Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Maryland Medicaid Provider Spending

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.

Cross-Dataset Analysis Available

Watchlist

693 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$18.9B

Total Claims

251.4M

Unique Providers

13.1K

Watchlist

2.2K

693 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
H0044Supported housing, per month$1.7B2.2M
90834Psytx w pt 45 minutes$1.3B11.9M
99214Office o/p est mod 30 min$1.1B12.4M
99213Office o/p est low 20 min$968.6M12.5M
S5102Adult day care per diem$753.1M8.8M
T1003Lpn/lvn services up to 15min$692.8M1.4M
H0015Alcohol and/or drug services; intensive outpatient (treatment program that$584.4M3.6M
H2016Comp comm supp svc, per diem$579.7M185.9K
H0020Alcohol and/or drug services; methadone administration and/or service$518.7M6.9M
T2022Case management, per month$367.7M2.7M
View all procedures β†’