| Code | Description | Claims | Beneficiaries | Total Paid |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
51,339 |
18,530 |
$5.29M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
8,383 |
7,187 |
$1.58M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
4,251 |
3,841 |
$914K |
| S0215 |
Non-emergency transportation; mileage, per mile |
26,986 |
7,287 |
$732K |
| A0425 |
Ground mileage, per statute mile |
34,659 |
20,397 |
$550K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
111 |
97 |
$15K |
| 4701Y |
|
101 |
80 |
$2K |