emergency transports rather than diversified outpatient or ancillary services.
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) | 1,700 | $380 | $639.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,630 | $320 | $515.1K |
| A0425 | Ground mileage, per statute mile | 12,520 | $10 | $87.7K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $540 | $16.7K |
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 40,450 | $970 | $39M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 25,410 | $940 | $23.8M |
| A0425 | Ground mileage, per statute mile | 65,100 | $10 | $911.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 6,210 | $10 | $68.4K |
| A0433 | Advanced life support, level 2 (als 2) | 70 | $180 | $12.8K |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois 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) | 6 | 360 | 1,340 | $910 | $4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5 | 340 | 1,050 | $770 | $2.8M |
| A0425 | Ground mileage, per statute mile | 12 | 450 | 2,450 | $40 | $602.5K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 70 | $190 | $117.5K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 9 | 70 | 800 | $10 | $56.8K |
Other providers in the same ZIP code as City Of Rockford, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Crusaders Central Clinic Association | IL | Federally Qualified Health Center (FQHC) | $0 | $38.9M |
| Rockford Public Schools Dis205 | IL | Local Education Agency (LEA) | $0 | $13.7M |
| Sara Fleming | IL | Anatomic Pathology & Clinical Pathology Physician | $24.6K | $12.9M |
| The Board Of Trustees Of The University Of Illinois | IL | Federally Qualified Health Center (FQHC) | $0 | $7.1M |
| Swedishamerican Hospital | IL | General Acute Care Hospital | $0 | $4.8M |
| Aunt Martha's Health And Wellness | IL | Federally Qualified Health Center (FQHC) | $0 | $2.9M |
| Wei Gao | IL | General Practice Dentistry | $0 | $2.9M |
| Juliette Strombeck | IL | Family Nurse Practitioner | $183.2K | $621K |
| Eric Cuasay | IL | Diagnostic Radiology Physician | $81.9K | $425.5K |
| Anna August | IL | Family Nurse Practitioner | $114.6K | $191.5K |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.