| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
29,982 |
18,546 |
$2.38M |
| A0425 |
Ground mileage, per statute mile |
33,099 |
20,931 |
$829K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
2,780 |
2,500 |
$238K |
| A0130 |
Non-emergency transportation: wheelchair van |
7,302 |
1,047 |
$157K |
| S0209 |
Wheelchair van, mileage, per mile |
7,283 |
1,046 |
$48K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
55 |
47 |
$6K |