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NPI 1861818965 · Hampton, VA · Ambulance
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American Medical Response Mid-atlantic, Inc. is a ambulance provider located in Hampton, Virginia. This profile covers 7 Medicare and 14 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 | American Medical Response Mid-atlantic, Inc. |
| Address | 5000 Incubator Rd |
| City | Hampton |
| State | VA |
| ZIP | 23661 |
| Taxonomy | Ambulance |
| NPI Enumerated | March 13, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.3M |
| Medicare | $4.9M |
AMERICAN MEDICAL RESPONSE MID-ATLANTIC, INC. is an ambulance-focused service line: its top Medicare codes are A0428, A0425 and A0426 which correspond to basic life support non-emergency transport, ground mileage, and advanced life support non-emergency transport. The prominence of both BLS and ALS non-emergency codes indicates the organization operates a high-volume transport fleet focused on scheduled or non-emergent transfers as well as mileage-driven runs. This mix is consistent with an EMS provider that provides both routine BLS transports and ALS-capable services when needed.
Revenue concentration is high on both payers. For Medicare the precomputed top-three codes account for 89.9% of total Medicare revenue, meaning the provider’s Medicare receipts are heavily dependent on a very small set of ambulance and mileage codes. Similarly, Medicaid revenue is concentrated with the top-three codes making up 80.8% of the provider’s total Medicaid revenue, again signaling reliance on a narrow set of transport services.
Payer mix shows comparable scale between programs: lifetime Medicare revenue is listed as $4.9M while lifetime Medicaid revenue is $5.3M, so the provider generates material revenue from both payers rather than being single-payer dependent. Both payers matter to the business, with Medicaid slightly larger in cumulative dollars.
Competitive standing on Medicare is nationally extreme for key volume drivers: A0428 ranks #43 of 2772 providers (98th percentile; described as an extreme outlier) and A0425 ranks #24 of 8934 providers (100th percentile; extreme outlier). These ranks indicate this entity is a major national-volume outlier for basic BLS non-emergency transports and ground mileage billed to Medicare, placing it well above typical national peers for those codes. By contrast, some Medicare codes such as A0427 and A0429 sit at more typical national percentiles (85th and 82nd respectively), reflecting that emergency transports are not as exceptionally concentrated as non-emergency and mileage billing.
Within Virginia Medicaid the provider is also a dominant state-level player on specific codes: A0425 (ground mileage) ranks #5 of 273 in-state (99th percentile; extreme outlier) and A0428 (BLS non-emergency) ranks #2 of 73 in-state (99th percentile; extreme outlier). Those rankings establish the provider as one of the largest in-state billers for mileage and non-emergency BLS transports to Medicaid, while other Medicaid codes such as A0429 and A0427 show high but more typical state percentiles (94th and 88th respectively).
Specific code-level patterns suggest operational emphasis on mileage-driven revenue: A0425 contributes $1.8M to Medicare revenue and $2M to Medicaid revenue, representing the single largest revenue line on both payers by raw listed amounts. Coupled with large claim counts for A0425 and A0428 on Medicaid (72.1K and 45.1K claims respectively), the data imply a business model with very high trip and mileage volumes—likely long-distance or frequent scheduled transports that generate substantial per-mile billing.
Tenure: the provider’s NPI was enumerated on 2014-03-13 (approximately 12 years ago), indicating an established presence in the market long enough to build significant volume and payer relationships for both Medicare and Medicaid ambulance services. This duration supports the observed high cumulative revenues and top-rank positions.
Several codes are called out as statistical outliers or notably above typical volume and warrant attention as distinguishing features of the profile. For Medicare, A0428 and A0425 are labeled extreme outliers nationally; for Medicaid, A0425 and A0428 are extreme outliers in-state. These labels reinforce that the provider’s operational footprint is unusually large for specific non-emergency and mileage codes versus peers, and those codes disproportionately shape its competitive standing and financial exposure.
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 |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 10,650 | $210 | $2.2M |
| A0425 | Ground mileage, per statute mile | 261,030 | $10 | $1.8M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,260 | $250 | $318K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 740 | $400 | $294.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 400 | $330 | $131.1K |
| A0434 | Specialty care transport (sct) | 70 | $690 | $50.7K |
| A0433 | Advanced life support, level 2 (als 2) | 30 | $580 | $15.7K |
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.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 72,140 | $30 | $2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13,580 | $110 | $1.4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 45,130 | $20 | $857.4K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,910 | $110 | $760.5K |
| T2005 | Non-emergency transportation; stretcher van | 1,090 | $140 | $149.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3,530 | $30 | $102.5K |
| T2049 | Non-emergency transportation; stretcher van, mileage; per mile | 1,090 | $1 | $4.4K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $80 | $1.4K |
| A0434 | Specialty care transport (sct) | 20 | $20 | $480 |
| A0999 | Unlisted ambulance service | 20 | $20 | $320 |
Showing 1–10 of 14
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
14 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T2005 | Non-emergency transportation; stretcher van | 52 | 120 | 760 | $250 | $656.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 70 | 1,160 | $80 | $511.5K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 24 | 200 | 1,250 | $90 | $326K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 14 | 220 | 1,390 | $80 | $307.1K |
| A0425 | Ground mileage, per statute mile | 5 | 270 | 2,410 | $20 | $166.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 4 | 30 | 250 | $130 | $149.4K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 87 | 110 | 13,080 | $1 | $58.3K |
| A0434 | Specialty care transport (sct) | 6 | 10 | 80 | $200 | $43.4K |
| A0433 | Advanced life support, level 2 (als 2) | 11 | 10 | 200 | $160 | $33.2K |
| T2049 | Non-emergency transportation; stretcher van, mileage; per mile | 52 | 120 | 760 | $1 | $12.3K |
Showing 1–10 of 14
Other providers in the same ZIP code as American Medical Response Mid-atlantic, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Versability Resources, Inc. | VA | Developmentally Disabled Services Day Training Agency | $0 | $22.2M |
| United & Empowered Care, Inc. | VA | Skilled Nursing Facility | $0 | $13.6M |
| Sahrawi Inc | VA | Taxi | $0 | $6M |
| Donna Hutzler | VA | Clinical Social Worker | $68.8K | $0 |
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