| Code | Description | Claims | Beneficiaries | Total Paid |
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
95,492 |
7,222 |
$6.07M |
| T2003 |
Non-emergency transportation; encounter/trip |
56,493 |
4,328 |
$1.05M |
| A0100 |
Non-emergency transportation; taxi |
14,763 |
1,191 |
$369K |
| S5170 |
Home delivered meals, including preparation; per meal |
12,702 |
877 |
$254K |
| S5102 |
Day care services, adult; per diem |
2,313 |
175 |
$179K |
| S9977 |
Meals, per diem, not otherwise specified |
5,194 |
430 |
$101K |
| A0130 |
Non-emergency transportation: wheelchair van |
4,264 |
295 |
$98K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
1,392 |
96 |
$40K |