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NPI 1962437855 · Alamogordo, NM · Ambulance
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American Medical Response Ambulance Service Inc is a ambulance provider located in Alamogordo, New Mexico. This profile covers 6 Medicare and 7 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 Ambulance Service Inc |
| Address | 2423 Lawrence Blvd |
| City | Alamogordo |
| State | NM |
| ZIP | 88310 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $23.9M |
| Medicare | $3M |
Service-line profile: The billing mix is characteristic of a high-volume ambulance operator with a strong focus on emergency advanced life support (ALS) and significant ground-mileage billing. A0427 (ALS emergency) is the single largest Medicare line ($1.5M, 49.0% of Medicare revenue) and the single largest Medicaid line ($10.8M, 45.2% of Medicaid revenue), while A0425 (ground mileage) also contributes materially on both payers (Medicare: 95.9K claims, $767.3K; Medicaid: 73.2K claims, $4M). This combination indicates routine emergency ALS transports and extensive mileage exposure consistent with long-distance or geographically dispersed service coverage.
Revenue concentration: Revenue is highly concentrated in a small set of transport and mileage codes for each payer. Precomputed aggregates show the top 3 Medicare codes account for 85.5% of this provider’s Medicare revenue and the top 3 Medicaid codes account for 81.3% of its Medicaid revenue, indicating limited diversification beyond core ambulance transport and mileage services. Analysts should therefore treat changes in utilization or reimbursement of those few codes as having outsized impact on overall revenue.
Payer mix and scale: This entity is materially Medicaid-dominant by scale, reporting $23.9M in lifetime Medicaid revenue versus $3M in lifetime Medicare revenue. The Medicaid program is the primary revenue driver for this provider, so state policy, Medicaid rate changes, or in-state competition will likely have larger financial impact than national Medicare trends.
National competitive standing (Medicare): For Medicare, the provider is a high-volume national participant on its principal emergency and mileage lines. A0427 ranks #198 of 6841 providers (97th percentile; notably above typical national volume) and A0425 ranks #166 of 8934 providers (98th percentile; notably above typical national volume), signaling above-average national activity on ALS emergency and mileage compared with peers, while A0428 (BLS non-emergency) is more typical (rank #460 of 2772, 83th percentile).
State competitive standing (Medicaid): Within New Mexico, the provider is a leading ambulance supplier on core codes. A0427 ranks #2 of 53 providers in-state (98th percentile; typical), A0429 ranks #3 of 56 (96th percentile; typical), and A0425 ranks #2 of 65 (98th percentile; labeled an extreme outlier), indicating near-top or outlier volumes statewide for emergency transport and mileage and suggesting dominant market share in parts of the state.
Statistical outliers and coding notes: Specific codes show flagged statistical standing that merits attention when benchmarking utilization. Medicaid A0425 (ground mileage) is described as an "extreme outlier, far above typical state volume," and both Medicare A0427 and A0425 are characterized as "notably above typical national volume," while codes such as Medicare A0428 and A0426 show more typical, unremarkable volumes. Such labels point to unusually high mileage and ALS emergency utilization relative to peers and should be considered when assessing network capacity, reimbursement risk, or audit exposure.
Operational implications of mileage and unlisted-service billing: The extremely high mileage counts (Medicare A0425: 95.9K claims; Medicaid A0425: 73.2K claims) together with substantial Medicaid billing for A0999 (16.2K claims, $1.3M; rank #1 of 8 in-state, 100th percentile) suggest frequent long-distance transports and a material amount of services billed under an unlisted ambulance code. This mix implies operational emphasis on extended transports and potentially specialized or nonstandard trips that are reported outside of typical CPT/HCPCS line items.
Tenure and stability signal: The provider’s NPI was enumerated on 2006-07-11 (~20 years ago), indicating long-term establishment in the market. That tenure, combined with concentrated but high-volume billing across both Medicare and Medicaid, points to an established ambulance operator that is highly dependent on a narrow set of transport and mileage services for revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,420 | $440 | $1.5M |
| A0425 | Ground mileage, per statute mile | 95,910 | $10 | $767.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,590 | $220 | $349.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 890 | $380 | $339.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 230 | $280 | $63K |
| A0433 | Advanced life support, level 2 (als 2) | 70 | $620 | $42.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 40,170 | $270 | $10.8M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16,970 | $270 | $4.6M |
| A0425 | Ground mileage, per statute mile | 73,200 | $50 | $4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 19,080 | $120 | $2.3M |
| A0999 | Unlisted ambulance service | 16,230 | $80 | $1.3M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6,040 | $110 | $676.3K |
| A0998 | Ambulance response and treatment, no transport | 2,970 | $70 | $201.8K |
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
7 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) | 2 | 50 | 1,320 | $270 | $2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 3 | 60 | 1,850 | $260 | $1.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 30 | 1,050 | $120 | $515.6K |
| A0425 | Ground mileage, per statute mile | 2 | 70 | 2,010 | $50 | $332.1K |
| A0999 | Unlisted ambulance service | 1 | 10 | 1,160 | $70 | $280.1K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2 | 10 | 560 | $120 | $225.1K |
| A0998 | Ambulance response and treatment, no transport | 3 | 30 | 470 | $40 | $77.6K |
Other providers in the same ZIP code as American Medical Response Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
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