| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
12,917 |
10,572 |
$1.71M |
| A0425 |
Ground mileage, per statute mile |
13,495 |
10,668 |
$815K |
| T2005 |
Non-emergency transportation; stretcher van |
6,889 |
845 |
$746K |
| A0130 |
Non-emergency transportation: wheelchair van |
7,085 |
1,352 |
$366K |
| A0434 |
Specialty care transport (sct) |
400 |
378 |
$144K |
| S0209 |
Wheelchair van, mileage, per mile |
5,488 |
945 |
$81K |
| A0380 |
Bls mileage (per mile) |
1,067 |
262 |
$19K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
46 |
37 |
$9K |
| A0999 |
Unlisted ambulance service |
46 |
25 |
$7K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
34 |
18 |
$357.33 |
| A0424 |
Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review) |
14 |
13 |
$252.57 |