| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
70,227 |
6,537 |
$5.24M |
| S5102 |
Day care services, adult; per diem |
12,582 |
1,218 |
$885K |
| T2003 |
Non-emergency transportation; encounter/trip |
22,608 |
2,079 |
$565K |
| S5101 |
Day care services, adult; per half day |
6,858 |
739 |
$432K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
6,773 |
532 |
$136K |
| S9977 |
Meals, per diem, not otherwise specified |
7,599 |
685 |
$116K |
| T2002 |
Non-emergency transportation; per diem |
778 |
100 |
$26K |