| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
30,400 |
17,793 |
$3.53M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
18,712 |
9,696 |
$1.65M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
3,543 |
2,909 |
$617K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
3,857 |
3,272 |
$570K |
| T2005 |
Non-emergency transportation; stretcher van |
1,183 |
934 |
$432K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,559 |
2,147 |
$304K |
| A0434 |
Specialty care transport (sct) |
781 |
654 |
$206K |
| A0130 |
Non-emergency transportation: wheelchair van |
3,742 |
1,070 |
$189K |
| S0215 |
Non-emergency transportation; mileage, per mile |
121 |
93 |
$10K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
1,183 |
934 |
$3K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
17 |
12 |
$315.64 |
| A0420 |
Ambulance waiting time (als or bls), one half (1/2) hour increments |
533 |
349 |
$0.00 |