| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0209 |
Wheelchair van, mileage, per mile |
35,803 |
7,129 |
$565K |
| A0130 |
Non-emergency transportation: wheelchair van |
37,169 |
7,474 |
$502K |
| S0215 |
Non-emergency transportation; mileage, per mile |
12,012 |
1,875 |
$139K |
| T2003 |
Non-emergency transportation; encounter/trip |
10,855 |
1,627 |
$71K |
| A0100 |
Non-emergency transportation; taxi |
8,514 |
1,269 |
$71K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
1,264 |
213 |
$1K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
1,265 |
213 |
$680.81 |