Agency
Sun River Health INC.
Sun River Health INC. was paid $546.52M by Medicaid between Jan 2018 and Dec 2024, across 243 billing codes. Its largest line is G9005, Coordinated care fee, risk adjusted maintenance — 30% of everything it billed.
33Billing provider infoSUN RIVER HEALTH INC.
PEEKSKILL, NY 10566
PEEKSKILL, NY 10566
33aNPI1619969458assigned 08/18/2005
33bProvider typeCase Management Agency
28Total paid$546.52M
24GClaims4,950,940
24DCodes billed243
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Case Management Agency providers in New York
Rank by total paid#2 of 180
Median peer was paid$1.76M
This provider vs. median310×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official LIPTON, ADAM controls 12+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 345,825 | $20.63M | |
| 2019 | 826,218 | $77.07M | |
| 2020 | 1,003,918 | $143.58M | |
| 2021 | 961,066 | $134.56M | |
| 2022 | 563,692 | $83.80M | |
| 2023 | 628,106 | $39.91M | |
| 2024incomplete | 622,115 | $46.96M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G9005 | Coordinated care fee, risk adjusted maintenance | 30% | 523,334 | 522,952 | $161.75M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 1,331,305 | 862,238 | $140.89M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 13% | 377,239 | 207,260 | $69.91M |
| T2022 | Case management, per month | 6.6% | 63,981 | 63,944 | $35.98M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 5.9% | 333,142 | 209,194 | $32.42M |
| T1016 | Case management, each 15 minutes | 3.7% | 71,087 | 71,000 | $20.37M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.1% | 204,283 | 136,039 | $16.81M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.4% | 37,698 | 26,422 | $7.86M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 72,482 | 41,182 | $4.99M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 65,861 | 36,842 | $4.73M |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 25,039 | 22,319 | $4.71M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 58,033 | 34,349 | $3.96M |
231 more codes
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 33,588 | $3.32M |
| D0120 | Dental checkup, returning patient | <1% | 88,405 | $2.97M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 35,214 | $2.39M |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 11,142 | $2.00M |
| S9083 | Global fee urgent care centers | <1% | 14,966 | $1.88M |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 20,150 | $1.63M |
| D0140 | Limited oral evaluation - problem focused | <1% | 26,929 | $1.61M |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 12,527 | $1.61M |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 48,564 | $1.53M |
| D1110 | Prophylaxis - adult | <1% | 25,507 | $1.39M |
| 99401 | <1% | 122,082 | $1.22M | |
| 59425 | <1% | 12,015 | $1.20M | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 101,594 | $1.18M |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12,860 | $1.10M |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 11,132 | $1.10M |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 23,503 | $1.02M |
| G0467 | Community health center visit, returning patient | <1% | 29,284 | $953K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 10,770 | $932K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 5,647 | $723K |
| 99385 | <1% | 7,092 | $649K | |
| D0274 | Bitewings - four radiographic images | <1% | 20,067 | $566K |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | <1% | 2,390 | $439K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 51,613 | $406K |
| 99386 | <1% | 4,119 | $393K | |
| D1120 | Dental cleaning, child | <1% | 9,340 | $390K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | <1% | 4,208 | $340K |
| G9001 | Coordinated care fee, initial rate | <1% | 4,411 | $335K |
| D0190 | <1% | 2,785 | $329K | |
| 99205 | Prolong outpt/office vis | <1% | 2,145 | $321K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 5,639 | $317K |
| 96127 | <1% | 110,074 | $295K | |
| 92552 | <1% | 58,023 | $290K | |
| 99381 | <1% | 3,392 | $275K | |
| 90837 | Psychotherapy session, about an hour | <1% | 1,261 | $275K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 4,472 | $274K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | <1% | 2,613 | $269K |
| 99499 | <1% | 3,676 | $249K | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | <1% | 2,674 | $216K |
| 90686 | <1% | 58,937 | $214K | |
| D0220 | Intraoral - periapical first radiographic image | <1% | 19,743 | $207K |
