| Code | Description | Claims | Beneficiaries | Total Paid |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
6,886 |
6,070 |
$1.09M |
| A0425 |
Ground mileage, per statute mile |
20,666 |
14,270 |
$533K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
3,233 |
2,914 |
$477K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
9,836 |
6,250 |
$450K |
| A0398 |
Als routine disposable supplies |
3,391 |
2,879 |
$50K |
| A0382 |
Bls routine disposable supplies |
2,649 |
2,213 |
$35K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
220 |
182 |
$3K |
| 93041 |
|
544 |
470 |
$81.47 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
165 |
139 |
$24.15 |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
589 |
476 |
$0.00 |