Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NY › PEEKSKILL › SUN RIVER HEALTH INC.

SUN RIVER HEALTH INC.

NPI: 1619969458 · PEEKSKILL, NY 10566 · Case Management Agency · NPI assigned 08/18/2005

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official LIPTON, ADAM controls 12+ related entities in our dataset. Read more

$546.52M
Total Medicaid Paid
4,950,940
Total Claims
3,704,323
Beneficiaries
243
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialLIPTON, ADAM (VP INFO/PRACTICE MGMT SYSTEMS)
Parent OrganizationSUN RIVER HEALTH INC.
NPI Enumeration Date08/18/2005

Related Entities

Other providers sharing the same authorized official: LIPTON, ADAM

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 622,115 $46.96M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
G9005 Coordinated care fee, risk adjusted maintenance 523,334 522,952 $161.75M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,331,305 862,238 $140.89M
90832 Psychotherapy, 30 minutes with patient 377,239 207,260 $69.91M
T2022 Case management, per month 63,981 63,944 $35.98M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 333,142 209,194 $32.42M
T1016 Case management, each 15 minutes 71,087 71,000 $20.37M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 204,283 136,039 $16.81M
90834 Psychotherapy, 45 minutes with patient 37,698 26,422 $7.86M
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 72,482 41,182 $4.99M
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 65,861 36,842 $4.73M
90791 Psychiatric diagnostic evaluation 25,039 22,319 $4.71M
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 58,033 34,349 $3.96M
90853 Group psychotherapy (other than of a multiple-family group) 33,588 10,463 $3.32M
D0120 Periodic oral evaluation - established patient 88,405 29,991 $2.97M
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 35,214 20,748 $2.39M
90792 Psychiatric diagnostic evaluation with medical services 11,142 10,190 $2.00M
S9083 Global fee urgent care centers 14,966 8,943 $1.88M
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 20,150 12,698 $1.63M
D0140 Limited oral evaluation - problem focused 26,929 12,508 $1.61M
99215 Prolong outpt/office vis 12,527 9,198 $1.61M
D0150 Comprehensive oral evaluation - new or established patient 48,564 11,943 $1.53M
D1110 Prophylaxis - adult 25,507 19,071 $1.39M
99401 122,082 112,827 $1.22M
59425 12,015 5,082 $1.20M
90460 Immunization administration through 18 years of age via any route, first or only component 101,594 100,881 $1.18M
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12,860 8,695 $1.10M
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 11,132 7,532 $1.10M
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 23,503 19,067 $1.02M
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face 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 fqhc visit 29,284 13,015 $953K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 10,770 6,630 $932K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 5,647 4,112 $723K
99385 7,092 5,019 $649K
D0274 Bitewings - four radiographic images 20,067 12,126 $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) 2,390 2,390 $439K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 51,613 50,741 $406K
99386 4,119 2,914 $393K
D1120 Prophylaxis - child 9,340 6,892 $390K
D2391 Resin-based composite - one surface, posterior, primary or permanent 4,208 2,436 $340K
G9001 Coordinated care fee, initial rate 4,411 4,411 $335K
D0190 2,785 1,354 $329K
99205 Prolong outpt/office vis 2,145 1,756 $321K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 5,639 3,517 $317K
