| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
861 |
781 |
$250K |
| A0425 |
Ground mileage, per statute mile |
900 |
807 |
$74K |
| A0998 |
Ambulance response and treatment, no transport |
586 |
513 |
$36K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
322 |
252 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
17 |
14 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
134 |
113 |
$2K |