Statistical flag only — not an accusation of fraud
This provider's $34.6M in total Medicare payments ranks in the 99th percentile of Ambulance Service Provider providers nationally.
Their average markup ratio of 8.82x is significantly above the specialty median of 4.1x.
Medicare payments to this provider grew 3609% from 2014 to 2023.
This provider has been statistically flagged with a risk score of 76/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 79% in 2020
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 | $207.61 | $35.67 | 5.82x | $171.94 | $297.6K | 8.3K | 5 |
| 2015 | $186.79 | $32.30 | 5.78x | $154.49 | $373.1K | 11.6K | 4 |
| 2016 | $159.66 | $28.54 | 5.59x | $131.12 | $534.4K | 18.7K | 4 |
| 2017 | $179.91 | $29.80 | 6.04x | $150.11 | $866.3K | 29.1K | 5 |
| 2018 | $143.19 | $23.49 | 6.10x | $119.70 | $1.4M | 61.4K | 5 |
| 2019 | $180.05 | $20.92 | 8.61x | $159.13 | $2.5M | 121.9K | 5 |
| 2020 | $195.69 | $19.41 | 10.08x | $176.28 | $4.6M | 235.8K | 6 |
| 2021 | $188.87 | $18.40 | 10.26x | $170.47 | $5.6M | 302.6K | 6 |
| 2022 | $175.58 | $18.96 | 9.26x | $156.62 | $7.3M | 387.0K | 7 |
| 2023 | $157.51 | $19.09 | 8.25x | $138.42 | $11.0M | 578.2K | 7 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 1.7M | $10.9M | $6.56 | 5.50x |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 26.4K | $9.6M | $364.90 | 8.00x |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 46.5K | $9.0M | $194.20 | 13.72x |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 14.7K | $4.5M | $306.57 | 8.66x |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1.2K | $274.6K | $231.50 | 12.15x |
| A0433 | Advanced life support, level 2 (als 2) | 258 | $140.5K | $544.69 | 6.70x |
| A0434 | Specialty care transport (sct) | 64 | $43.1K | $673.95 | 13.41x |
This provider submits charges 8.82 times higher than what Medicare actually pays.
A markup ratio of 8.82x means for every $100 Medicare pays, this provider initially charges $882. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Acadian Ambulance Service Of Texas Llc | Beaumont, TX | $193.0M | ⚠️ Flagged |
| Lone Star Ambulance 1, Llc | Corpus Christi, TX | $142.8M | ✓ Clear |
| Careflite | Grand Prairie, TX | $111.4M | ⚠️ Flagged |
| Lifenet, Inc. | Texarkana, TX | $84.5M | ✓ Clear |
| City Of Houston | Houston, TX | $76.2M | ✓ 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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