| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
10,352 |
1,568 |
$229K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,044 |
927 |
$113K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,174 |
1,012 |
$64K |
| S0209 |
Wheelchair van, mileage, per mile |
10,349 |
1,567 |
$39K |
| A0425 |
Ground mileage, per statute mile |
5,750 |
2,181 |
$21K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
114 |
110 |
$9K |