Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or New York for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New York only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. New York (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Sun River Health Inc. (NPI 1619969458)

Field	Value
Entity Type	Organization
Organization	Sun River Health Inc.
Address	1037 Main St
City	Peekskill
State	NY
ZIP	10566
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 18, 2005

Payer Source	Total Paid
Medicaid	$546.7M
Medicare	$0

Key Findings

SUN RIVER HEALTH INC. is effectively a single-payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $546.7M, indicating that its entire recorded federal revenue footprint in our data is driven by Medicaid payments rather than Medicare. This concentration implies operational focus on Medicaid-covered services and patient populations.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top 3 Medicaid codes account for 70.5% of the provider’s total Medicaid revenue, with G9005 ($161.7M, 30.6%) and 99213 ($141.1M, 26.7%) alone representing the majority of dollars. This concentration signals dependence on a few high-volume service lines for the bulk of reimbursement.

The code mix indicates a combined primary service model of FQHC core primary care and integrated behavioral health/care coordination: 99213 and related E/M codes (99214, 99212) together contribute large volumes and revenue, while psychotherapy codes 90832 and 90834 and psychiatric evaluation codes 90791/90792 also appear among top revenue drivers. In addition, case management codes T2022 and T1016 and the coordinated care fee G9005 point to a care-coordination and chronic-care management emphasis consistent with FQHC operations.

SUN RIVER Health is a statewide leader for multiple high-volume Medicaid codes: 99213 ranks #2 of 19110 providers in-state (100th percentile) and 99214 and 99212 likewise rank at or near the top (100th percentile), which we label as extreme outlier volumes compared with peers. G9005 ranks #4 of 37 providers (92th percentile) and T2022/T1016 sit in the 95th percentile range, indicating the organization holds a notable competitive position in coordinated care and case management services within New York.

Several pediatric and preventive codes show outsized volume relative to peers, consistent with an FQHC population health orientation: preventive visits 99392/99391 and well-child code 99393 are all ranked #2–#3 in-state (100th percentile), and immunization administration 90460 ranks #6 (100th percentile). These placements characterize the provider as a major deliverer of preventive and pediatric services in the state Medicaid market.

Behavioral health services are a material revenue stream: 90832 contributes $69.8M (13.2% of Medicaid revenue) and 90834, 90853, 90791, and 90792 all appear in the top codes list, many labeled as extreme outliers in-state. This pattern suggests integrated mental health care is a core component of the organization’s service mix and revenue base.

Dental services and urgent care also appear as meaningful ancillary lines: D0120, D0140, D0150, and D1110 among the top codes (each flagged as extreme outliers in statewide rank) together add several million in revenue and point to an on-site dental program; S9083 indicates an urgent care component. These diversified service lines reinforce the multi-service FQHC model rather than a narrow specialty focus.

Tenure in the provider directory is long: the NPI was enumerated on 2005-08-18 (~21 years ago), which supports a sustained operational presence in the market and helps explain the ability to scale high-volume Medicaid programs across primary care, behavioral health, dental, and care coordination service lines.

Medicaid: Complete Services Breakdown

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

243 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9005	Coordinated care fee, risk adjusted maintenance	523,330	$310	$161.7M
99213	The 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…	1,331,310	$110	$141.1M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	377,240	$190	$69.8M
T2022	Case management, per month	63,980	$560	$36M
99214	The 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…	333,140	$100	$32.3M
T1016	Case management, each 15 minutes	71,090	$290	$20.4M
99212	The 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,…	204,280	$80	$16.8M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	37,700	$210	$7.8M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	72,480	$70	$5M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	65,860	$70	$4.7M

Showing 1–10 of 243

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Sun River Health Inc. — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

243 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9005	Coordinated care fee, risk adjusted maintenance	4	40	105,510	$300	$55.6M
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	4	10	130,390	$90	$29.5M
T2022	Case management, per month	5	80	360	$550	$11.6M
T1016	Case management, each 15 minutes	3	40	3,630	$220	$3.7M
S5102	Day care services, adult; per diem	364	360	11,920	$90	$2.4M
S9083	Global fee urgent care centers	28	200	340	$120	$1.7M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	5	1,510	1,010	$110	$1.1M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	82	2,200	1,010	$130	$892.2K
G0481	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…	35	40	440	$90	$511.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	25	620	1,130	$60	$370.5K

Showing 1–10 of 243

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Shore-lij Medical PC	NY	Urology Physician	$0	$388.1M
Premium Health Inc	NY	Federally Qualified Health Center (FQHC)	$0	$85.4M
Sun River Health Inc	NY	Adult Day Care Clinic/Center	$0	$18.5M
David Cohen	NY	Dermatology Physician	$352K	$8.4M
Prisma Health Medical Group-midlands	SC	Orthopaedic Surgery Physician	$0	$8.7M
Marian David	NY	Cardiovascular Disease Physician	$348.5K	$8.3M
Edward Bennett	NY	Internal Medicine Physician	$152.7K	$6.7M
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Eric Shakin	NY	Ophthalmology Physician	$3.3M	$291.7K
John Rigney	NY	Diagnostic Radiology Physician	$850.2K	$2.7M

Nearby Providers

Other providers in the same ZIP code as Sun River Health Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Srh Chn Lead Health Home LLC	NY	Case Management Agency	$0	$238.8M
Lexington Center For Recovery, Inc.	NY	Methadone Clinic	$143.2K	$66.4M
Vernon Peryea	NY	Optometrist	$140.9K	$1M

Sun River Health Inc. — Billing Profile & Reimbursement Data

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Sun River Health Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References