| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
7,195 |
5,346 |
$256K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,638 |
1,534 |
$196K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,209 |
2,051 |
$170K |
| A0130 |
Non-emergency transportation: wheelchair van |
5,960 |
1,690 |
$143K |
| S0209 |
Wheelchair van, mileage, per mile |
5,959 |
1,690 |
$120K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
722 |
678 |
$39K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
497 |
458 |
$38K |