| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0425 |
Ground mileage, per statute mile |
145,018 |
24,492 |
$1.18M |
| A0130 |
Non-emergency transportation: wheelchair van |
95,524 |
10,240 |
$815K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
124,293 |
21,652 |
$814K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
30,551 |
6,284 |
$0.00 |
| S0215 |
Non-emergency transportation; mileage, per mile |
35,802 |
6,523 |
$0.00 |
| A0100 |
Non-emergency transportation; taxi |
346 |
106 |
$0.00 |