| Code | Description | Claims | Beneficiaries | Total Paid |
| S0215 |
Non-emergency transportation; mileage, per mile |
50,736 |
10,308 |
$3.82M |
| T2003 |
Non-emergency transportation; encounter/trip |
60,944 |
9,770 |
$2.66M |
| A0130 |
Non-emergency transportation: wheelchair van |
5,437 |
1,338 |
$514K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
24,752 |
5,196 |
$476K |
| T2005 |
Non-emergency transportation; stretcher van |
337 |
165 |
$83K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
337 |
165 |
$0.00 |