| Code | Description | Claims | Beneficiaries | Total Paid |
| S5102 |
Day care services, adult; per diem |
81,715 |
5,843 |
$7.85M |
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
86,357 |
7,675 |
$6.97M |
| S5170 |
Home delivered meals, including preparation; per meal |
24,061 |
1,675 |
$359K |
| S9977 |
Meals, per diem, not otherwise specified |
16,402 |
1,379 |
$328K |
| T2002 |
Non-emergency transportation; per diem |
3,214 |
295 |
$64K |
| A0100 |
Non-emergency transportation; taxi |
14,454 |
984 |
$59K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
1,416 |
141 |
$29K |
| A0130 |
Non-emergency transportation: wheelchair van |
1,000 |
75 |
$25K |
| T2003 |
Non-emergency transportation; encounter/trip |
557 |
40 |
$14K |