| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
85,879 |
9,533 |
$7.39M |
| S5102 |
Day care services, adult; per diem |
4,702 |
596 |
$392K |
| T2003 |
Non-emergency transportation; encounter/trip |
14,000 |
1,699 |
$317K |
| A0100 |
Non-emergency transportation; taxi |
10,950 |
1,260 |
$173K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
4,623 |
554 |
$103K |
| S9977 |
Meals, per diem, not otherwise specified |
3,252 |
432 |
$64K |
| S5170 |
Home delivered meals, including preparation; per meal |
1,757 |
215 |
$34K |
| A0130 |
Non-emergency transportation: wheelchair van |
673 |
96 |
$17K |