96127 110,074 103,070 $295K
92552 58,023 56,015 $290K
99381 3,392 1,947 $275K
90837 Psychotherapy, 53 minutes with patient 1,261 1,218 $275K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 4,472 2,194 $274K
92340 Fitting of spectacles, except for aphakia; monofocal 2,613 1,905 $269K
99499 3,676 1,775 $249K
D2392 Resin-based composite - two surfaces, posterior, primary or permanent 2,674 1,555 $216K
90686 58,937 58,807 $214K
D0220 Intraoral - periapical first radiographic image 19,743 18,624 $207K
D0210 Intraoral - complete series of radiographic images 4,235 2,826 $203K
11721 4,004 2,677 $196K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient 2,415 1,230 $192K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 5,156 2,983 $190K
D5899 1,551 769 $189K
97162 1,739 1,238 $186K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 5,346 5,055 $170K
92002 2,377 1,094 $167K
99201 2,040 1,141 $167K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 6,105 5,091 $154K
90472 Immunization administration, each additional vaccine (list separately) 12,006 11,671 $128K
97164 1,429 1,066 $127K
99493 1,372 1,183 $124K
D0330 Panoramic radiographic image 2,623 991 $122K
0012A 4,414 4,408 $117K
36415 Collection of venous blood by venipuncture 46,776 42,502 $108K
0011A 4,596 4,595 $104K
D0230 Intraoral - periapical each additional radiographic image 14,449 11,752 $104K
99383 1,681 743 $104K
97802 4,414 4,115 $99K
90670 15,676 15,636 $94K
99173 58,589 58,470 $89K
90461 28,561 28,427 $85K
81025 21,368 20,443 $78K
D1351 Sealant - per tooth 1,208 329 $78K
92015 Determination of refractive state 1,509 950 $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 4,019 1,905 $72K
99382 1,106 466 $71K
90677 3,568 3,567 $70K
90651 5,031 5,011 $69K
D7140 Extraction, erupted tooth or exposed root 980 408 $68K
97803 2,824 2,465 $67K
0064A 1,841 1,836 $62K
99406 3,861 3,307 $59K
0001A 1,746 1,741 $57K
D1206 Topical application of fluoride varnish 2,857 2,841 $51K
11056 812 798 $51K
0002A 1,495 1,493 $50K
97161 480 298 $47K
86703 5,583 5,550 $43K
99397 522 310 $39K
D1208 Topical application of fluoride, excluding varnish 3,728 3,725 $38K
59430 282 155 $38K
11719 1,463 1,327 $35K
90715 2,333 2,314 $33K
99384 469 262 $31K
90734 3,528 3,515 $31K
81003 16,725 12,939 $31K
99407 1,208 785 $31K
90732 373 372 $30K
0071A 839 838 $30K
90750 223 223 $29K
83036 Hemoglobin; glycosylated (A1C) 5,340 5,260 $29K
0072A 786 783 $29K
97014 3,196 1,942 $27K
96110 Developmental screening, with scoring and documentation, per standardized instrument 4,863 4,850 $27K
81005 14,415 11,908 $26K
D0145 Oral evaluation for a patient under three years of age 285 179 $20K
D4341 278 112 $20K
96160 35,772 33,990 $19K
90697 3,892 3,886 $18K
90746 505 496 $18K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 1,009 862 $18K
82962 11,036 9,938 $18K
D0272 Bitewings - two radiographic images 1,510 1,499 $18K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 2,299 2,268 $17K
99496 236 234 $16K
90707 1,064 1,061 $16K
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 353 341 $15K
3074F 53,245 49,427 $15K
3078F 48,978 45,759 $14K
90863 331 312 $13K
97530 Therapeutic activities, direct patient contact, each 15 minutes 304 149 $13K
59025 Fetal non-stress test 238 118 $12K
36416 13,664 12,721 $11K
0031A 401 401 $10K
V2020 Frames, purchases 778 757 $10K
90656 4,001 3,999 $9K
D1999 143 107 $9K
91322 91 91 $9K
90739 70 70 $8K
V2784 Lens, polycarbonate or equal, any index, per lens 212 188 $8K
0134A 240 240 $8K
87081 2,299 2,277 $7K
D1330 2,226 2,198 $6K
90716 1,046 1,042 $6K
D2140 93 43 $6K
90636 81 81 $6K
82948 334 222 $5K
