| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
1,995 |
1,729 |
$236K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
278 |
261 |
$31K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
445 |
383 |
$21K |
| A0130 |
Non-emergency transportation: wheelchair van |
889 |
752 |
$16K |
| T2005 |
Non-emergency transportation; stretcher van |
13 |
13 |
$3K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
12 |
12 |
$1K |
| S0215 |
Non-emergency transportation; mileage, per mile |
105 |
89 |
$988.32 |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
13 |
13 |
$0.00 |