| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
12,713 |
1,354 |
$320K |
| T2005 |
Non-emergency transportation; stretcher van |
943 |
174 |
$108K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
947 |
352 |
$35K |
| T2003 |
Non-emergency transportation; encounter/trip |
828 |
153 |
$27K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
699 |
454 |
$25K |
| A0425 |
Ground mileage, per statute mile |
1,917 |
864 |
$16K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
187 |
130 |
$7K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
1,000 |
199 |
$482.50 |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
18 |
14 |
$150.00 |