| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0215 |
Non-emergency transportation; mileage, per mile |
26,159 |
9,637 |
$4.89M |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
27,957 |
9,429 |
$493K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
26,197 |
9,651 |
$360K |
| S0209 |
Wheelchair van, mileage, per mile |
1,367 |
504 |
$318K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,320 |
492 |
$27K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
53 |
39 |
$10K |
| T2005 |
Non-emergency transportation; stretcher van |
53 |
39 |
$7K |