Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Arizona Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

601 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$33.1B

Total Claims

577.8M

Unique Providers

10.8K

Watchlist

1.6K

601 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
S5125Attendant care service /15m$3.5B28.1M
T1015Clinic service$2.8B11.8M
T2016Habil res waiver per diem$1.4B4.5M
T1016Case management$1.4B40.1M
H0004Behavioral health counseling and therapy, per 15 minutes$1.2B13.7M
99214Office o/p est mod 30 min$1.1B19.5M
99285Emergency dept visit hi mdm$904.2M3.8M
99284Emergency dept visit mod mdm$874.1M4.7M
H0018Behavioral health; short-term residential (non-hospital residential treatment$817.6M2.5M
99213Office o/p est low 20 min$742.0M16.1M
View all procedures β†’