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    OpenPayerNPI Medicare & MedicaidAdventist Health System Sunbelt, Inc.
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    Adventist Health System Sunbelt, Inc. — Billing Profile & Reimbursement Data

    NPI 1073565610 · Maitland, FL · Urgent Care Clinic/Center

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    Adventist Health System Sunbelt, Inc. is a urgent care clinic/center provider located in Maitland, Florida. This profile covers 0 Medicare and 66 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationAdventist Health System Sunbelt, Inc.
    Address2600 Westhall Lane
    CityMaitland
    StateFL
    ZIP32751
    TaxonomyUrgent Care Clinic/Center
    NPI EnumeratedMay 16, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$67.5M
    Medicare$0

    Key Findings

    This provider has no Medicare billing on file and reports $67.5M in lifetime Medicaid revenue, making its billings effectively single-payer (Medicaid) in scale. The absence of Medicare activity combined with substantial Medicaid receipts indicates payer concentration risk and means Medicaid-related utilization and reimbursement trends will drive financial performance and contracting leverage.

    Revenue is heavily concentrated in office/outpatient evaluation-and-management codes: the top three Medicaid codes (99213, 99214, 99203) together account for 82.7% of this provider's total Medicaid revenue. Individually those codes generate $22.2M (32.9%) for 99213, $19M (28.2%) for 99214, and $14.6M (21.6%) for 99203, showing that standard E/M visits are the dominant revenue drivers.

    The provider’s taxonomy as an Urgent Care Clinic/Center coupled with the code mix (large volumes of 99213, 99214, 99203 and presence of S9083) points to a high-throughput ambulatory urgent care/clinic operation that bills primarily through office/outpatient E/M codes rather than packaged urgent-care global fees. S9083 (global fee urgent care centers) contributes only $276.2K (0.4%) of Medicaid revenue, suggesting the organization relies mainly on discrete E/M visit billing rather than global urgent-care billing.

    This entity is a statewide outlier and dominant volume performer for its top visit codes: 99213 ranks #4 of 5934 providers in-state (100th percentile; extreme outlier), 99214 ranks #7 of 6379 (100th percentile; extreme outlier), and 99203 ranks #1 of 1673 (100th percentile; extreme outlier). These rank/percentile positions indicate the provider is a leading Medicaid visit-volume player in Florida for routine and higher-complexity E/M visits, not a modest participant.

    Claim counts reflect very high patient throughput: 207.5K claims for 99213, 158.3K claims for 99214, and 128.8K claims for 99203. Such sustained, large claim volumes are consistent with a large-scale urgent care or centralized ambulatory access model and imply significant front-line visit capacity and operational focus on face-to-face encounters.

    The provider also runs a substantial rapid-testing footprint by volume, with 87426 at 156.4K claims ($469.1K revenue, 0.7%) ranked #1 of 642 providers in-state (100th percentile; extreme outlier), 87804 at 108.3K claims ($108.3K revenue, 0.2%) ranked #3 of 1111 (100th percentile; extreme outlier), and 87880 at 67.7K claims ($67.7K revenue, 0.1%) ranked #2 of 1118 (100th percentile; extreme outlier). These tests generate low average paid/claim amounts (e.g., $3 or $1) and therefore contribute little to total revenue despite very high throughput, reinforcing a service mix that prioritizes volume testing alongside visit care.

    While testing volumes are extreme outliers by count, the dollar impact of those test codes is small relative to visit E/M codes (for example, 87426 produces $469.1K or 0.7% of Medicaid revenue). This contrast—very high test claim volumes but low revenue share—suggests testing is an operational throughput activity rather than a primary revenue line for the provider.

    The provider has an established NPI tenure, enumerated on 2006-05-16 (~20 years ago), indicating long-standing presence in the market. That longevity, combined with dominant state-level ranks on high-volume E/M and testing codes, suggests an entrenched operational footprint in Florida’s Medicaid ambulatory care landscape.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    66 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…207,460$110$22.2M
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…158,330$120$19M
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…128,760$110$14.6M
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…46,110$120$5.5M
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…24,130$120$3M
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…17,890$110$1.9M
    87426The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…156,360$1$469.1K
    S9083Global fee urgent care centers1,890$150$276.2K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…940$120$109.4K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.108,330$1$108.3K

    Showing 1–10 of 66

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Florida median

    66 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    A9150Non-prescription drugs31040$320$577.2K
    S9083Global fee urgent care centers48130680$90$517.2K
    A4649Surgical supply; miscellaneous42090$630$303.3K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…45,930460$40$169.3K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…76,380430$50$139.3K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…159980120$90$76.8K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…21,85090$110$71.5K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…11,67090$80$69.2K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…8234060$130$42.3K
    71046In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…245610690$10$41K

    Showing 1–10 of 66

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Adventist Health System Sunbelt, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Adventist Health System-sunbelt, IncFLGeneral Acute Care Hospital$0$173.7M
    Florida Hospital Medical Group IncFLFamily Medicine Physician$0$71.2M
    Adventist Health System-sunbelt, IncFLClinical Medical Laboratory$0$28.2M
    Florida Hospital Physician Group IncFLFamily Medicine Physician$0$21.4M
    Memorial Health Systems IncFLRehabilitation Hospital Unit$0$17.6M
    Memorial Hospital Flagler IncFLGeneral Acute Care Hospital$0$13.9M
    Florida Hospital Medical Group IncFLDiagnostic Radiology Physician$0$13.1M
    Sedigheh EbadiFLPediatrics Physician$0$10.1M
    Florida Hospital Zephyrhills IncFLGeneral Acute Care Hospital$0$9.9M
    Memorial Health Systems IncFLSurgery Physician$0$7.4M

    Nearby Providers

    Other providers in the same ZIP code as Adventist Health System Sunbelt, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Maxim Healthcare Services, Inc.FLHome Health Agency$0$124.5M
    Integrity Health Services Orlando, LLCFLHome Health Agency$0$24.8M
    Kacian BrownFLFamily Medicine Physician$9.4M$0
    Childrens Surgery Center LLCFLAmbulatory Surgical Clinic/Center$735.2K$2.8M
    Vivia FranksonFLFamily Nurse Practitioner$1.5M$0
    Amish ParikhFLCardiovascular Disease Physician$1.2M$0
    Arnaldo IsaFLSpecialist$844.6K$0
    Penny GlickmanFLEndocrinology, Diabetes & Metabolism Physician$485.9K$0
    Neel PatelFLCardiovascular Disease Physician$481.6K$0
    William GrisaitisFLDermatology Physician$470K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Florida Providers
    6 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Florida Distribution
    Adventist Health System Sunbelt, Inc. — 15 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Florida