Physician
Rise & Shine Pediatrics, PC
Rise & Shine Pediatrics, PC was paid $136K by Medicaid between Jan 2018 and Oct 2024, across 14 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 47% of everything it billed.
33Billing provider infoRISE & SHINE PEDIATRICS, PC
SOUTH PLAINFIELD, NJ 07080
SOUTH PLAINFIELD, NJ 07080
33aNPI1043650252assigned 07/02/2013
33bProvider typePediatrics Physician
28Total paid$136K
24GClaims4,511
24DCodes billed14
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Pediatrics Physician providers in New Jersey
Rank by total paid#287 of 549
Median peer was paid$154K
This provider vs. median0.9×
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.
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 | 409 | $14K | |
| 2019 | 569 | $18K | |
| 2020 | 781 | $14K | |
| 2021 | 559 | $20K | |
| 2022 | 1,154 | $40K | |
| 2023 | 794 | $17K | |
| 2024incomplete | 245 | $13K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 47% | 1,046 | 849 | $64K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 35% | 1,046 | 936 | $47K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 10% | 1,108 | 1,008 | $14K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.2% | 301 | 264 | $3K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.6% | 25 | 25 | $2K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.3% | 236 | 220 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 15 | 14 | $1K |
| 90686 | <1% | 168 | 159 | $846.38 | |
| 92587 | <1% | 75 | 69 | $497.44 | |
| 99173 | <1% | 171 | 162 | $371.60 | |
| 96127 | <1% | 165 | 119 | $352.04 | |
| 90656 | <1% | 12 | 12 | $247.19 |
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 officialKUMARI, KALPANA (MEDICAL DIRECTOR)