| Code | Description | Claims | Beneficiaries | Total Paid |
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
164,428 |
14,710 |
$12.71M |
| S5102 |
Day care services, adult; per diem |
78,633 |
5,335 |
$5.64M |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
70,679 |
4,501 |
$1.75M |
| T2003 |
Non-emergency transportation; encounter/trip |
50,976 |
3,934 |
$1.06M |
| A0100 |
Non-emergency transportation; taxi |
13,773 |
1,158 |
$343K |
| S5170 |
Home delivered meals, including preparation; per meal |
10,317 |
767 |
$199K |
| S9977 |
Meals, per diem, not otherwise specified |
9,650 |
890 |
$191K |
| T2002 |
Non-emergency transportation; per diem |
6,743 |
595 |
$167K |
| A0130 |
Non-emergency transportation: wheelchair van |
3,765 |
346 |
$69K |