Physician
Sunshine Pediatrics, PA
Sunshine Pediatrics, PA was paid $11.49M by Medicaid between Jan 2018 and Dec 2024, across 67 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 32% of everything it billed.
33Billing provider infoSUNSHINE PEDIATRICS, PA
SMITHFIELD, NC 27577
SMITHFIELD, NC 27577
33aNPI1093096141assigned 09/02/2011
33bProvider typePediatrics Physician
28Total paid$11.49M
24GClaims455,751
24DCodes billed67
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#25 of 433
Median peer was paid$942K
This provider vs. median12×
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 | 44,769 | $1.69M | |
| 2019 | 49,069 | $2.25M | |
| 2020 | 39,975 | $1.97M | |
| 2021 | 71,844 | $2.05M | |
| 2022 | 96,598 | $1.39M | |
| 2023 | 85,480 | $1.22M | |
| 2024incomplete | 68,016 | $914K |
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 | 32% | 33,896 | 26,218 | $3.66M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 15,388 | 12,711 | $1.18M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 10% | 18,649 | 14,659 | $1.16M |
| 99199 | Unlisted special service, procedure or report | 9.8% | 193,293 | 114,173 | $1.13M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.2% | 6,806 | 5,879 | $600K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.3% | 5,417 | 4,559 | $489K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 4.2% | 2,922 | 2,410 | $482K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.1% | 5,829 | 4,827 | $468K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.8% | 5,673 | 4,940 | $435K |
| 99205 | Prolong outpt/office vis | 2.5% | 1,448 | 1,200 | $283K |
| 99051 | 1.7% | 9,883 | 8,153 | $197K | |
| 92552 | 1.7% | 14,834 | 12,565 | $197K |
55 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.7% | 14,977 | $192K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.6% | 3,579 | $180K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.5% | 22,594 | $176K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 9,340 | $95K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 3,222 | $76K |
| 99070 | <1% | 8,946 | $57K | |
| 90651 | <1% | 2,548 | $51K | |
| 96127 | <1% | 10,997 | $45K | |
| 90647 | <1% | 3,623 | $41K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 3,080 | $35K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,808 | $34K |
| D1206 | Topical application of fluoride varnish | <1% | 3,225 | $34K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,266 | $32K |
| 86769 | <1% | 1,106 | $29K | |
| 90696 | <1% | 953 | $24K | |
| 90734 | <1% | 2,251 | $22K | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 703 | $10K |
| 90621 | <1% | 986 | $7K | |
| 99173 | <1% | 14,863 | $7K | |
| 90474 | <1% | 602 | $7K | |
| 99443 | <1% | 51 | $6K | |
| 90686 | <1% | 5,519 | $6K | |
| 87807 | <1% | 500 | $6K | |
| 90461 | <1% | 1,521 | $5K | |
| 81002 | <1% | 1,952 | $5K | |
| 0001A | <1% | 81 | $4K | |
| 90715 | <1% | 1,027 | $4K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 33 | $3K |
| 99383 | <1% | 34 | $2K | |
| 99442 | <1% | 26 | $2K | |
| 99441 | <1% | 26 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 109 | $2K |
| 90670 | <1% | 5,085 | $1K | |
| 69210 | <1% | 35 | $797.17 | |
| 90633 | <1% | 2,606 | $506.08 | |
| 90723 | <1% | 3,556 | $366.34 | |
| 90672 | <1% | 118 | $307.32 | |
| 90680 | <1% | 3,387 | $285.75 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 90 | $211.66 |
| 90710 | <1% | 2,438 | $150.00 | |
| 94664 | <1% | 16 | $100.17 | |
| 90700 | <1% | 804 | $35.77 | |
| 3008F | 0% | 62 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 104 | $0.00 |
| 90697 | 0% | 288 | $0.00 | |
| 90656 | 0% | 121 | $0.00 | |
| 90620 | 0% | 12 | $0.00 | |
| 99000 | 0% | 19 | $0.00 | |
| 3074F | 0% | 40 | $0.00 | |
| 1160F | 0% | 142 | $0.00 | |
| 90685 | 0% | 981 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 100 | $0.00 |
| 91300 | 0% | 73 | $0.00 | |
| 3078F | 0% | 62 | $0.00 | |
| G9920 | Screening performed and negative | 0% | 26 | $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 officialFOX, KIMBERLY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Nitelite Pediatric Urgent Care | Smithfield, NC | $4.31M |
| Fox-Stepps Therapy Services | Pine Bluff, AR | $14K |
| Moonlight Pediatric Urgent Care PA | Wake Forest, NC | $8K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.