Against 13 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$837
−21.0% vs peer median
13th highest of 14 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$24,459,688,035
10th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
2,000,953
9th highest of 51 states
Most recent CMS monthly report
Visible in claims
28.1%
−4.0% vs peer median
8th highest of 14 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 Michigan providers. One referral rests on Michigan Attorney General charges already on the public record; most dental growth flags land on the January and April 2023 dental rate and benefit changes. 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.
$38.9B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $5.7B / year
668.9M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 97.9M / year
16.8K
Distinct billing NPIs, Jan 2018 – Oct 2024
898
127 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| H2015 | Comp comm supp svc, 15 min | $3.7B | 39.3M |
| H2016 | Comp comm supp svc, per diem | $2.6B | 8.4M |
| T1017 | Targeted case management | $1.4B | 6.6M |
| 99214 | Office o/p est mod 30 min | $1.3B | 18.5M |
| T1019 | Personal care ser per 15 min | $1.2B | 16.9M |
| 99213 | Office o/p est low 20 min | $1.2B | 24.8M |
| 99285 | Emergency dept visit hi mdm | $1.1B | 5.5M |
| T1020 | Personal care ser per diem | $1.0B | 5.9M |
| 97153 | Adaptive behavior tx by tech | $995.8M | 5.3M |
| 99284 | Emergency dept visit mod mdm | $812.6M | 7.1M |