| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
693 |
492 |
$125K |
| A0425 |
Ground mileage, per statute mile |
1,955 |
1,244 |
$107K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
669 |
376 |
$99K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
488 |
380 |
$58K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,559 |
860 |
$44K |
| S0209 |
Wheelchair van, mileage, per mile |
1,558 |
858 |
$17K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
12 |
12 |
$2K |