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NPI 1730280447 · Newport, OR · Land Ambulance
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Pacific West Ambulance Inc is a land ambulance provider located in Newport, Oregon. This profile covers 7 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 | Pacific West Ambulance Inc |
| Address | 609 Nw Coast St |
| City | Newport |
| State | OR |
| ZIP | 97365 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | September 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.4M |
| Medicare | $1.3M |
Business profile: PACIFIC WEST AMBULANCE INC is a land-ambulance operator whose Medicare and Medicaid revenue is driven primarily by emergency advanced-life-support transports (A0427) and ground mileage (A0425), with notable specialty-care transport (A0434) activity on the Medicaid side. The presence of high-count A0427 and A0425 claims across both payers (Medicare A0427: 2K claims; A0425: 35.3K claims — Medicaid A0427: 15.6K claims; A0425: 19.1K claims) indicates an operational focus on frequent emergency ALS responses and long- or mid-distance ground movements rather than a fleet dominated by non-emergency interfacility work.
Revenue concentration: Revenue is highly concentrated in a very small set of codes for each payer — the top 3 Medicare codes by revenue account for 89.8% of the provider's Medicare revenue, and the top 3 Medicaid codes by revenue account for 91.0% of the provider's Medicaid revenue. This concentration means changes in reimbursement or utilization for those specific codes (notably A0427, A0425, and A0429/A0434) would materially affect the provider's overall revenue.
Payer mix and scale: PACIFIC WEST AMBULANCE reports $1.3M in total Medicare revenue and $4.4M in total Medicaid revenue, showing a materially larger Medicaid footprint by dollar volume. The Medicaid program is the dominant revenue source in scale for this provider, while Medicare represents a smaller but still meaningful share of billed ambulance activity.
Medicare competitive standing: For Medicare, A0427 generates $764.9K (57.5% of Medicare revenue) and the provider ranks #338 of 6841 nationally (95th percentile), while A0425 contributes $318K (23.9%) and ranks #600 of 8934 (93th percentile). Although these percentiles place the provider well above many peers on those codes, the record summary describes this as "typical, unremarkable volume for this code," suggesting solid placement among many active ambulance vendors rather than unique dominance.
Medicaid competitive standing: In Medicaid, A0427 is the clear revenue driver with $3.2M (73.8% of Medicaid revenue) and a #10 of 88 in-state ranking (90th percentile), indicating a top-tier in-state position on emergency ALS transports. A0434 contributes $444.7K (10.2%) and ranks #13 of 21 in-state (40th percentile), showing the provider has a strong emergency-ALS footprint statewide but more modest market share in specialty care transport within Oregon.
Service-line nuance: Comparison of unit economics across payers shows differences in average paid per claim that reflect payer policy and case mix — Medicare A0427 averages $380 paid/claim while Medicaid A0427 averages $206 paid/claim, and ground mileage (A0425) averages $9 paid/claim on Medicare versus $16 on Medicaid. This suggests the provider performs a high volume of mileage-based transports where Medicaid payments per-mile are relatively higher than Medicare, and that the Medicaid mix includes many lower-paid ALS encounters but at much higher claim counts.
Operational scope and tenure: The provider's NPI was enumerated on 2006-09-26 (~20 years ago), indicating a long-established presence in the market which is consistent with the high claim counts reported across both payers. Longevity combined with concentrated-code revenue implies an established operational model centered on emergency ALS and mileage-based ground services.
Statistical standing and risk surface: Across reported codes, most entries are labeled in the source as "typical, unremarkable volume for this code," and no codes are flagged as extreme outliers in the supplied data. While the provider ranks in high percentiles for several top codes (e.g., Medicare A0427 at the 95th percentile and Medicaid A0427 at the 90th percentile), the available labels and ranks together indicate a high-activity ambulance vendor rather than an anomalous statistical outlier in coding pattern.
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) | 2,010 | $380 | $764.9K |
| A0425 | Ground mileage, per statute mile | 35,340 | $10 | $318K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 340 | $330 | $111.8K |
| A0434 | Specialty care transport (sct) | 90 | $670 | $60.1K |
| A0433 | Advanced life support, level 2 (als 2) | 80 | $560 | $45.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 120 | $200 | $23.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 30 | $240 | $6.2K |
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 15,630 | $210 | $3.2M |
| A0434 | Specialty care transport (sct) | 280 | $1,590 | $444.7K |
| A0425 | Ground mileage, per statute mile | 19,090 | $20 | $305.4K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,080 | $130 | $262.2K |
| A0998 | Ambulance response and treatment, no transport | 910 | $150 | $131.9K |
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
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) | 10 | 90 | 2,490 | $240 | $2M |
| A0434 | Specialty care transport (sct) | 13 | 20 | 530 | $670 | $850.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 29 | 70 | 1,600 | $170 | $661.9K |
| A0998 | Ambulance response and treatment, no transport | 7 | 20 | 230 | $200 | $212.5K |
| A0425 | Ground mileage, per statute mile | 13 | 110 | 2,790 | $10 | $134.1K |
Other providers in the same ZIP code as Pacific West Ambulance Inc, ranked by combined Medicare and Medicaid revenue.
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