| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
119,404 |
102,906 |
$48.02M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
65,788 |
56,296 |
$23.22M |
| A0425 |
Ground mileage, per statute mile |
218,750 |
171,947 |
$15.54M |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
3,285 |
3,004 |
$9.95M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
22,751 |
19,284 |
$5.74M |
| A0436 |
Rotary wing air mileage, per statute mile |
3,278 |
3,002 |
$5.45M |
| A0433 |
Advanced life support, level 2 (als 2) |
2,588 |
2,359 |
$1.34M |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
5,094 |
4,411 |
$1.29M |
| A0434 |
Specialty care transport (sct) |
1,615 |
1,411 |
$989K |
| A0130 |
Non-emergency transportation: wheelchair van |
23,878 |
20,144 |
$599K |
| S0209 |
Wheelchair van, mileage, per mile |
23,838 |
20,121 |
$284K |
| A0390 |
Als mileage (per mile) |
1,627 |
1,387 |
$207K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
703 |
545 |
$75K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
289 |
259 |
$55K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
252 |
229 |
$48K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
57 |
55 |
$7K |
| 70450 |
Computed tomography, head or brain; without contrast material |
45 |
42 |
$6K |
| A0998 |
Ambulance response and treatment, no transport |
15 |
14 |
$4K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
115 |
100 |
$3K |
| A0380 |
Bls mileage (per mile) |
15 |
15 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
13 |
13 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
27 |
24 |
$906.33 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
374 |
306 |
$608.80 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
659 |
549 |
$311.14 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,242 |
425 |
$276.22 |
| 80053 |
Comprehensive metabolic panel |
15 |
13 |
$201.86 |
| 96375 |
Therapeutic injection; each additional sequential IV push |
18 |
16 |
$38.03 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
54 |
46 |
$34.97 |
| 71045 |
Radiologic examination, chest; single view |
30 |
28 |
$34.48 |
| 84484 |
|
162 |
138 |
$24.28 |
| 80076 |
|
77 |
71 |
$12.98 |
| 85027 |
|
82 |
74 |
$2.90 |
| 82947 |
|
14 |
12 |
$0.58 |
| 83690 |
|
31 |
27 |
$0.54 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14 |
14 |
$0.00 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
14 |
12 |
$0.00 |