Against 23 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$642
−37.5% vs peer median
23rd highest of 24 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$5,915,435,332
34th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
675,955
31st highest of 51 states
Most recent CMS monthly report
Visible in claims
22.0%
+10.7% vs peer median
8th highest of 24 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 Nevada providers. Six were referred: each traces to a Nevada MFCU conviction, a state termination, a federal exclusion, or an out-of-state payment suspension already on the public record. 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.
$8.1B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $1.2B / year
172.2M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 25.2M / year
9.0K
Distinct billing NPIs, Jan 2018 – Oct 2024
460
50 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $752.3M | 9.3M |
| T2017 | Habil res waiver 15 min | $695.3M | 325.5K |
| T1017 | Targeted case management | $335.8M | 2.3M |
| 99214 | Office o/p est mod 30 min | $311.8M | 4.9M |
| 99213 | Office o/p est low 20 min | $269.0M | 5.8M |
| 99285 | Emergency dept visit hi mdm | $241.3M | 2.1M |
| T1015 | Clinic service | $231.2M | 715.8K |
| 90999 | Unlisted dialysis procedure | $180.3M | 2.8M |
| 99284 | Emergency dept visit mod mdm | $176.1M | 2.0M |
| A0427 | Als1-emergency | $171.3M | 572.1K |