| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
1,514 |
692 |
$524K |
| A0130 |
Non-emergency transportation: wheelchair van |
2,248 |
769 |
$164K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
5,581 |
476 |
$112K |
| T2003 |
Non-emergency transportation; encounter/trip |
1,373 |
535 |
$58K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
1,514 |
692 |
$25K |
| S0215 |
Non-emergency transportation; mileage, per mile |
365 |
181 |
$10K |