| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
120,140 |
12,193 |
$8.14M |
| S5102 |
Day care services, adult; per diem |
33,565 |
3,333 |
$2.27M |
| T2003 |
Non-emergency transportation; encounter/trip |
78,064 |
7,661 |
$2.02M |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
25,582 |
2,256 |
$509K |
| S9977 |
Meals, per diem, not otherwise specified |
28,893 |
2,566 |
$423K |
| S5170 |
Home delivered meals, including preparation; per meal |
9,556 |
1,042 |
$182K |
| A0100 |
Non-emergency transportation; taxi |
2,059 |
259 |
$51K |
| A0130 |
Non-emergency transportation: wheelchair van |
888 |
92 |
$22K |