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 Nevada for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nevada 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. Nevada (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.

Sunrise Hospital And Medical Center, LLC (NPI 1689611774)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sunrise Hospital And Medical Center, LLC
Address	3186 S Maryland Pkwy
City	Las Vegas
State	NV
ZIP	89109
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$17.1M
Medicare	$0

SUNRISE HOSPITAL AND MEDICAL CENTER, LLC shows effectively single‑payer activity in these records: it has no Medicare billing on file and reports $17.1M in total Medicaid revenue, so Medicaid drives the provider’s documented payer footprint. This absence of Medicare billing means any Medicare-based competitive or utilization analysis is not possible from these data.

Revenue is highly concentrated in emergency department evaluation-and-management codes: the precomputed top 3 Medicaid codes by revenue account for 51.4% of total Medicaid revenue, led by 99284 ($4.2M, 25.7%), 99283 ($2.4M, 14.4%), and 99285 ($1.8M, 11.3%). This concentration indicates that a majority of Medicaid dollars flow through ED visits rather than elective or ambulatory specialty procedures.

Service-line mix supports an ED-centered acute care operation with substantial imaging support: high-revenue ED codes are complemented by large CT and CT-angiography volumes such as 74177 ($1.8M, 7K claims) and 70450 ($1.3M, 10.6K claims), plus CTA 71275 ($390.5K). The combination of high-volume ED E/M codes and multiple imaging codes suggests the provider functions as a busy emergency and acute diagnostic center for Medicaid patients.

On competitive standing for ED services, SUNRISE ranks strongly in the state for certain ED codes: 99284 ranks #13 of 398 providers in-state (97th percentile; notably above typical state volume for this code) and 99283 ranks #14 of 390 providers in-state (97th percentile; notably above typical state volume for this code). By contrast 99285 is ranked #26 of 352 (93th percentile; typical, unremarkable volume for this code), indicating the provider is a major state player for moderate- and low-complexity ED visits but more typical for the highest-complexity ED cases.

Observation and therapy services contribute materially to Medicaid revenue and reflect downstream ED/short-stay care: G0378 (hospital observation service) generates $995.5K (10.2K claims) and 97530 (therapeutic activities) generates $898.3K (20K claims). G0378 ranks #14 of 38 in-state (65th percentile; typical, unremarkable volume) while 97530 ranks #25 of 309 (92th percentile; typical, unremarkable volume), suggesting a robust therapy throughput alongside observation-level care.

Imaging and procedural support lines are meaningful secondary revenue drivers beyond ED E/M codes: beyond 74177 and 70450, the file shows other imaging contributions such as 74176 ($388.9K), 71275 ($390.5K), and MRI codes 70551/70553 ($113.2K and $85.4K respectively). Many of these imaging codes sit in high state percentiles (for example 70450 at the 92th percentile and 74177 at the 89th percentile), underlining that the provider’s clinical model pairs ED demand with substantial diagnostic imaging capacity.

Operational concentration poses exposure to Medicaid ED and imaging reimbursement changes because over half of Medicaid revenue is tied to three ED E/M codes (top 3 = 51.4%). Given the provider reports no Medicare revenue, any Medicaid policy or rate shifts affecting ED visits, observation care, or associated imaging would likely have an outsized impact on overall reported revenue.

The provider has an established presence: its NPI was enumerated on 2006-05-31 (~20 years ago), indicating long tenure in the market. Combined with the high state rankings on key ED codes, this tenure supports the interpretation that SUNRISE is an established, high-volume Medicaid ED and acute diagnostic provider in Las Vegas, NV.

Medicaid: Complete Services Breakdown

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

240 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	45,890	$90	$4.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	42,740	$60	$2.4M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	20,640	$90	$1.8M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,970	$260	$1.8M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	10,650	$120	$1.3M
G0378	Hospital observation service, per hour	10,160	$100	$995.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	19,960	$50	$898.3K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	17,460	$30	$454K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	810	$490	$401.3K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	2,110	$190	$390.5K

Showing 1–10 of 240

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Sunrise Hospital And Medical Center, LLC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

240 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	14	40	4,770	$110	$1.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	26	350	240	$110	$685.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	33	150	1,060	$50	$482K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	13	400	200	$90	$442.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	16	140	210	$140	$421K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	25	310	680	$50	$373.3K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	14	390	200	$60	$289.8K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	11	30	290	$60	$260.3K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	18	60	330	$150	$250.4K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	15	50	120	$240	$209.3K

Showing 1–10 of 240

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fremont Emergency Services Scherr Ltd	NV	Emergency Medicine Physician	$0	$20.9M
Sanjay Kandoth Md PC	NV	Pediatrics Physician	$0	$14.6M
Sdmi, LLC	NV	Diagnostic Radiology Physician	$0	$14.3M
Harold Zilberman M D Chtd	NV	Pediatrics Physician	$0	$14.3M
Radiology Specialists Ltd Marasso-miller	NV	Diagnostic Radiology Physician	$0	$13.9M
1st Love & Life Caregivers, LLC	NV	In Home Supportive Care Agency	$0	$10.8M
Childrens Lung Specialists	NV	Pediatric Pulmonology Physician	$0	$8.6M
Jlk Home Care, Inc	NV	In Home Supportive Care Agency	$0	$5.1M
Elsa Home Care Inc	NV	In Home Supportive Care Agency	$0	$4.8M
Michael Rosenman	NV	Pediatrics Physician	$0	$4.7M

Sunrise Hospital And Medical Center, LLC — Billing Profile & Reimbursement Data

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Sunrise Hospital And Medical Center, LLC — 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