Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Oklahoma Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

186 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$9.5B

Total Claims

117.1M

Unique Providers

5.9K

Watchlist

829

186 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
T1041Comm bh clinic svc per month$803.8M912.3K
H0004Behavioral health counseling and therapy, per 15 minutes$720.5M11.1M
T1015Clinic service$634.9M2.9M
99212Office o/p est sf 10 min$622.9M1.4M
99214Office o/p est mod 30 min$520.7M5.5M
99213Office o/p est low 20 min$451.2M6.8M
G9012Other specified case mgmt$426.0M1.4M
T1016Case management$320.1M5.2M
99284Emergency dept visit mod mdm$286.9M1.7M
99283Emergency dept visit low mdm$280.7M2.2M
View all procedures β†’