| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
632,614 |
73,999 |
$17.65M |
| T2005 |
Non-emergency transportation; stretcher van |
98,866 |
13,773 |
$7.28M |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
782,506 |
38,609 |
$6.19M |
| S0215 |
Non-emergency transportation; mileage, per mile |
879,802 |
44,234 |
$4.79M |
| S0209 |
Wheelchair van, mileage, per mile |
629,740 |
73,841 |
$4.12M |
| A0100 |
Non-emergency transportation; taxi |
501,035 |
36,320 |
$3.94M |
| A0999 |
Unlisted ambulance service |
34,445 |
9,571 |
$3.53M |
| A0425 |
Ground mileage, per statute mile |
427,880 |
32,889 |
$3.51M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
7,153 |
1,472 |
$2.03M |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
49,114 |
7,249 |
$1.49M |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
98,338 |
13,753 |
$265K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
7,332 |
1,209 |
$76K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
1,268 |
359 |
$21K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
32 |
15 |
$18K |
| A0380 |
Bls mileage (per mile) |
190 |
66 |
$16K |
| A0420 |
Ambulance waiting time (als or bls), one half (1/2) hour increments |
112 |
53 |
$13K |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
577,694 |
44,956 |
$6K |
| T2003 |
Non-emergency transportation; encounter/trip |
75,692 |
25,062 |
$4K |
| A0382 |
Bls routine disposable supplies |
102 |
26 |
$262.93 |