| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0430 |
Ambulance service, conventional air services, transport, one way (fixed wing) |
3,747 |
3,412 |
$5.81M |
| A0435 |
Fixed wing air mileage, per statute mile |
3,773 |
3,429 |
$5.08M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
2,348 |
1,851 |
$538K |
| A0425 |
Ground mileage, per statute mile |
2,502 |
1,957 |
$115K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
59 |
30 |
$8K |
| A0390 |
Als mileage (per mile) |
147 |
94 |
$4K |
| A0380 |
Bls mileage (per mile) |
20 |
14 |
$529.77 |