| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
2,005 |
1,962 |
$4.11M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
17,554 |
16,023 |
$2.86M |
| A0425 |
Ground mileage, per statute mile |
69,833 |
60,313 |
$2.51M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
39,397 |
34,848 |
$1.94M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
10,314 |
9,620 |
$1.54M |
| A0436 |
Rotary wing air mileage, per statute mile |
2,000 |
1,958 |
$1.13M |
| A0398 |
Als routine disposable supplies |
10,864 |
10,020 |
$158K |
| A0382 |
Bls routine disposable supplies |
6,386 |
6,127 |
$93K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
3,041 |
2,845 |
$33K |
| A0433 |
Advanced life support, level 2 (als 2) |
143 |
135 |
$32K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
519 |
496 |
$28K |
| A0434 |
Specialty care transport (sct) |
13 |
12 |
$3K |
| HN |
Inj marstacim-hncq, 0.5 mg |
102 |
47 |
$240.00 |