Modivcare Solutions, LLC
Transportation Broker
Denver, Colorado
NPI: 1699725143
Risk Tier
Elevated
Total Paid
$3.09B
$3,093,063,113
Total Claims
107.7M
Beneficiaries
16.4M
Avg Cost/Claim
$28.71
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 9 procedure codes: A0426 at 3.8× median, 93005 at 38.1× median.
Advanced Detection Signals
Billing Velocity
58288.1 claims per working day — may exceed physically possible volume for a single provider.
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