Against 5 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$685
−27.4% vs peer median
6th highest of 6 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$14,870,296,553
22nd highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,662,466
11th highest of 51 states
Most recent CMS monthly report
Visible in claims
5.3%
−52.6% vs peer median
6th highest of 6 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 21 flagged Georgia providers. Five referrals, all resting on public convictions or federal exclusions that predate or postdate the billing in the source data; no post-exclusion billing was found. 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.
$5.8B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $847.7M / year
122.9M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 18.0M / year
3.7K
Distinct billing NPIs, Jan 2018 – Oct 2024
166
14 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| S5125 | Attendant care service /15m | $477.7M | 5.5M |
| 99213 | Office o/p est low 20 min | $331.0M | 5.1M |
| T2033 | Res, nos waiver per diem | $304.1M | 684.1K |
| 99285 | Emergency dept visit hi mdm | $259.4M | 914.9K |
| T1019 | Personal care ser per 15 min | $235.6M | 2.7M |
| T2025 | Waiver service, nos | $224.6M | 1.7M |
| 99284 | Emergency dept visit mod mdm | $216.5M | 1.3M |
| 99214 | Office o/p est mod 30 min | $202.3M | 3.1M |
| 99283 | Emergency dept visit low mdm | $184.7M | 1.6M |
| T2017 | Habil res waiver 15 min | $165.5M | 936.4K |