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NPI 1811552136 · King Of Prussia, PA · Ambulance
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Ambulnz PA, LLC is a ambulance provider located in King Of Prussia, Pennsylvania. This profile covers 5 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 | Ambulnz PA, LLC |
| Address | 154 Hansen Access Rd |
| City | King Of Prussia |
| State | PA |
| ZIP | 19406 |
| Taxonomy | Ambulance |
| NPI Enumerated | May 2, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.8M |
| Medicare | $3.3M |
AMBULNZ PA, LLC's billing profile shows a clear ground-ambulance service orientation: the provider's Medicare and Medicaid revenue is driven by basic life support non-emergency transports and mileage codes (A0428 and A0425), with additional revenue from specialty care transport (A0434) and advanced life support non-emergency (A0426). This mix indicates an operation concentrated on non-emergency patient moves rather than emergency scene responses, consistent with high counts of non-emergency BLS claims across both payers.
Medicare revenue is concentrated in a very small set of services: the top 3 Medicare codes account for 93.6% of the provider's $3.3M Medicare revenue, led by A0428 at $2.2M (66.4% of Medicare revenue), A0425 at $723.8K (21.7%), and A0434 at $185.8K (5.6%). That degree of concentration suggests financial sensitivity to reimbursement or utilization shifts affecting those few codes.
Medicaid billing is even more concentrated: the top 3 Medicaid codes account for 95.9% of the provider's $3.8M Medicaid revenue, dominated by A0428 at $2.8M (75.1%), with A0426 at $407.4K (10.8%) and A0425 at $376.9K (10.0%). Such dependence on A0428 for three-quarters of Medicaid revenue highlights a narrow service portfolio on the state program and limited diversification of Medicaid revenue streams.
On payer mix, AMBULNZ reports $3.3M in Medicare revenue versus $3.8M in Medicaid revenue, indicating it is a dual-payer operator with Medicaid slightly larger in lifetime revenue. The similar magnitude of both payers means contract negotiations and utilization management with either program could materially affect overall revenue.
Nationally and in-state ranking data show a strong competitive position for core codes: for Medicare A0428 the provider ranks #48 of 2772 (98th percentile; extreme outlier) and A0425 ranks #142 of 8934 (98th percentile; notably above typical national volume). On Medicaid A0428 is a dominant in-state performer at #3 of 157 (99th percentile; extreme outlier), and A0426 is also high at #4 of 59 (95th percentile); these rankings indicate the provider is a major volume player in its state for core ambulance services.
Several individual-code metrics underscore operational scale: Medicare A0425 shows 103.4K claims and Medicare A0428 shows 10K claims, while Medicaid A0428 has 22.4K claims — volumes that are large for ground-ambulance services and likely reflect a substantial non-emergency transport footprint. High claim counts combined with high rank percentiles suggest sizable ongoing operational capacity and frequent trips billed to both payers.
Code-level statistical characterizations reinforce the above: Medicare A0428 and A0425 are described as an "extreme outlier" and "notably above typical national volume" respectively, and Medicaid A0428 is an "extreme outlier" in-state. These labels, paired with the rankings and dollar concentrations, emphasize that AMBULNZ is operating well above typical peer volumes for its primary billing codes.
The provider's NPI was enumerated on 2019-05-02 (~7 years ago), and despite relatively recent enumeration it has already established very high-volume positions for core transport codes. That tenure combined with concentrated, high-ranking billing suggests a rapidly scaled or focused ambulance operation that is materially engaged with both Medicare and Medicaid revenue streams.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,000 | $220 | $2.2M |
| A0425 | Ground mileage, per statute mile | 103,400 | $10 | $723.8K |
| A0434 | Specialty care transport (sct) | 260 | $720 | $185.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 680 | $270 | $180.1K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 80 | $420 | $32.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 22,350 | $130 | $2.8M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,110 | $190 | $407.4K |
| A0425 | Ground mileage, per statute mile | 15,080 | $30 | $376.9K |
| A0434 | Specialty care transport (sct) | 520 | $290 | $148.8K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 40 | $190 | $7.8K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0434 | Specialty care transport (sct) | 7 | 10 | 350 | $20 | $2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 254 | 290 | 710 | $300 | $631.5K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3 | 160 | 460 | $150 | $316.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 60 | 120 | $270 | $160.6K |
| A0425 | Ground mileage, per statute mile | 9 | 440 | 400 | $30 | $76K |
Other providers in the same ZIP code as Ambulnz PA, LLC, ranked by combined Medicare and Medicaid revenue.
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