| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
19,282 |
4,938 |
$980K |
| A0425 |
Ground mileage, per statute mile |
23,650 |
6,003 |
$314K |
| A0130 |
Non-emergency transportation: wheelchair van |
13,279 |
2,092 |
$297K |
| T2003 |
Non-emergency transportation; encounter/trip |
5,671 |
881 |
$56K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
12 |
12 |
$2K |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
701 |
86 |
$221.31 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
25 |
12 |
$149.10 |
| T2001 |
Non-emergency transportation; patient attendant/escort |
23 |
13 |
$105.00 |