| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0430 |
Ambulance service, conventional air services, transport, one way (fixed wing) |
152 |
149 |
$191K |
| A0435 |
Fixed wing air mileage, per statute mile |
152 |
149 |
$100K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
570 |
443 |
$67K |
| A0425 |
Ground mileage, per statute mile |
1,097 |
782 |
$18K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
12 |
12 |
$1K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
12 |
12 |
$0.00 |
| A0398 |
Als routine disposable supplies |
19 |
14 |
$0.00 |