| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
4,772 |
1,443 |
$4K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,208 |
708 |
$2K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
808 |
496 |
$1K |
| A0398 |
Als routine disposable supplies |
616 |
228 |
$549.00 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
196 |
98 |
$114.00 |
| T2005 |
Non-emergency transportation; stretcher van |
207 |
65 |
$110.00 |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
2,175 |
453 |
$4.83 |