| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
13,540 |
11,552 |
$767K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
8,044 |
6,882 |
$652K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
4,013 |
3,647 |
$429K |
| A0431 |
Ambulance service, conventional air services, transport, one way (rotary wing) |
265 |
253 |
$395K |
| A0436 |
Rotary wing air mileage, per statute mile |
265 |
253 |
$62K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,248 |
969 |
$25K |
| A0433 |
Advanced life support, level 2 (als 2) |
96 |
82 |
$21K |
| S0209 |
Wheelchair van, mileage, per mile |
1,143 |
892 |
$14K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
89 |
78 |
$7K |
| A0434 |
Specialty care transport (sct) |
60 |
57 |
$6K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
26 |
25 |
$2K |