| Code | Description | Claims | Beneficiaries | Total Paid |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
3,776 |
2,968 |
$444K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
3,374 |
2,606 |
$314K |
| A0425 |
Ground mileage, per statute mile |
7,738 |
5,245 |
$131K |
| A0390 |
Als mileage (per mile) |
676 |
539 |
$97K |
| A0998 |
Ambulance response and treatment, no transport |
1,347 |
915 |
$65K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,676 |
1,049 |
$60K |
| A0380 |
Bls mileage (per mile) |
524 |
367 |
$48K |
| A0382 |
Bls routine disposable supplies |
3,489 |
2,755 |
$33K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
988 |
819 |
$10K |