| Code | Description | Claims | Beneficiaries | Total Paid |
| S0215 |
Non-emergency transportation; mileage, per mile |
2,153,982 |
619,358 |
$6.78M |
| S0209 |
Wheelchair van, mileage, per mile |
148,744 |
41,095 |
$1.89M |
| A0130 |
Non-emergency transportation: wheelchair van |
148,859 |
41,031 |
$1.36M |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
212,419 |
55,319 |
$1.01M |
| A0100 |
Non-emergency transportation; taxi |
1,944,770 |
571,379 |
$484K |
| T2005 |
Non-emergency transportation; stretcher van |
8,357 |
4,564 |
$396K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
7,946 |
4,383 |
$154K |
| A0180 |
Non-emergency transportation: ancillary: lodging-recipient |
1,117 |
111 |
$66K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
292 |
279 |
$2K |