| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
38,166 |
4,512 |
$2.64M |
| S5102 |
Day care services, adult; per diem |
17,300 |
2,006 |
$1.37M |
| T2003 |
Non-emergency transportation; encounter/trip |
10,473 |
1,484 |
$169K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
4,620 |
524 |
$87K |
| S5170 |
Home delivered meals, including preparation; per meal |
3,929 |
354 |
$51K |
| S9977 |
Meals, per diem, not otherwise specified |
1,779 |
180 |
$33K |
| S9110 |
Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month |
144 |
12 |
$5K |
| A0130 |
Non-emergency transportation: wheelchair van |
331 |
50 |
$4K |