Against 23 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$798
−22.2% vs peer median
20th highest of 24 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$8,109,366,769
30th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
736,452
29th highest of 51 states
Most recent CMS monthly report
Visible in claims
21.1%
+6.2% vs peer median
11th highest of 24 similar states
Share of program these claims see
Published figures are FY2024 CMS-64 and CMS enrollment. Claims figures cover 2018–2024.
Public-record research has been run on 30 flagged Alabama providers, including 2 seeded from the state's enforcement record. Three referrals rest on federal convictions; hospice room-and-board pass-through billing explains most statistical flags. Methodology
CMS T-MSIS data, 2018-2024
Concourse Sentinel connects to large-scale healthcare billing datasets — including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists — and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.
$10.3B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $1.5B / year
200.8M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 29.4M / year
6.6K
Distinct billing NPIs, Jan 2018 – Oct 2024
267
20 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $1.8B | 477.6K |
| T1015 | Clinic service | $700.3M | 5.9M |
| T1019 | Personal care ser per 15 min | $627.9M | 3.5M |
| 99214 | Office o/p est mod 30 min | $401.7M | 7.1M |
| 99213 | Office o/p est low 20 min | $369.1M | 8.9M |
| H0036 | Comm psy face-face per 15min | $338.8M | 4.8M |
| 81479 | Unlisted molecular pathology | $267.9M | 168.8K |
| T2021 | Day habil waiver per 15 min | $211.7M | 520.3K |
| 99284 | Emergency dept visit mod mdm | $192.2M | 3.1M |
| A0431 | Rotary wing air transport | $176.1M | 105.9K |