| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
1,155 |
400 |
$38K |
| A0425 |
Ground mileage, per statute mile |
1,570 |
632 |
$16K |
| A0130 |
Non-emergency transportation: wheelchair van |
964 |
296 |
$15K |
| S0215 |
Non-emergency transportation; mileage, per mile |
571 |
174 |
$4K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
169 |
135 |
$4K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
47 |
39 |
$3K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
50 |
43 |
$2K |