| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
6,251 |
2,174 |
$2.03M |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
13,866 |
4,965 |
$1.50M |
| A0425 |
Ground mileage, per statute mile |
15,924 |
6,460 |
$984K |
| A0130 |
Non-emergency transportation: wheelchair van |
13,950 |
2,430 |
$518K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
6,249 |
2,173 |
$102K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
798 |
642 |
$52K |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,749 |
482 |
$25K |