| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
13,985 |
2,881 |
$9.69M |
| S0215 |
Non-emergency transportation; mileage, per mile |
6,474 |
2,705 |
$1.33M |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
6,469 |
2,704 |
$89K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
3,693 |
1,989 |
$57K |
| S0209 |
Wheelchair van, mileage, per mile |
40 |
18 |
$9K |
| A0130 |
Non-emergency transportation: wheelchair van |
40 |
18 |
$952.38 |