| D0210 | Intraoral - complete series of radiographic images | <1% | 4,235 | $203K |
| 11721 | <1% | 4,004 | $196K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 2,415 | $192K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 5,156 | $190K |
| D5899 | <1% | 1,551 | $189K | |
| 97162 | <1% | 1,739 | $186K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 5,346 | $170K |
| 92002 | <1% | 2,377 | $167K | |
| 99201 | <1% | 2,040 | $167K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 6,105 | $154K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 12,006 | $128K |
| 97164 | <1% | 1,429 | $127K | |
| 99493 | <1% | 1,372 | $124K | |
| D0330 | Panoramic radiographic image | <1% | 2,623 | $122K |
| 0012A | <1% | 4,414 | $117K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 46,776 | $108K |
| 0011A | <1% | 4,596 | $104K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 14,449 | $104K |
| 99383 | <1% | 1,681 | $104K | |
| 97802 | <1% | 4,414 | $99K | |
| 90670 | <1% | 15,676 | $94K | |
| 99173 | <1% | 58,589 | $89K | |
| 90461 | <1% | 28,561 | $85K | |
| 81025 | <1% | 21,368 | $78K | |
| D1351 | Sealant - per tooth | <1% | 1,208 | $78K |
| 92015 | Determination of refractive state | <1% | 1,509 | $75K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | <1% | 4,019 | $72K |
| 99382 | <1% | 1,106 | $71K | |
| 90677 | <1% | 3,568 | $70K | |
| 90651 | <1% | 5,031 | $69K | |
| D7140 | Extraction, erupted tooth or exposed root | <1% | 980 | $68K |
| 97803 | <1% | 2,824 | $67K | |
| 0064A | <1% | 1,841 | $62K | |
| 99406 | <1% | 3,861 | $59K | |
| 0001A | <1% | 1,746 | $57K | |
| D1206 | Topical application of fluoride varnish | <1% | 2,857 | $51K |
| 11056 | <1% | 812 | $51K | |
| 0002A | <1% | 1,495 | $50K | |
| 97161 | <1% | 480 | $47K | |
| 86703 | <1% | 5,583 | $43K | |
| 99397 | <1% | 522 | $39K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 3,728 | $38K |
| 59430 | <1% | 282 | $38K | |
| 11719 | <1% | 1,463 | $35K | |
| 90715 | <1% | 2,333 | $33K | |
| 99384 | <1% | 469 | $31K | |
| 90734 | <1% | 3,528 | $31K | |
| 81003 | <1% | 16,725 | $31K | |
| 99407 | <1% | 1,208 | $31K | |
| 90732 | <1% | 373 | $30K | |
| 0071A | <1% | 839 | $30K | |
| 90750 | <1% | 223 | $29K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 5,340 | $29K |
| 0072A | <1% | 786 | $29K | |
| 97014 | <1% | 3,196 | $27K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 4,863 | $27K |
| 81005 | <1% | 14,415 | $26K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 285 | $20K |
| D4341 | <1% | 278 | $20K | |
| 96160 | <1% | 35,772 | $19K | |
| 90697 | <1% | 3,892 | $18K | |
| 90746 | <1% | 505 | $18K | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | <1% | 1,009 | $18K |
| 82962 | <1% | 11,036 | $18K | |
| D0272 | Bitewings - two radiographic images | <1% | 1,510 | $18K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 2,299 | $17K |
| 99496 | <1% | 236 | $16K | |
| 90707 | <1% | 1,064 | $16K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 353 | $15K |
| 3074F | <1% | 53,245 | $15K | |
| 3078F | <1% | 48,978 | $14K | |
| 90863 | <1% | 331 | $13K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 304 | $13K |
| 59025 | Fetal non-stress test | <1% | 238 | $12K |
| 36416 | <1% | 13,664 | $11K | |
| 0031A | <1% | 401 | $10K | |
| V2020 | Frames, purchases | <1% | 778 | $10K |
| 90656 | <1% | 4,001 | $9K | |
| D1999 | <1% | 143 | $9K | |
| 91322 | <1% | 91 | $9K | |
| 90739 | <1% | 70 | $8K | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | <1% | 212 | $8K |
| 0134A | <1% | 240 | $8K | |
| 87081 | <1% | 2,299 | $7K | |
| D1330 | <1% | 2,226 | $6K | |
| 90716 | <1% | 1,046 | $6K | |
| D2140 | <1% | 93 | $6K | |
| 90636 | <1% | 81 | $6K | |
| 82948 | <1% | 334 | $5K | |
| 99492 | <1% | 57 | $5K | |
| 93000 | <1% | 561 | $5K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 119 | $5K |
| 0054A | <1% | 141 | $5K | |
| D4910 | <1% | 32 | $4K | |
| H2011 | Crisis intervention service, per 15 minutes | <1% | 35 | $4K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 47 | $4K |
| D2330 | <1% | 52 | $4K | |
| 85018 | <1% | 2,381 | $4K | |
| 90480 | <1% | 105 | $3K | |
| 0052A | <1% | 94 | $3K | |
| 83655 | <1% | 492 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 288 | $3K |
| S5102 | Adult day care, billed per day | <1% | 37 | $3K |
| 3079F | <1% | 10,315 | $3K | |
| 0004A | <1% | 102 | $3K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 52 | $3K |
| 92341 | <1% | 109 | $3K | |
