Medco Respiratory Instruments, Inc.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $12.4M (2020) to $42.2M (2021) — a 240% swing with $29.8M absolute change.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $201.33 per claim for B4155 — 4.3× the national median of $46.72.
Billing above the 90th percentile for 4 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Durable Medical Equipment & Medical Supplies Peers
Total spending distribution among 35 providers in this specialty
This provider's total spending of $171.6M is at the 50th percentile among 35 Durable Medical Equipment & Medical Supplies providers.
Total Paid
$171.6M
$171,568,602
Total Claims
1.6M
Beneficiaries
1.4M
1.1 claims/patient
Avg Cost/Claim
$107
#571 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Medco Respiratory Instruments, Inc. is a Durable Medical Equipment & Medical Supplies provider based in Houston, TX. From the 2018–2024 period, this provider received $171.6M in Medicaid payments across 1.6M claims.
Why This Matters
This provider received $171.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,446 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (B4161 (Enteral formula, semisolid, 100 calories = 1 unit)) accounts for 19% of total spending.
$31.8M
56K claims
$569.41
$465.86
Enteral formula, semisolid, 100 calories = 1 unit
$31.8M
56K claims · 18.5%
$25.1M
127K claims
$198.03
$117.24
Enteral feeding supply kit, pump fed, per day
$25.1M
127K claims · 14.6%
$22.5M
114K claims
$196.78
$157.30
Enteral formula, per 100 calories
$22.5M
114K claims · 13.1%
$10.0M
138K claims
$73.00
$55.51
Enteral/parenteral nutritional supplies, NOS
$10.0M
138K claims · 5.9%
$7.2M
71K claims
$100.90
$110.54
Adult-sized disposable underpads/pads, small
$7.2M
71K claims · 4.2%
$6.4M
7K claims · 3.7%
$6.0M
19K claims
$317.40
$300.16
Enteral formula, manufactured blenderized, per 100 calories
$6.0M
19K claims · 3.5%
Disposable underpads, all sizes
$5.0M
170K claims · 2.9%
$4.9M
24K claims · 2.8%
$3.6M
23K claims
$159.94
$89.79
Enteral formula, nutritionally complete with fiber, per 100 calories
$3.6M
23K claims · 2.1%
$3.4M
18K claims
$187.34
$92.20
Enteral formula, calorically dense, per 100 calories
$3.4M
18K claims · 2.0%
$3.1M
40K claims · 1.8%
$2.6M
8K claims · 1.5%
$2.4M
20K claims · 1.4%
$2.4M
3K claims
$779.33
$583.21
Home ventilator, any type, used with invasive interface
$2.4M
3K claims · 1.4%
$2.3M
24K claims
$97.15
$88.94
Adult-sized disposable incontinence product, medium
$2.3M
24K claims · 1.3%
$2.3M
26K claims · 1.3%
$2.2M
26K claims
$87.07
$84.50
Adult-sized disposable incontinence product, brief/diaper, above XL
$2.2M
26K claims · 1.3%
$1.9M
17K claims
$109.96
$99.53
Adult-sized disposable incontinence product, large
$1.9M
17K claims · 1.1%
$1.8M
24K claims · 1.0%
$1.8M
11K claims · 1.0%
$1.4M
13K claims · 0.8%
$1.3M
14K claims
$96.34
$96.13
Adult-sized disposable incontinence product, brief/diaper, small
$1.3M
14K claims · 0.8%
$1.3M
13K claims
$103.57
$45.11
Oxygen concentrator, single delivery port
$1.3M
13K claims · 0.8%
$1.2M
230K claims · 0.7%
$1.2M
9K claims
$137.19
$105.14
Adult-sized disposable incontinence product, extra-large
$1.2M
9K claims · 0.7%
$1.1M
2K claims · 0.6%
$1.0M
2K claims
$508.49
$508.29
Intermittent urinary catheter, with insertion supplies
$1.0M
2K claims · 0.6%
$923K
9K claims · 0.5%
$897K
31K claims · 0.5%
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