| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
59,841 |
12,033 |
$7.13M |
| A0130 |
Non-emergency transportation: wheelchair van |
56,561 |
10,154 |
$1.80M |
| A0425 |
Ground mileage, per statute mile |
72,981 |
25,570 |
$1.55M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
9,190 |
8,697 |
$1.55M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
5,969 |
5,734 |
$1.01M |
| S0215 |
Non-emergency transportation; mileage, per mile |
52,671 |
9,312 |
$502K |
| T2005 |
Non-emergency transportation; stretcher van |
492 |
62 |
$59K |
| A0434 |
Specialty care transport (sct) |
85 |
84 |
$37K |
| S0209 |
Wheelchair van, mileage, per mile |
3,175 |
692 |
$37K |
| A0380 |
Bls mileage (per mile) |
1,837 |
325 |
$8K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
275 |
50 |
$4K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
181 |
77 |
$1K |
| A0382 |
Bls routine disposable supplies |
161 |
113 |
$1K |
| A0398 |
Als routine disposable supplies |
21 |
19 |
$0.00 |