| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
465 |
343 |
$398K |
| A0425 |
Ground mileage, per statute mile |
875 |
490 |
$135K |
| A0380 |
Bls mileage (per mile) |
973 |
644 |
$117K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
866 |
484 |
$71K |
| A0130 |
Non-emergency transportation: wheelchair van |
306 |
186 |
$40K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
90 |
54 |
$5K |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
22 |
17 |
$2K |