| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
4,524 |
3,573 |
$784K |
| A0425 |
Ground mileage, per statute mile |
6,281 |
4,329 |
$280K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,269 |
1,087 |
$191K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
871 |
287 |
$29K |
| A0888 |
Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) |
1,358 |
1,032 |
$0.00 |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
12 |
12 |
$0.00 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
12 |
12 |
$0.00 |
| G0404 |
Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination |
24 |
18 |
$0.00 |
| A0382 |
Bls routine disposable supplies |
22 |
22 |
$0.00 |