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.
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| 99283 | Emergency dept visit low mdm | $232.6M | 679.6K |
| 99213 | Office o/p est low 20 min | $193.8M | 2.2M |
| 99284 | Emergency dept visit mod mdm | $179.5M | 628.4K |
| 99214 | Office o/p est mod 30 min | $163.3M | 1.8M |
| 90999 | Unlisted dialysis procedure | $148.7M | 1.2M |
| 99285 | Emergency dept visit hi mdm | $129.9M | 392.6K |
| J0887 | Epoetin beta esrd use | $96.9M | 84.3K |
| H2021 | Com wrap-around sv, 15 min | $82.9M | 209.4K |
| S9122 | Home health aide or certifie | $80.9M | 644.0K |
| T2016 | Habil res waiver per diem | $77.7M | 66.2K |