Against 5 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$853
−9.6% vs peer median
5th highest of 6 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$32,464,090,021
7th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
2,661,257
6th highest of 51 states
Most recent CMS monthly report
Visible in claims
11.2%
+20.5% vs peer median
3rd 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 30 flagged Illinois providers. Three referrals rest on a pending federal complaint, a federal conviction, and an OIG exclusion already on the public record. 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.
$19.9B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $2.9B / year
472.8M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 69.2M / year
44.4K
Distinct billing NPIs, Jan 2018 – Oct 2024
1.0K
128 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1015 | Clinic service | $3.3B | 26.4M |
| A0427 | Als1-emergency | $1.5B | 1.6M |
| A0429 | Bls-emergency | $963.7M | 1.3M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $774.7M | 8.6M |
| 99214 | Office o/p est mod 30 min | $720.2M | 14.9M |
| H2015 | Comp comm supp svc, 15 min | $582.1M | 7.1M |
| 99213 | Office o/p est low 20 min | $556.2M | 23.9M |
| A0425 | Ground mileage | $269.9M | 6.4M |
| H2000 | Comp multidisipln evaluation | $267.5M | 2.6M |
| 99285 | Emergency dept visit hi mdm | $253.7M | 2.9M |