| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
6,221 |
3,584 |
$186K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
3,607 |
2,691 |
$186K |
| A0398 |
Als routine disposable supplies |
1,047 |
763 |
$99K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
196 |
135 |
$4K |
| T2005 |
Non-emergency transportation; stretcher van |
93 |
58 |
$2K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
135 |
115 |
$881.00 |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
99 |
67 |
$232.20 |