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

Why is the Medicaid comparison limited to Delaware 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. Delaware (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 Behavioral Delaware, LLC (NPI 1891213179)

Sun Behavioral Delaware, LLC is a psychiatric hospital provider located in Georgetown, Delaware. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Sun Behavioral Delaware, LLC
Address	21655 Biden Ave
City	Georgetown
State	DE
ZIP	19947
Taxonomy	Psychiatric Hospital
NPI Enumerated	September 6, 2017

Payer Source	Total Paid
Medicaid	$366.1K
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	9,150	$20	$137.3K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1,240	$50	$60.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	790	$50	$38.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	750	$50	$35.2K
H0035	Mental health partial hospitalization, treatment, less than 24 hours	120	$260	$31.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,260	$30	$31.5K
S9480	Intensive outpatient psychiatric services, per diem	110	$190	$20.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	440	$20	$7.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	60	$50	$3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Sun Behavioral Delaware, LLC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	28	50	1,030	$60	$292.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	48	80	940	$30	$277.8K
H0035	Mental health partial hospitalization, treatment, less than 24 hours	5	10	1,100	$160	$250.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	12	10	900	$50	$192.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	57	60	240	$80	$148.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	11	30	690	$50	$128.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	25	70	260	$60	$96.7K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	4	50	660	$20	$53.9K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	9	30	420	$60	$52.9K
S9480	Intensive outpatient psychiatric services, per diem	1	10	110	$190	$20.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Kalkstein	PA	Psychiatry Physician	$235K	$0
Edward Hendricks	DE	Family Nurse Practitioner	$188.6K	$0
Ana Guerrero	DE	Psychiatric/Mental Health Nurse Practitioner	$60.9K	$50
Marcia Reynolds	DE	Family Nurse Practitioner	$49.9K	$0
Delphine Fombi-ndifor	DE	Psychiatric/Mental Health Nurse Practitioner	$45.7K	$0
Syed Sikandar Shah	DE	Psychiatry Physician	$18.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Packd LLC	DE	In Home Supportive Care Agency	$0	$31M
Sea Care LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$10.1M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$7.3M
Cheer, Inc.	DE	Home Health Agency	$0	$7.3M
Rainbow Pediatrics	DE	Pediatrics Physician	$0	$5.6M
Wilmington Orthodontic Center	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.8M
Horizon House Delaware Inc.	DE	Case Management Agency	$0	$3.3M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$3.1M
Fellowship Health Resources, Inc	DE	Community/Behavioral Health Agency	$0	$2.8M
Nutrihealth LLC	DE	Internal Medicine Physician	$0	$994.6K

Sun Behavioral Delaware, LLC — Billing Profile & Reimbursement Data

Sign up for Sun Behavioral Delaware, LLC — Billing Profile & Reimbursement Data policy alerts

Sun Behavioral Delaware, LLC — Billing Profile & Reimbursement Data

Sign up for Sun Behavioral Delaware, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References