Statistical flag only — not an accusation of fraud
This provider's $207.1M in total Medicare payments ranks in the 99th percentile of Ambulance Service Provider providers nationally.
Their average markup ratio of 6.25x is significantly above the specialty median of 4.1x.
Medicare payments to this provider grew 159% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 79/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
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 | $149.51 | $28.90 | 5.17x | $120.61 | $9.8M | 339.5K | 7 |
| 2015 | $153.33 | $31.06 | 4.94x | $122.27 | $13.7M | 441.2K | 7 |
| 2016 | $156.47 | $31.83 | 4.92x | $124.64 | $18.2M | 571.4K | 7 |
| 2017 | $155.19 | $31.93 | 4.86x | $123.26 | $23.7M | 743.4K | 7 |
| 2018 | $207.70 | $29.84 | 6.96x | $177.86 | $26.6M | 890.0K | 7 |
| 2019 | $270.62 | $31.26 | 8.66x | $239.36 | $25.2M | 805.5K | 7 |
| 2020 | $185.70 | $32.12 | 5.78x | $153.58 | $21.1M | 657.6K | 7 |
| 2021 | $168.28 | $31.07 | 5.42x | $137.21 | $21.2M | 682.5K | 17 |
| 2022 | $158.30 | $30.11 | 5.26x | $128.19 | $22.2M | 738.0K | 16 |
| 2023 | $275.30 | $32.72 | 8.41x | $242.58 | $25.4M | 776.4K | 7 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 432.8K | $82.4M | $190.34 | 6.77x |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 128.9K | $40.9M | $317.19 | 4.96x |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 104.2K | $39.3M | $377.38 | 5.12x |
| A0425 | Ground mileage, per statute mile | 5.9M | $35.1M | $5.90 | 8.13x |
| A0434 | Specialty care transport (sct) | 7.7K | $5.1M | $668.09 | 4.26x |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 14.4K | $3.4M | $236.31 | 6.42x |
| A0433 | Advanced life support, level 2 (als 2) | 1.2K | $659.4K | $552.27 | 4.09x |
| 0012A | Adm sarscov2 100mcg/0.5ml2nd | 1.8K | $66.5K | $36.83 | 2.72x |
| 0011A | Adm sarscov2 100mcg/0.5ml1st | 1.7K | $45.3K | $26.55 | 3.77x |
| 0064A | Adm sarscov2 50mcg/0.25mlbst | 940 | $42.9K | $45.63 | 2.19x |
| 0002A | Adm sarscov2 30mcg/0.3ml 2nd | 705 | $32.3K | $45.87 | 2.18x |
| 0001A | Adm sarscov2 30mcg/0.3ml 1st | 677 | $31.0K | $45.83 | 2.18x |
| 0004A | Adm sarscov2 30mcg/0.3ml bst | 483 | $22.1K | $45.81 | 2.18x |
| 0013A | Adm sarscov2 100mcg/0.5ml3rd | 389 | $17.8K | $45.81 | 2.18x |
| 0003A | Adm sarscov2 30mcg/0.3ml 3rd | 364 | $16.7K | $45.81 | 2.18x |
| 0031A | Adm sarscov2 vac ad26 .5ml | 237 | $10.7K | $45.01 | 2.22x |
| 0054A | Adm sarscv2 30mcg trs-sucr b | 200 | $9.0K | $45.06 | 2.22x |
| 0124A | Fee covid-19 vac 13 res | 102 | $4.5K | $44.58 | 2.24x |
| 0034A | Adm sarscov2 vac ad26 .5ml b | 76 | $3.5K | $45.78 | 2.18x |
| 0134A | Fee covid-19 vac 14 res | 74 | $3.3K | $44.58 | 2.24x |
This provider submits charges 6.25 times higher than what Medicare actually pays.
A markup ratio of 6.25x means for every $100 Medicare pays, this provider initially charges $625. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Cataldo Ambulance Service Inc | Somerville, MA | $134.4M | ✓ Clear |
| American Medical Response Of Massachusetts Inc | Springfield, MA | $104.1M | ⚠️ Flagged |
| Eascare Llc | Weymouth, MA | $62.4M | ✓ Clear |
| Boston Public Health Commission | Boston, MA | $61.9M | ✓ Clear |
| Armstrong Ambulance Service | Arlington, MA | $50.9M | ✓ Clear |
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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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