Statistical flag only — not an accusation of fraud
This provider's $43.6M in total Medicare payments ranks in the 99th percentile of Ambulance Service Provider providers nationally.
Their average markup ratio of 11.08x is significantly above the specialty median of 4.1x.
Medicare payments to this provider grew 65% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 73/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 80% in 2023
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $264.21 | $34.69 | 7.62x | $229.52 | $4.1M | 117.2K | 6 |
| 2015 | $278.45 | $31.77 | 8.76x | $246.68 | $4.9M | 154.0K | 6 |
| 2016 | $284.70 | $30.68 | 9.28x | $254.02 | $4.6M | 148.3K | 6 |
| 2017 | $312.98 | $28.32 | 11.05x | $284.66 | $4.2M | 146.8K | 6 |
| 2018 | $330.22 | $27.32 | 12.09x | $302.90 | $4.0M | 147.9K | 6 |
| 2019 | $368.84 | $28.16 | 13.10x | $340.68 | $4.3M | 152.4K | 6 |
| 2020 | $367.22 | $28.34 | 12.96x | $338.88 | $4.0M | 140.0K | 6 |
| 2021 | $348.18 | $27.18 | 12.81x | $321.00 | $3.2M | 119.5K | 6 |
| 2022 | $350.49 | $28.04 | 12.50x | $322.45 | $3.7M | 132.3K | 6 |
| 2023 | $310.27 | $27.03 | 11.48x | $283.24 | $6.7M | 247.5K | 6 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 120.2K | $24.7M | $205.26 | 11.23x |
| A0425 | Ground mileage, per statute mile | 1.4M | $8.2M | $6.03 | 10.40x |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 13.0K | $4.3M | $329.48 | 10.69x |
| A0434 | Specialty care transport (sct) | 4.2K | $3.0M | $718.37 | 11.15x |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7.2K | $2.8M | $389.34 | 11.93x |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2.7K | $686.3K | $257.72 | 12.39x |
This provider submits charges 11.08 times higher than what Medicare actually pays.
A markup ratio of 11.08x means for every $100 Medicare pays, this provider initially charges $1108. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ambulance Service Provider providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Falck Mobile Health Corp | Orange, CA | $175.0M | ✓ Clear |
| City Of Los Angeles | Los Angeles, CA | $150.4M | ✓ Clear |
| Reach Air Medical Services Llc | Brawley, CA | $146.8M | ⚠️ Flagged |
| Kwph Enterprises Inc | Fresno, CA | $101.2M | ⚠️ Flagged |
| Rural-Metro Of California Inc | San Jose, CA | $77.8M | ⚠️ Flagged |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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