Against 23 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,026
+3.3% vs peer median
12th highest of 24 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$3,201,110,676
43rd highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
222,987
43rd highest of 51 states
Most recent CMS monthly report
Visible in claims
21.8%
+9.7% vs peer median
9th 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 33 flagged Delaware providers, including 3 seeded from the state's enforcement record. Three referrals: two pending federal False Claims Act complaints and a 2018 guilty plea now excluded; homemaker and waiver billing mechanics explain most 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.
$4.0B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $580.6M / year
61.6M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 9.0M / year
1.9K
Distinct billing NPIs, Jan 2018 – Oct 2024
171
35 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| S5130 | Homaker service nos per 15m | $530.8M | 4.0M |
| T2025 | Waiver service, nos | $508.0M | 768.8K |
| T2016 | Habil res waiver per diem | $204.5M | 333.5K |
| S9124 | Nursing care, in the home; b | $177.2M | 551.8K |
| 99214 | Office o/p est mod 30 min | $118.1M | 2.3M |
| 99213 | Office o/p est low 20 min | $100.3M | 2.6M |
| S5125 | Attendant care service /15m | $99.6M | 738.1K |
| 99283 | Emergency dept visit low mdm | $88.2M | 784.6K |
| S9123 | Nursing care in home rn | $75.5M | 225.1K |
| T2020 | Day habil waiver per diem | $69.8M | 606.2K |