| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
58,795 |
4,934 |
$4.32M |
| S5102 |
Day care services, adult; per diem |
31,494 |
2,720 |
$2.29M |
| T2003 |
Non-emergency transportation; encounter/trip |
44,355 |
3,523 |
$1.20M |
| A0130 |
Non-emergency transportation: wheelchair van |
28,146 |
2,422 |
$928K |
| S5170 |
Home delivered meals, including preparation; per meal |
12,551 |
856 |
$300K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
6,315 |
499 |
$221K |