| Code | Description | Claims | Beneficiaries | Total Paid |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,328 |
2,576 |
$189K |
| A0425 |
Ground mileage, per statute mile |
5,774 |
4,449 |
$172K |
| A0130 |
Non-emergency transportation: wheelchair van |
2,736 |
608 |
$62K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
658 |
601 |
$45K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
348 |
308 |
$16K |
| S0209 |
Wheelchair van, mileage, per mile |
2,661 |
594 |
$15K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
145 |
134 |
$12K |