| Code | Description | Claims | Beneficiaries | Total Paid |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,302 |
1,008 |
$584K |
| T2005 |
Non-emergency transportation; stretcher van |
1,403 |
336 |
$369K |
| A0425 |
Ground mileage, per statute mile |
5,281 |
1,365 |
$217K |
| T2003 |
Non-emergency transportation; encounter/trip |
2,455 |
495 |
$78K |
| A0100 |
Non-emergency transportation; taxi |
800 |
136 |
$29K |
| A0130 |
Non-emergency transportation: wheelchair van |
320 |
112 |
$13K |
| S0215 |
Non-emergency transportation; mileage, per mile |
323 |
131 |
$8K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
1,403 |
336 |
$4K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
287 |
114 |
$2K |