| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
12,318 |
8,122 |
$256K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
4,142 |
3,433 |
$256K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
5,117 |
4,294 |
$248K |
| T2005 |
Non-emergency transportation; stretcher van |
923 |
625 |
$31K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
2,155 |
1,572 |
$14K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,661 |
1,069 |
$12K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
685 |
563 |
$957.50 |