| 86580 | <1% | 551 | $3K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 38 | $2K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 592 | $2K |
| 92250 | <1% | 72 | $2K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 15 | $2K |
| D9995 | <1% | 39 | $2K | |
| 0124A | <1% | 53 | $2K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 16 | $2K |
| 0051A | <1% | 54 | $2K | |
| 90473 | <1% | 390 | $2K | |
| 90474 | <1% | 421 | $1K | |
| 90632 | <1% | 24 | $1K | |
| 90723 | <1% | 7,675 | $1K | |
| 80061 | Lipid panel | <1% | 312 | $1K |
| D0270 | <1% | 100 | $1K | |
| 96380 | <1% | 140 | $1K | |
| 99000 | <1% | 8,881 | $1K | |
| G0468 | Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv | <1% | 123 | $1K |
| 99460 | <1% | 14 | $1K | |
| 97010 | <1% | 4,365 | $938.63 | |
| 11057 | <1% | 12 | $934.39 | |
| 90620 | <1% | 780 | $843.72 | |
| 4124F | <1% | 52 | $780.00 | |
| 90633 | <1% | 7,602 | $702.31 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 66 | $700.46 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 175 | $630.82 |
| 3075F | <1% | 4,139 | $617.35 | |
| 3077F | <1% | 4,867 | $561.99 | |
| 90647 | <1% | 7,693 | $552.96 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 55 | $537.34 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | <1% | 14 | $536.47 |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 785 | $536.34 |
| 90681 | <1% | 5,209 | $473.00 | |
| 90688 | <1% | 257 | $416.00 | |
| 20552 | <1% | 21 | $380.16 | |
| 1000F | <1% | 68,829 | $305.39 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 12 | $278.59 |
| 90680 | <1% | 49 | $231.00 | |
| H0033 | Oral medication administration, direct observation | <1% | 823 | $205.98 |
| 90380 | <1% | 17 | $148.00 | |
| 90710 | <1% | 846 | $146.30 | |
| 81000 | <1% | 73 | $121.89 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 112 | $53.22 |
| 3455F | <1% | 52,763 | $46.18 | |
| G0476 | Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test | <1% | 1,657 | $40.92 |
| 90744 | <1% | 63 | $28.97 | |
| 90713 | <1% | 14 | $28.97 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 12 | $17.28 |
| 3080F | <1% | 2,366 | $14.50 | |
| 91307 | <1% | 1,482 | $13.68 | |
| 91306 | <1% | 1,481 | $4.01 | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | <1% | 17 | $3.24 |
| 91305 | <1% | 412 | $1.25 | |
| 91313 | <1% | 158 | $1.05 | |
| 91301 | <1% | 7,404 | $0.45 | |
| 91300 | <1% | 2,831 | $0.42 | |
| G9016 | Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only] | <1% | 2,001 | $0.35 |
| 91312 | <1% | 44 | $0.26 | |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | <1% | 90 | $0.03 |
| 90611 | <1% | 15 | $0.03 | |
| 3044F | <1% | 4,056 | $0.02 | |
| 91303 | 0% | 340 | $0.00 | |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 92 | $0.00 |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 154 | $0.00 |
| 90696 | 0% | 162 | $0.00 | |
| 99429 | 0% | 312 | $0.00 | |
| 90698 | 0% | 351 | $0.00 | |
| 0001F | 0% | 38 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 51 | $0.00 |
| 90381 | 0% | 65 | $0.00 | |
| 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 0% | 42 | $0.00 |
| 87430 | 0% | 17 | $0.00 | |
| 99001 | 0% | 611 | $0.00 | |
| 90700 | 0% | 284 | $0.00 | |
| 90685 | 0% | 1,067 | $0.00 | |
| 99080 | 0% | 941 | $0.00 | |
| 2028F | 0% | 338 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 204 | $0.00 |
| 90672 | 0% | 219 | $0.00 | |
| 90648 | 0% | 158 | $0.00 | |
| S9470 | Nutritional counseling, dietitian visit | 0% | 21 | $0.00 |
| A0090 | Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest | 0% | 12 | $0.00 |
| T1013 | Sign language or oral interpretive services, per 15 minutes | 0% | 13 | $0.00 |
| 99223 | Prolong inpt eval add15 m | 0% | 14 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLIPTON, ADAM (VP INFO/PRACTICE MGMT SYSTEMS)
Parent organizationSUN RIVER HEALTH INC.
| Provider | Location | Paid |
|---|---|---|
| Sun River Health INC | Bronx, NY | $18.49M |
| Sun River Health INC | Shirley, NY | $695K |
| Hudson River Primary Medical Care P.C. | Haverstraw, NY | $26K |
| Sun River Health INC | Beacon, NY | $11K |
| Sun River Health INC | Patchogue, NY | $6K |
| Sun River Health INC | Coram, NY | $5K |
| Sun River Health INC | Riverhead, NY | $1K |
| Sun River Health INC | Wyandanch, NY | $1K |
| Sun River Health INC | Poughkeepsie, NY | $1K |
| Sun River Health INC | Bronx, NY | $979.04 |
| Sun River Health INC | Staten Island, NY | $386.23 |
| Sun River Health INC | Brentwood, NY | $58.24 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.