| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0130 |
Non-emergency transportation: wheelchair van |
12,913 |
4,769 |
$612K |
| A0380 |
Bls mileage (per mile) |
11,600 |
4,769 |
$258K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
106 |
68 |
$3K |
| T2005 |
Non-emergency transportation; stretcher van |
29 |
28 |
$1K |
| A0888 |
Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) |
28 |
27 |
$950.34 |
| T2001 |
Non-emergency transportation; patient attendant/escort |
29 |
28 |
$160.08 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
14 |
13 |
$139.72 |