Against 13 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,104
+11.5% vs peer median
5th highest of 14 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$1,403,466,725
50th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
98,607
50th highest of 51 states
Most recent CMS monthly report
Visible in claims
26.9%
−8.3% vs peer median
12th 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 8 flagged North Dakota providers, the smallest roster of any state. One referral: a Bismarck transportation company charged in June 2025 in parallel federal and county cases alleging ghost rides and vehicle-type upcharging. 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.
$2.2B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $316.7M / year
18.6M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 2.7M / year
1.2K
Distinct billing NPIs, Jan 2018 – Oct 2024
108
15 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $408.0M | 1.0M |
| W0725 | Code W0725 | $247.8M | 98.3K |
| T2021 | Day habil waiver per 15 min | $172.5M | 1.0M |
| 99213 | Office o/p est low 20 min | $104.5M | 1.1M |
| W0715 | Code W0715 | $96.0M | 212.6K |
| 99214 | Office o/p est mod 30 min | $72.0M | 727.9K |
| W0300 | Code W0300 | $51.6M | 82.4K |
| S5125 | Attendant care service /15m | $48.1M | 269.6K |
| 99284 | Emergency dept visit mod mdm | $47.4M | 270.9K |
| 99283 | Emergency dept visit low mdm | $39.8M | 261.4K |