| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
20,470 |
9,277 |
$1.19M |
| A0130 |
Non-emergency transportation: wheelchair van |
32,432 |
6,083 |
$762K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
5,674 |
4,994 |
$412K |
| A0425 |
Ground mileage, per statute mile |
27,019 |
13,390 |
$242K |
| S0209 |
Wheelchair van, mileage, per mile |
32,396 |
6,081 |
$226K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
53 |
25 |
$4K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
16 |
13 |
$2K |