| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
28,784 |
1,796 |
$1.96M |
| S5102 |
Day care services, adult; per diem |
15,061 |
1,158 |
$1.29M |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
16,203 |
813 |
$335K |
| T2003 |
Non-emergency transportation; encounter/trip |
10,480 |
670 |
$255K |
| A0130 |
Non-emergency transportation: wheelchair van |
2,645 |
168 |
$65K |
| S5170 |
Home delivered meals, including preparation; per meal |
1,791 |
136 |
$32K |
| S9110 |
Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month |
1,624 |
80 |
$27K |