| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0215 |
Non-emergency transportation; mileage, per mile |
121,820 |
23,069 |
$3.13M |
| A0180 |
Non-emergency transportation: ancillary: lodging-recipient |
4,292 |
1,905 |
$758K |
| A0140 |
Non-emergency transportation and air travel (private or commercial) intra or inter state |
11,393 |
6,014 |
$600K |
| T2003 |
Non-emergency transportation; encounter/trip |
121,527 |
23,408 |
$539K |
| A0130 |
Non-emergency transportation: wheelchair van |
31,522 |
3,899 |
$346K |
| S0209 |
Wheelchair van, mileage, per mile |
34,582 |
4,125 |
$305K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
1,620 |
423 |
$34K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
1,820 |
222 |
$31K |
| A0210 |
Non-emergency transportation: ancillary: meals-escort |
1,320 |
323 |
$30K |
| A0200 |
Non-emergency transportation: ancillary: lodging escort |
216 |
57 |
$26K |
| S9977 |
Meals, per diem, not otherwise specified |
844 |
413 |
$25K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
18,286 |
1,494 |
$21K |
| A0425 |
Ground mileage, per statute mile |
177 |
73 |
$8K |
| T2005 |
Non-emergency transportation; stretcher van |
484 |
108 |
$4K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
848 |
220 |
$809.70 |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
14 |
13 |
$0.00 |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
14 |
14 |
$0.00 |