| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
13,096 |
9,929 |
$1.13M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
5,922 |
5,117 |
$952K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,561 |
2,885 |
$381K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
1,361 |
1,299 |
$273K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,850 |
1,635 |
$225K |
| A0398 |
Als routine disposable supplies |
4,077 |
1,923 |
$43K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
538 |
457 |
$9K |
| 93041 |
|
250 |
225 |
$904.20 |
| 93040 |
|
524 |
474 |
$0.00 |