| Code | Description | Claims | Beneficiaries | Total Paid |
| A0425 |
Ground mileage, per statute mile |
177,123 |
82,354 |
$5.18M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
112,759 |
37,269 |
$4.85M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
29,147 |
25,968 |
$3.27M |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
33,544 |
29,609 |
$2.76M |
| A0130 |
Non-emergency transportation: wheelchair van |
75,316 |
13,461 |
$1.85M |
| S0209 |
Wheelchair van, mileage, per mile |
75,334 |
13,480 |
$663K |
| A0426 |
Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) |
689 |
639 |
$112K |
| T2005 |
Non-emergency transportation; stretcher van |
43 |
37 |
$1K |
| A0433 |
Advanced life support, level 2 (als 2) |
12 |
12 |
$1K |