99492 57 43 $5K
93000 561 554 $5K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 119 55 $5K
0054A 141 141 $5K
D4910 32 28 $4K
H2011 Crisis intervention service, per 15 minutes 35 33 $4K
D2150 Silver amalgam - two surfaces, primary or permanent 47 24 $4K
D2330 52 26 $4K
85018 2,381 2,374 $4K
90480 105 105 $3K
0052A 94 94 $3K
83655 492 490 $3K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 288 189 $3K
S5102 Day care services, adult; per diem 37 15 $3K
3079F 10,315 9,750 $3K
0004A 102 101 $3K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 52 26 $3K
92341 109 106 $3K
86580 551 476 $3K
99231 Subsequent hospital care, per day, straightforward or low complexity 38 24 $2K
87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) 592 582 $2K
92250 72 70 $2K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 15 14 $2K
D9995 39 33 $2K
0124A 53 53 $2K
99222 Initial hospital care, per day, moderate complexity 16 13 $2K
0051A 54 54 $2K
90473 390 390 $2K
90474 421 421 $1K
90632 24 24 $1K
90723 7,675 7,649 $1K
80061 Lipid panel 312 305 $1K
D0270 100 95 $1K
96380 140 140 $1K
99000 8,881 8,326 $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 123 121 $1K
99460 14 14 $1K
97010 4,365 2,652 $938.63
11057 12 12 $934.39
90620 780 779 $843.72
4124F 52 50 $780.00
90633 7,602 7,565 $702.31
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg 66 58 $700.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 175 60 $630.82
3075F 4,139 4,006 $617.35
3077F 4,867 4,504 $561.99
90647 7,693 7,662 $552.96
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 55 54 $537.34
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml 14 14 $536.47
G0447 Face-to-face behavioral counseling for obesity, 15 minutes 785 686 $536.34
90681 5,209 5,189 $473.00
90688 257 257 $416.00
20552 21 13 $380.16
1000F 68,829 67,820 $305.39
99238 Hospital discharge day management, 30 minutes or less 12 12 $278.59
90680 49 49 $231.00
H0033 Oral medication administration, direct observation 823 802 $205.98
90380 17 17 $148.00
90710 846 842 $146.30
81000 73 45 $121.89
J1050 Injection, medroxyprogesterone acetate, 1 mg 112 107 $53.22
3455F 52,763 52,599 $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 1,657 1,654 $40.92
90744 63 63 $28.97
90713 14 14 $28.97
J1100 Injection, dexamethasone sodium phosphate, 1 mg 12 12 $17.28
3080F 2,366 2,203 $14.50
91307 1,482 1,380 $13.68
91306 1,481 1,478 $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 17 12 $3.24
91305 412 407 $1.25
91313 158 158 $1.05
91301 7,404 7,134 $0.45
91300 2,831 2,536 $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] 2,001 1,854 $0.35
91312 44 43 $0.26
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg 90 89 $0.03
90611 15 15 $0.03
3044F 4,056 4,038 $0.02
91303 340 339 $0.00
S9451 Exercise classes, non-physician provider, per session 92 92 $0.00
G8420 Bmi is documented within normal parameters and no follow-up plan is required 154 154 $0.00
90696 162 162 $0.00
99429 312 242 $0.00
90698 351 351 $0.00
0001F 38 35 $0.00
H0049 Alcohol and/or drug screening 51 51 $0.00
90381 65 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 42 33 $0.00
87430 17 15 $0.00
99001 611 572 $0.00
90700 284 283 $0.00
90685 1,067 1,065 $0.00
99080 941 353 $0.00
2028F 338 329 $0.00
G0444 Annual depression screening, 5 to 15 minutes 204 198 $0.00
90672 219 219 $0.00
90648 158 157 $0.00
S9470 Nutritional counseling, dietitian visit 21 19 $0.00
A0090 Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest 12 12 $0.00
T1013 Sign language or oral interpretive services, per 15 minutes 13 13 $0.00
99223 Prolong inpt eval add15 m 14 14 $0.00