| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2005 |
Non-emergency transportation; stretcher van |
2,886 |
1,294 |
$3K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
76 |
76 |
$0.00 |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
2,878 |
1,290 |
$0.00 |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
356 |
356 |
$0.00 |
| S0215 |
Non-emergency transportation; mileage, per mile |
568,029 |
90,918 |
$0.00 |
| A0130 |
Non-emergency transportation: wheelchair van |
140,537 |
27,834 |
$0.00 |
| A0100 |
Non-emergency transportation; taxi |
692,424 |
96,360 |
$0.00 |
| S0209 |
Wheelchair van, mileage, per mile |
139,427 |
27,663 |
$0.00 |