| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
5,072 |
3,497 |
$555K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,192 |
1,353 |
$191K |
| A0425 |
Ground mileage, per statute mile |
7,351 |
4,867 |
$104K |
| A0398 |
Als routine disposable supplies |
2,468 |
1,695 |
$11K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
415 |
186 |
$2K |
| 93041 |
|
119 |
67 |
$138.60 |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
2,809 |
1,952 |
$52.00 |
| G0403 |
Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report |
271 |
204 |
$0.00 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
412 |
287 |
$0.00 |