| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
35,160 |
13,928 |
$2.70M |
| A0130 |
Non-emergency transportation: wheelchair van |
34,882 |
8,209 |
$919K |
| A0425 |
Ground mileage, per statute mile |
44,492 |
19,659 |
$869K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
3,507 |
3,262 |
$411K |
| S0215 |
Non-emergency transportation; mileage, per mile |
29,117 |
6,828 |
$407K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
2,087 |
1,998 |
$293K |
| S0209 |
Wheelchair van, mileage, per mile |
1,315 |
250 |
$16K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
66 |
55 |
$9K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
4,380 |
1,960 |
$4K |
| 93041 |
|
732 |
697 |
$1K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
494 |
479 |
$204.30 |
| 93000 |
|
13 |
13 |
$7.08 |