| Code | Description | Claims | Beneficiaries | Total Paid |
| A0130 |
Non-emergency transportation: wheelchair van |
50,605 |
6,189 |
$1.25M |
| T2005 |
Non-emergency transportation; stretcher van |
15,724 |
4,295 |
$1.19M |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
9,643 |
1,459 |
$612K |
| S0209 |
Wheelchair van, mileage, per mile |
19,797 |
3,252 |
$539K |
| A0425 |
Ground mileage, per statute mile |
38,969 |
4,573 |
$369K |
| A0380 |
Bls mileage (per mile) |
10,276 |
2,084 |
$284K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
10,685 |
1,238 |
$215K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
1,138 |
805 |
$74K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,137 |
775 |
$50K |
| A0998 |
Ambulance response and treatment, no transport |
803 |
535 |
$46K |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
1,016 |
281 |
$37K |
| A0420 |
Ambulance waiting time (als or bls), one half (1/2) hour increments |
368 |
298 |
$13K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
3,326 |
558 |
$201.00 |
| A0999 |
Unlisted ambulance service |
1,466 |
281 |
$0.00 |