| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
21,313 |
4,380 |
$508K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
9,860 |
2,043 |
$425K |
| S0209 |
Wheelchair van, mileage, per mile |
21,307 |
4,379 |
$156K |
| A0425 |
Ground mileage, per statute mile |
10,482 |
2,397 |
$108K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
66 |
56 |
$2K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
13 |
12 |
$331.10 |