| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
5,228 |
1,293 |
$677K |
| S0209 |
Wheelchair van, mileage, per mile |
5,566 |
1,715 |
$285K |
| A0130 |
Non-emergency transportation: wheelchair van |
2,344 |
644 |
$132K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
174 |
118 |
$70K |
| A0425 |
Ground mileage, per statute mile |
980 |
251 |
$59K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
627 |
434 |
$55K |
| A0999 |
Unlisted ambulance service |
404 |
113 |
$51K |
| A0998 |
Ambulance response and treatment, no transport |
357 |
275 |
$18K |
| A0420 |
Ambulance waiting time (als or bls), one half (1/2) hour increments |
20 |
19 |
$733.52 |