| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,755 |
3,147 |
$189K |
| A0425 |
Ground mileage, per statute mile |
4,959 |
4,144 |
$108K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
950 |
875 |
$52K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,056 |
653 |
$22K |
| S0209 |
Wheelchair van, mileage, per mile |
1,055 |
653 |
$12K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
63 |
60 |
$7K |