| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
83,550 |
8,398 |
$5.73M |
| S5102 |
Day care services, adult; per diem |
21,656 |
2,233 |
$1.74M |
| T2003 |
Non-emergency transportation; encounter/trip |
22,068 |
2,809 |
$454K |
| S9977 |
Meals, per diem, not otherwise specified |
20,059 |
1,983 |
$257K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
5,966 |
661 |
$130K |
| S5170 |
Home delivered meals, including preparation; per meal |
8,834 |
874 |
$122K |
| A0100 |
Non-emergency transportation; taxi |
3,127 |
357 |
$74K |
| A0130 |
Non-emergency transportation: wheelchair van |
297 |
24 |
$6K |
| T2002 |
Non-emergency transportation; per diem |
56 |
13 |
$340.00 |