| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
294 |
236 |
$43K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
493 |
354 |
$25K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
780 |
487 |
$13K |
| A0390 |
Als mileage (per mile) |
267 |
187 |
$8K |
| A0382 |
Bls routine disposable supplies |
3,184 |
1,123 |
$7K |
| A0380 |
Bls mileage (per mile) |
529 |
327 |
$7K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
755 |
367 |
$3K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
29 |
25 |
$406.06 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
68 |
36 |
$119.31 |
| A0425 |
Ground mileage, per statute mile |
137 |
89 |
$0.00 |