Sun River Health Inc.
Clinic/Center Federally Qualified Health Center (FQHC)
Peekskill, New York
NPI: 1619969458
Risk Tier
Critical
Total Paid
$546.5M
$546,516,639
Total Claims
5.0M
Beneficiaries
3.7M
Avg Cost/Claim
$110.39
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (3)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $185.32 per claim for 90832 (Psychotherapy, 30 minutes), which is 4.5× the national median of $41.28.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $20.6M (2018) to $77.1M (2019) — a 274% swing with $56.4M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 41 procedure codes: 99213 at 2.8× median, 90832 at 4.5× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024