Rgh Enterprises, LLC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 19 procedure codes: A4253 at 7.0× median, A4332 at 3.1× median.
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:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
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 $48.68 per claim for A4253 (Blood glucose test strips) — 7.0× the national median of $6.92.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$424.8M
$424,768,920
Total Claims
5.8M
Beneficiaries
5.0M
1.2 claims/patient
Avg Cost/Claim
$73
#148 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Rgh Enterprises, LLC is a Prosthetic/Orthotic Supplier provider based in Twinsburg, OH. From the 2018–2024 period, this provider received $424.8M in Medicaid payments across 5.8M claims.
Why This Matters
This provider received $424.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 53,096 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 (A9276 (Breath test analyzer, FDA approved, disposable)) accounts for 18% of total spending.
$75.4M
230K claims
$327.06
$294.58
Breath test analyzer, FDA approved, disposable
$75.4M
230K claims · 17.7%
$32.7M
11K claims
$3,031.88
$1,188.30
External ambulatory infusion pump, insulin
$32.7M
11K claims · 7.7%
$30.5M
245K claims
$124.44
$136.09
Infusion supplies, non-chemotherapy, per visit
$30.5M
245K claims · 7.2%
$20.9M
172K claims
$121.13
$131.70
Breast pump, electric, any type
$20.9M
172K claims · 4.9%
$20.3M
59K claims
$345.92
$407.76
Breath alcohol test, per administration
$20.3M
59K claims · 4.8%
$19.1M
151K claims
$126.42
$53.20
Supply allowance for therapeutic CGM, per month
$19.1M
151K claims · 4.5%
$14.7M
33K claims
$446.74
$466.16
External ambulatory insulin delivery system, disposable
$14.7M
33K claims · 3.5%
$12.0M
27K claims
$441.33
$508.29
Intermittent urinary catheter, with insertion supplies
$12.0M
27K claims · 2.8%
$11.9M
90K claims
$132.36
$73.75
Supply allowance for non-insulin pump CGM, per month
$11.9M
90K claims · 2.8%
$8.5M
77K claims
$110.40
$116.15
Intermittent urinary catheter, straight tip, each
$8.5M
77K claims · 2.0%
$7.7M
137K claims · 1.8%
$6.7M
254K claims
$26.28
$41.28
Pediatric-sized disposable incontinence product, large
$6.7M
254K claims · 1.6%
$6.2M
128K claims
$48.57
$88.94
Adult-sized disposable incontinence product, medium
$6.2M
128K claims · 1.5%
$6.2M
98K claims · 1.5%
$5.8M
123K claims
$47.19
$99.53
Adult-sized disposable incontinence product, large
$5.8M
123K claims · 1.4%
$5.6M
78K claims
$71.61
$110.54
Adult-sized disposable underpads/pads, small
$5.6M
78K claims · 1.3%
$5.2M
141K claims · 1.2%
$4.9M
59K claims · 1.1%
$4.6M
92K claims
$50.72
$105.14
Adult-sized disposable incontinence product, extra-large
$4.6M
92K claims · 1.1%
Blood glucose test strips
$4.3M
89K claims · 1.0%
$4.2M
11K claims · 1.0%
$4.1M
12K claims
$353.66
$280.71
Intermittent urinary catheter, Coude tip, each
$4.1M
12K claims · 1.0%
$4.0M
150K claims · 0.9%
$3.7M
191K claims
$19.45
$42.03
Adult-sized disposable underpads/pads, large
$3.7M
191K claims · 0.9%
$3.7M
88K claims · 0.9%
$3.3M
24K claims
$137.74
$157.30
Enteral formula, per 100 calories
$3.3M
24K claims · 0.8%
$3.2M
9K claims
$362.82
$465.86
Enteral formula, semisolid, 100 calories = 1 unit
$3.2M
9K claims · 0.7%
$2.9M
30K claims · 0.7%
$2.8M
81K claims · 0.7%
$2.7M
6K claims · 0.6%
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