| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0215 |
Non-emergency transportation; mileage, per mile |
41,749 |
9,143 |
$1.75M |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
41,669 |
9,110 |
$475K |
| S0209 |
Wheelchair van, mileage, per mile |
8,080 |
3,338 |
$371K |
| A0130 |
Non-emergency transportation: wheelchair van |
8,043 |
3,301 |
$191K |
| T2005 |
Non-emergency transportation; stretcher van |
1,817 |
1,537 |
$144K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
1,775 |
1,511 |
$52K |
| 99072 |
|
53 |
15 |
$0.00 |