| Code | Description | Claims | Beneficiaries | Total Paid |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
20,339 |
12,838 |
$5.37M |
| A0434 |
Specialty care transport (sct) |
3,361 |
1,556 |
$2.48M |
| A0425 |
Ground mileage, per statute mile |
28,481 |
18,097 |
$1.67M |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
2,907 |
2,860 |
$613K |
| A0999 |
Unlisted ambulance service |
814 |
636 |
$159K |
| A0420 |
Ambulance waiting time (als or bls), one half (1/2) hour increments |
595 |
443 |
$52K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
131 |
125 |
$13K |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
493 |
398 |
$6K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
136 |
112 |
$607.93 |