| Code | Description | Claims | Beneficiaries | Total Paid |
| A0100 |
Non-emergency transportation; taxi |
12,810 |
932 |
$209K |
| S0215 |
Non-emergency transportation; mileage, per mile |
6,049 |
883 |
$163K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
2,732 |
608 |
$37K |
| A0140 |
Non-emergency transportation and air travel (private or commercial) intra or inter state |
69 |
15 |
$2K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
424 |
135 |
$1K |