| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
25,970 |
5,886 |
$964K |
| A0425 |
Ground mileage, per statute mile |
45,248 |
18,776 |
$924K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
9,077 |
7,629 |
$702K |
| A0130 |
Non-emergency transportation: wheelchair van |
17,531 |
2,989 |
$422K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
7,681 |
6,274 |
$389K |
| A0398 |
Als routine disposable supplies |
2,013 |
1,854 |
$351K |
| S0209 |
Wheelchair van, mileage, per mile |
17,525 |
2,990 |
$155K |
| A0382 |
Bls routine disposable supplies |
287 |
244 |
$30K |
| T2005 |
Non-emergency transportation; stretcher van |
1,295 |
486 |
$12K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
561 |
479 |
$5K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
27 |
24 |
$3K |