Mains'l Florida, Inc.
Home Health
Brooklyn Park, Minnesota
NPI: 1932341898
Risk Tier
Critical
Total Paid
$996.8M
$996,801,122
Total Claims
306K
Beneficiaries
284K
Avg Cost/Claim
$3,256.13
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (5)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $3,271.45 per claim for H0044 (Supported housing, per diem), which is 4.1× the national median of $797.87.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T2028 (2 unique codes).
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Spending Spike
Experienced a dramatic increase in billing over a short period.
Advanced Detection Signals
Suspicious Concentration
Herfindahl-Hirschman Index of 1 across 2 procedure codes — billing is highly concentrated in very few services.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024