| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
22,425 |
3,601 |
$545K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
5,263 |
4,323 |
$383K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
2,649 |
2,417 |
$310K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
4,562 |
2,340 |
$175K |
| A0425 |
Ground mileage, per statute mile |
13,049 |
8,585 |
$172K |
| S0209 |
Wheelchair van, mileage, per mile |
22,398 |
3,599 |
$101K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
303 |
288 |
$25K |