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.
$17.4B
Cumulative, Jan 2018 β Dec 2024 (7 years)
β $2.5B / year
328.0M
Cumulative, Jan 2018 β Dec 2024 (7 years)
β 46.9M / year
10.2K
Distinct billing NPIs, Jan 2018 β Dec 2024
730
164 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| H2014 | Skills train and dev, 15 min | $1.7B | 13.2M |
| 99214 | Office o/p est mod 30 min | $956.7M | 15.2M |
| T2016 | Habil res waiver per diem | $955.1M | 1.5M |
| 99213 | Office o/p est low 20 min | $897.4M | 18.8M |
| 97153 | Adaptive behavior tx by tech | $735.4M | 1.7M |
| H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction | $728.4M | 1.9M |
| 99284 | Emergency dept visit mod mdm | $580.5M | 5.8M |
| 99283 | Emergency dept visit low mdm | $547.3M | 5.1M |
| 99600 | Unlisted home visit svc/px | $495.1M | 4.5M |
| 99285 | Emergency dept visit hi mdm | $359.5M | 3.7M |