| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
9,394 |
6,887 |
$1.24M |
| A0425 |
Ground mileage, per statute mile |
13,338 |
9,730 |
$724K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
1,590 |
1,262 |
$362K |
| A0434 |
Specialty care transport (sct) |
261 |
221 |
$75K |
| A0130 |
Non-emergency transportation: wheelchair van |
2,551 |
1,481 |
$62K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
304 |
241 |
$4K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
22 |
14 |
$3K |