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NPI 1376587113 · Hicksville, NY · Clinical Medical Laboratory
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Sunrise Medical Laboratories, Inc. is a clinical medical laboratory provider located in Hicksville, New York. This profile covers 515 Medicare and 478 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Sunrise Medical Laboratories, Inc. |
| Address | 250 Miller Pl |
| City | Hicksville |
| State | NY |
| ZIP | 11801 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $101.5M |
| Medicare | $30.3M |
SUNRISE MEDICAL LABORATORIES, INC. shows a Medicaid-dominant payer mix: Medicaid revenue is $101.5M compared with Medicare revenue of $30.3M, so Medicaid is the larger source of lifetime billing for this NPI. The NPI has been enumerated since 2006-06-15 (~20 years ago), indicating long tenure in the market that may support the scale seen in its claims activity.
Medicare billing is concentrated in routine clinical chemistry and endocrinology panels: the three Medicare revenue leaders include 80053, 82306, and 84443 and the top 3 Medicare codes together account for 35.3% of Medicare revenue. High claim volumes for these codes (for example, 80053: 242.6K claims, 82306: 82.5K claims, 84443: 148.9K claims) and modest average paid/claim levels point to a high-throughput reference laboratory model focused on outpatient screening and monitoring tests.
Medicaid activity is extremely weighted toward infectious disease and STD testing plus high-throughput COVID PCR work: U0003 accounts for $18.3M and 281.7K claims (26.4% of Medicaid revenue), while 87491 (296.5K claims, $5.0M) and 87591 (295.2K claims, $4.7M) are also major Medicaid revenue drivers. The top 3 Medicaid codes together account for 40.5% of Medicaid revenue, signaling that a few high-volume molecular and infectious-disease assays drive a large share of Medicaid dollars.
Revenue concentration creates dependence on a narrow set of tests across both payers: precomputed totals show the top 3 Medicare codes account for 35.3% of Medicare revenue and the top 3 Medicaid codes account for 40.5% of Medicaid revenue. That concentration means changes to reimbursement, clinical screening guidelines, or demand for a small number of assays (notably U0003 and the leading Medicare panels) could materially impact overall revenue.
On national Medicare measures SUNRISE is a high-volume outlier: many Medicare codes rank at the 100th percentile nationally and are labeled "extreme outlier" (examples include 80053 rank #24 of 26416, 82306 rank #18 of 12453, 84443 rank #21 of 19722). These rank positions indicate the laboratory bills far more for common panels and analytes than typical national peers, consistent with a centralized, large-scale testing operation.
Within New York Medicaid the provider is a dominant state-level biller for multiple assays: several Medicaid codes rank #1 in-state (for example, 87491, 87591, 87661, 86480, 88175 and 87086 are listed as rank #1) and many other codes are in the 98–100th percentiles. This statewide dominance is especially pronounced for STD, TB, and some cytology services, positioning the lab as a major in-state reference provider for public-health–oriented testing.
The mix of very high-volume, low-unit-value routine tests (for example Medicaid 80061 $5 avg paid/claim; Medicare 80053 $10 avg paid/claim) alongside high-unit-value molecular assays (for example Medicaid U0003 $65 avg paid/claim; Medicare 83970 $40 avg paid/claim) suggests diversified reimbursement exposure. Operationally, that pattern is consistent with a high-throughput central laboratory that combines mass-screening services with more lucrative molecular diagnostics, which creates both scale benefits and sensitivity to volume and reimbursement swings across those segments.
Multiple explicit outlier labels in the file (e.g., "extreme outlier", "notably above typical") across both Medicare and Medicaid code lists indicate claim volumes that are far above typical peers rather than modest participation. For analysts, these statistical outlier flags, the high absolute claim counts (hundreds of thousands for many Medicaid codes and hundreds of thousands for key Medicare panels), and the provider's long enumeration suggest this entity operates as a large regional/national reference lab rather than a small clinical laboratory, with implications for network contracting, utilization management, and audit prioritization.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
515 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 242,620 | $10 | $2.4M |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 82,470 | $30 | $2.4M |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 148,930 | $20 | $2.4M |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 177,680 | $10 | $2.3M |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 200,330 | $10 | $1.6M |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 138,750 | $10 | $1.4M |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 67,690 | $20 | $1M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 91,990 | $10 | $735.9K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 61,010 | $10 | $549.1K |
| 82746 | The lab analyst measures the folic acid level in serum to determine if there is a deficiency. Folic acid deficiency is attributed to many conditions such as malabsorption, Crohn’s disease, celiac… | 37,540 | $10 | $525.5K |
Showing 1–10 of 515
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 515 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
515 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 88361 | 7 | 10 | 100 | $60 | $554.4K |
| 87798 | 5 | 40 | 740 | $30 | $218.3K |
| 88120 | 21 | 30 | 90 | $450 | $133.6K |
| 87507 | 4 | 10 | 120 | $410 | $83.7K |
| G0480 | 7 | 30 | 170 | $110 | $76.5K |
| 87801 | 13 | 20 | 60 | $70 | $75.1K |
| 88185 | 5 | 100 | 1,210 | $20 | $74.9K |
| 88305 | 108 | 980 | 370 | $50 | $58.5K |
| 87636 | 3 | 180 | 20 | $140 | $54.9K |
| 88377 | 26 | 50 | 50 | $210 | $50.8K |
Showing 1–10 of 515
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
478 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high… | 281,660 | $70 | $18.3M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 296,520 | $20 | $5M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 295,190 | $20 | $4.7M |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 189,980 | $20 | $4M |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 301,120 | $10 | $3.9M |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 228,730 | $20 | $3.4M |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 158,000 | $20 | $2.4M |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 472,190 | $10 | $2.4M |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 426,160 | $10 | $2.1M |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 72,870 | $30 | $2M |
Showing 1–10 of 478
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
478 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high… | 8 | 340 | 1,090 | $70 | $1.4M |
| 88361 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. The lab analyst processes the slides using computer assisted… | 3 | 10 | 3,040 | $110 | $934.7K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 11 | 140 | 360 | $130 | $492.1K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,… | 10 | 300 | 1,710 | $20 | $458.6K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 11 | 110 | 690 | $50 | $442K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 13 | 290 | 1,900 | $30 | $390.6K |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 4 | 60 | 230 | $370 | $340.9K |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 10 | 30 | 260 | $480 | $329.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 4 | 590 | 1,160 | $20 | $277.2K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 29 | 640 | 1,080 | $60 | $251.5K |
Showing 1–10 of 478
Other providers in the same ZIP code as Sunrise Medical Laboratories, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cottage Homecare, Services, Inc | NY | Home Health Agency | $0 | $121.8M |
| Acutis Diagnostics Inc | NY | Clinical Medical Laboratory | $5.2M | $60.6M |
| Aides At Home Inc | NY | Home Health Agency | $0 | $56.4M |
| Central Nassau Guidance & Counseling Services, Inc. | NY | Community/Behavioral Health Agency | $0 | $46M |
| James Maisel | NY | Ophthalmology Physician | $4.4M | $8.9K |
| Leena Doshi | NY | Diagnostic Radiology Physician | $914.5K | $500 |
| Stephanie Becker | NY | Ophthalmology Physician | $757.2K | $41.4K |
| Michael Sable | NY | Ophthalmology Physician | $671K | $470 |
| Florante Melchor | NY | Internal Medicine Physician | $211.5K | $102.2K |
| Richard Obedian | NY | Orthopaedic Surgery Physician | $268.3K | $0 |
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