| Code | Description | Claims | Beneficiaries | Total Paid |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,361 |
1,176 |
$172K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,940 |
1,558 |
$154K |
| A0425 |
Ground mileage, per statute mile |
3,783 |
2,926 |
$30K |
| A0130 |
Non-emergency transportation: wheelchair van |
248 |
30 |
$4K |
| S0209 |
Wheelchair van, mileage, per mile |
248 |
30 |
$2K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
17 |
15 |
$848.75 |