Against 5 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,133
+24.1% vs peer median
1st highest of 6 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$16,040,344,828
20th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,094,915
23rd highest of 51 states
Most recent CMS monthly report
Visible in claims
8.6%
−23.3% vs peer median
5th 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 31 flagged Oregon providers, including 1 seeded from the state's enforcement record. One referral rests on a federal drug-distribution conviction with exclusion; Oregon's July 2022 behavioral-health rate increase and January 2022 SUD reform explain the largest steps. 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.
$7.7B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $1.1B / year
165.3M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 24.2M / year
6.7K
Distinct billing NPIs, Jan 2018 – Oct 2024
584
90 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $501.8M | 3.5M |
| 99214 | Office o/p est mod 30 min | $470.2M | 6.9M |
| 99284 | Emergency dept visit mod mdm | $405.4M | 2.5M |
| 99213 | Office o/p est low 20 min | $376.9M | 7.4M |
| 99283 | Emergency dept visit low mdm | $312.9M | 2.4M |
| 99285 | Emergency dept visit hi mdm | $299.8M | 1.5M |
| T1020 | Personal care ser per diem | $282.9M | 241.2K |
| H0019 | Behavioral health; long-term residential (non-medical, non-acute care in a | $276.5M | 688.4K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $181.3M | 2.1M |
| A0427 | Als1-emergency | $176.8M | 746.6K |