| Code | Description | Claims | Beneficiaries | Total Paid |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
13,601 |
11,461 |
$3.53M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
8,055 |
7,011 |
$2.24M |
| A0425 |
Ground mileage, per statute mile |
24,912 |
20,707 |
$1.04M |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
1,875 |
1,620 |
$458K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,290 |
1,119 |
$151K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
2,596 |
2,154 |
$28K |