Against 5 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$944
+3.4% vs peer median
3rd highest of 6 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$3,646,271,928
41st highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
296,519
39th highest of 51 states
Most recent CMS monthly report
Visible in claims
9.3%
−17.0% vs peer median
4th 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 10 flagged Nebraska providers, the smallest roster of any state after artifact suppression. One referral, an Omaha counselor convicted of felony Medicaid fraud in November 2024; Nebraska's January 2024 dental managed-care carve-in explains the dental growth 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.
$2.3B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $341.6M / year
46.2M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 6.8M / year
3.3K
Distinct billing NPIs, Jan 2018 – Oct 2024
215
30 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $213.1M | 3.2M |
| 99214 | Office o/p est mod 30 min | $150.4M | 2.0M |
| T1015 | Clinic service | $101.4M | 451.6K |
| 99284 | Emergency dept visit mod mdm | $86.7M | 763.6K |
| 90834 | Psytx w pt 45 minutes | $86.5M | 868.3K |
| 99283 | Emergency dept visit low mdm | $84.4M | 764.3K |
| 90837 | Psytx w pt 60 minutes | $79.9M | 583.6K |
| H2016 | Comp comm supp svc, per diem | $45.9M | 162.0K |
| H0018 | Behavioral health; short-term residential (non-hospital residential treatment | $44.2M | 76.8K |
| 99285 | Emergency dept visit hi mdm | $40.5M | 344.7K |