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.
$8.6B
Cumulative, Jan 2018 β Dec 2024 (7 years)
β $1.2B / year
121.6M
Cumulative, Jan 2018 β Dec 2024 (7 years)
β 17.4M / year
3.8K
Distinct billing NPIs, Jan 2018 β Dec 2024
403
58 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| S5125 | Attendant care service /15m | $1.6B | 4.0M |
| T1015 | Clinic service | $948.3M | 15.4M |
| 99285 | Emergency dept visit hi mdm | $841.6M | 17.8M |
| S5130 | Homaker service nos per 15m | $509.0M | 2.3M |
| 99213 | Office o/p est low 20 min | $466.7M | 11.7M |
| H2036 | A/d tx program, per diem | $429.9M | 3.7M |
| 99214 | Office o/p est mod 30 min | $414.6M | 8.8M |
| 99284 | Emergency dept visit mod mdm | $377.8M | 9.2M |
| T1019 | Personal care ser per 15 min | $367.1M | 1.7M |
| 87491 | Chlmyd trach dna amp probe | $220.1M | 8.8M |