| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
535 |
452 |
$82K |
| A0425 |
Ground mileage, per statute mile |
845 |
708 |
$30K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
141 |
127 |
$28K |
| A0382 |
Bls routine disposable supplies |
183 |
153 |
$8K |
| A0398 |
Als routine disposable supplies |
80 |
72 |
$5K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
62 |
56 |
$3K |
| A0380 |
Bls mileage (per mile) |
61 |
56 |
$2K |
| A0390 |
Als mileage (per mile) |
30 |
26 |
$1K |
| 93041 |
|
60 |
40 |
$207.63 |