| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
1,196 |
306 |
$849K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
4,886 |
1,059 |
$668K |
| A0130 |
Non-emergency transportation: wheelchair van |
3,646 |
774 |
$653K |
| A0425 |
Ground mileage, per statute mile |
3,656 |
789 |
$347K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,179 |
306 |
$257K |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
391 |
64 |
$241K |
| A0999 |
Unlisted ambulance service |
1,679 |
327 |
$133K |