Against 23 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,032
+4.0% vs peer median
9th highest of 24 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$33,987,517,237
6th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
2,400,994
8th highest of 51 states
Most recent CMS monthly report
Visible in claims
22.6%
+13.3% vs peer median
7th 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 Ohio providers. Two referrals: a June 2026 federal indictment (pending) and an October 2024 Medicaid fraud conviction, both matching the flagged codes. 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.
$37.0B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $5.4B / year
867.1M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 126.9M / year
21.1K
Distinct billing NPIs, Jan 2018 – Oct 2024
897
57 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $2.6B | 37.7M |
| 99214 | Office o/p est mod 30 min | $1.7B | 28.0M |
| 99213 | Office o/p est low 20 min | $1.7B | 38.4M |
| H2019 | Ther behav svc, per 15 min | $1.5B | 17.4M |
| T2046 | Hospice long term care, r&b | $1.3B | 8.6M |
| G0156 | Hhcp-svs of aide,ea 15 min | $1.2B | 34.9M |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that | $1.2B | 7.7M |
| 90837 | Psytx w pt 60 minutes | $1.1B | 12.6M |
| 99284 | Emergency dept visit mod mdm | $970.7M | 10.8M |
| G0463 | Hospital outpt clinic visit | $889.8M | 9.2M |