| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,474 |
2,166 |
$193K |
| A0425 |
Ground mileage, per statute mile |
5,712 |
4,105 |
$190K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
762 |
702 |
$147K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
321 |
311 |
$63K |
| A0382 |
Bls routine disposable supplies |
2,552 |
1,510 |
$8K |
| A0398 |
Als routine disposable supplies |
864 |
556 |
$6K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
81 |
48 |
$704.74 |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
13 |
13 |
$408.50 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
14 |
14 |
$5.08 |
| 94760 |
|
33 |
31 |
$3.74 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
14 |
14 |
$0.00 |