| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
14,561 |
7,925 |
$1.46M |
| A0425 |
Ground mileage, per statute mile |
22,746 |
13,979 |
$1.31M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,963 |
2,770 |
$453K |
| A0130 |
Non-emergency transportation: wheelchair van |
11,606 |
4,108 |
$444K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
2,690 |
2,560 |
$426K |
| A0434 |
Specialty care transport (sct) |
837 |
830 |
$279K |
| S0215 |
Non-emergency transportation; mileage, per mile |
6,660 |
3,622 |
$253K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
1,258 |
1,173 |
$151K |
| S0209 |
Wheelchair van, mileage, per mile |
1,092 |
508 |
$26K |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
3,684 |
2,350 |
$5K |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
304 |
292 |
$935.00 |