| Non-emergency Medical Transport (VAN) | 343900000X | |
| Registered Nurse - Infusion Therapy — Infusion Therapy | 163WI0500X | |
| Case Management | 251B00000X | |
| Home Health | 251E00000X | |
| Home Infusion | 251F00000X | |
| Nursing Care | 251J00000X | |
| Clinic/Center - Developmental Disabilities — Developmental Disabilities | 261QD1600X | |
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment | 261QE0700X | |
| Clinic/Center - Health Service — Health Service | 261QH0100X | |
| Clinic/Center - Infusion Therapy — Infusion Therapy | 261QI0500X | |
| Clinic/Center - VA — VA | 261QV0200X | |
| In Home Supportive Care | 253Z00000X | Primary |