| Code | Description | Claims | Beneficiaries | Total Paid |
| S5102 |
Day care services, adult; per diem |
74,519 |
5,419 |
$6.35M |
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
82,948 |
7,580 |
$5.06M |
| T2003 |
Non-emergency transportation; encounter/trip |
47,175 |
4,220 |
$1.29M |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
36,643 |
2,491 |
$912K |
| S5170 |
Home delivered meals, including preparation; per meal |
19,898 |
1,420 |
$375K |
| S9977 |
Meals, per diem, not otherwise specified |
10,453 |
939 |
$208K |
| A0100 |
Non-emergency transportation; taxi |
5,767 |
493 |
$156K |
| T2002 |
Non-emergency transportation; per diem |
4,922 |
466 |
$100K |
| A0130 |
Non-emergency transportation: wheelchair van |
394 |
42 |
$8K |