Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

The Nemours Foundation

General Acute Care Hospital Children·Orlando, FL·NPI: 1245520386SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Compared to General Acute Care Hospital Children Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $105.0M is at the below 25th percentile among 16 General Acute Care Hospital Children providers.

Total Paid

$105.0M

$104,950,093

Total Claims

644K

Beneficiaries

502K

1.3 claims/patient

Avg Cost/Claim

$163

🔍 Analysis

Provider Overview

The Nemours Foundation is a General Acute Care Hospital Children provider based in Orlando, FL. From the 2018–2024 period, this provider received $105.0M in Medicaid payments across 644K claims.

Why This Matters

This provider received $105.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 13,118 Medicaid beneficiaries for a full year at average per-enrollee costs.