Mainstream Living Inc.
Social Worker
Ames, Iowa
NPI: 1992886881
Risk Tier
Critical
Total Paid
$134.3M
$134,327,009
Total Claims
137K
Beneficiaries
34K
Avg Cost/Claim
$978.22
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (3)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $1,988.35 per claim for H2016 (Comprehensive community support services, per 15 min), which is 6.2× the national median of $321.53.
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.
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