| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
3,032 |
698 |
$429K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
9,067 |
801 |
$304K |
| T2003 |
Non-emergency transportation; encounter/trip |
5,835 |
271 |
$214K |
| A0130 |
Non-emergency transportation: wheelchair van |
517 |
192 |
$11K |
| S0215 |
Non-emergency transportation; mileage, per mile |
499 |
218 |
$4K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
3,032 |
698 |
$2K |