| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
177,120 |
145,299 |
$33.21M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
76,622 |
69,078 |
$14.05M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
83,202 |
48,508 |
$8.31M |
| A0425 |
Ground mileage, per statute mile |
339,735 |
240,808 |
$5.04M |
| A0130 |
Non-emergency transportation: wheelchair van |
80,952 |
22,939 |
$2.44M |
| A0999 |
Unlisted ambulance service |
47,266 |
28,928 |
$975K |
| S0215 |
Non-emergency transportation; mileage, per mile |
80,686 |
22,956 |
$838K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
3,988 |
3,755 |
$583K |
| A0434 |
Specialty care transport (sct) |
823 |
764 |
$377K |
| A0433 |
Advanced life support, level 2 (als 2) |
1,000 |
964 |
$285K |
| 0124A |
|
5,228 |
5,220 |
$188K |
| 0134A |
|
3,098 |
3,092 |
$100K |
| A0998 |
Ambulance response and treatment, no transport |
465 |
461 |
$78K |
| 0154A |
|
725 |
725 |
$33K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
367 |
128 |
$30K |
| 0051A |
|
384 |
382 |
$16K |
| 0052A |
|
345 |
345 |
$15K |
| 0054A |
|
365 |
365 |
$13K |
| 0081A |
|
193 |
193 |
$9K |
| 0111A |
|
187 |
187 |
$9K |
| 0072A |
|
174 |
174 |
$8K |
| 0071A |
|
171 |
171 |
$8K |
| 0011A |
|
138 |
138 |
$6K |
| 0064A |
|
197 |
197 |
$6K |
| 0074A |
|
126 |
126 |
$6K |
| 0082A |
|
125 |
125 |
$6K |
| 0112A |
|
124 |
124 |
$6K |
| 0012A |
|
135 |
135 |
$6K |
| 90686 |
|
257 |
256 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
161 |
160 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
259 |
257 |
$2K |
| 90694 |
|
71 |
70 |
$2K |
| 90674 |
|
67 |
67 |
$2K |
| 0002A |
|
50 |
50 |
$2K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
102 |
33 |
$1K |
| 0001A |
|
48 |
48 |
$880.95 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
43 |
$853.40 |
| 0053A |
|
16 |
16 |
$733.94 |
| 0144A |
|
28 |
28 |
$688.31 |
| 0164A |
|
12 |
12 |
$550.50 |
| 0083A |
|
12 |
12 |
$550.49 |
| 0173A |
|
12 |
12 |
$550.44 |
| 91313 |
|
1,550 |
1,548 |
$0.00 |
| 91308 |
|
264 |
254 |
$0.00 |
| 91312 |
|
2,823 |
2,818 |
$0.00 |
| 91311 |
|
144 |
141 |
$0.00 |
| 91300 |
|
52 |
52 |
$0.00 |
| 91307 |
|
257 |
256 |
$0.00 |
| 91315 |
|
443 |
443 |
$0.00 |
| 91301 |
|
217 |
217 |
$0.00 |
| 91306 |
|
91 |
91 |
$0.00 |
| 91305 |
|
767 |
749 |
$0.00 |