| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
12,101 |
6,840 |
$359K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
2,606 |
2,067 |
$304K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
3,276 |
2,555 |
$249K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,303 |
2,180 |
$107K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
1,218 |
995 |
$84K |
| A0130 |
Non-emergency transportation: wheelchair van |
619 |
179 |
$7K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
109 |
74 |
$729.57 |
| A0398 |
Als routine disposable supplies |
137 |
89 |
$0.00 |