| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2003 |
Non-emergency transportation; encounter/trip |
4,016 |
2,027 |
$888K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
33,336 |
22,734 |
$471K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
8,645 |
6,944 |
$260K |
| A0425 |
Ground mileage, per statute mile |
30,671 |
22,268 |
$119K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
215 |
91 |
$4K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
75 |
25 |
$0.00 |