Against 5 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$957
+4.9% vs peer median
2nd highest of 6 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$19,423,914,901
15th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,277,765
16th highest of 51 states
Most recent CMS monthly report
Visible in claims
14.5%
+56.7% vs peer median
1st 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 Indiana providers. No referrals; two federal exclusions confirmed with billing that ended years before the exclusion. Indiana's January 2024 dental rebasing and new group-NPI ramps explain a third of the 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.
$17.4B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $2.5B / year
328.0M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 48.0M / year
10.2K
Distinct billing NPIs, Jan 2018 – Oct 2024
450
6 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| H2014 | Skills train and dev, 15 min | $1.7B | 13.2M |
| 99214 | Office o/p est mod 30 min | $956.7M | 15.2M |
| T2016 | Habil res waiver per diem | $955.1M | 1.5M |
| 99213 | Office o/p est low 20 min | $897.4M | 18.8M |
| 97153 | Adaptive behavior tx by tech | $735.4M | 1.7M |
| H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction | $728.4M | 1.9M |
| 99284 | Emergency dept visit mod mdm | $580.5M | 5.8M |
| 99283 | Emergency dept visit low mdm | $547.3M | 5.1M |
| 99600 | Unlisted home visit svc/px | $495.1M | 4.5M |
| 99285 | Emergency dept visit hi mdm | $359.5M | 3.7M |