| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
5,429 |
1,075 |
$121K |
| A0140 |
Non-emergency transportation and air travel (private or commercial) intra or inter state |
836 |
568 |
$118K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
41,150 |
1,810 |
$83K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
522 |
144 |
$22K |
| S9977 |
Meals, per diem, not otherwise specified |
184 |
55 |
$8K |
| S0215 |
Non-emergency transportation; mileage, per mile |
14 |
13 |
$5K |
| A0210 |
Non-emergency transportation: ancillary: meals-escort |
101 |
27 |
$3K |
| T2003 |
Non-emergency transportation; encounter/trip |
14 |
13 |
$104.50 |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
1,251 |
324 |
$77.30 |