| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
12,636 |
9,205 |
$636K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
6,981 |
5,185 |
$431K |
| A0425 |
Ground mileage, per statute mile |
36,277 |
23,850 |
$376K |
| T2005 |
Non-emergency transportation; stretcher van |
5,558 |
4,717 |
$246K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
11,302 |
7,117 |
$110K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
267 |
234 |
$10K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
1,477 |
1,014 |
$7K |
| A0433 |
Advanced life support, level 2 (als 2) |
17 |
13 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,905 |
1,260 |
$2K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
1,132 |
734 |
$275.88 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,302 |
897 |
$218.00 |
| A0398 |
Als routine disposable supplies |
55 |
26 |
$4.84 |
| A0888 |
Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) |
12 |
12 |
$0.00 |