| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
1,392 |
843 |
$267K |
| A0425 |
Ground mileage, per statute mile |
2,377 |
1,281 |
$144K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
2,019 |
1,096 |
$34K |
| A0130 |
Non-emergency transportation: wheelchair van |
972 |
453 |
$32K |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
19 |
15 |
$591.84 |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
12 |
12 |
$388.30 |