| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
4,413 |
4,040 |
$592K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,044 |
1,945 |
$355K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
879 |
848 |
$186K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
633 |
577 |
$54K |
| S0209 |
Wheelchair van, mileage, per mile |
296 |
116 |
$17K |
| A0130 |
Non-emergency transportation: wheelchair van |
237 |
85 |
$16K |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
279 |
268 |
$2K |