| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
30,427 |
27,526 |
$5.96M |
| A0425 |
Ground mileage, per statute mile |
37,758 |
32,528 |
$685K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
6,702 |
5,853 |
$507K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
3,574 |
3,293 |
$28K |
| A0434 |
Specialty care transport (sct) |
12 |
12 |
$2K |
| S5102 |
Day care services, adult; per diem |
14 |
14 |
$1K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
58 |
55 |
$106.09 |
| A0398 |
Als routine disposable supplies |
15 |
15 |
$0.00 |