| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
1,105 |
924 |
$284K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
259 |
227 |
$48K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
259 |
238 |
$36K |
| A0398 |
Als routine disposable supplies |
488 |
432 |
$31K |
| A0382 |
Bls routine disposable supplies |
632 |
536 |
$28K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
226 |
195 |
$24K |
| A0380 |
Bls mileage (per mile) |
138 |
117 |
$22K |
| A0390 |
Als mileage (per mile) |
39 |
38 |
$16K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
27 |
26 |
$7K |
| 93041 |
|
162 |
153 |
$667.56 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
40 |
38 |
$416.77 |