Physician
Sunshine Pediatrics LLC
Sunshine Pediatrics LLC was paid $2.69M by Medicaid between Jan 2018 and Dec 2024, across 37 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 36% of everything it billed.
33Billing provider infoSUNSHINE PEDIATRICS LLC
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
33aNPI1235315284assigned 01/20/2008
33bProvider typeDevelopmental - Behavioral Pediatrics Physician
28Total paid$2.69M
24GClaims49,685
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Developmental - Behavioral Pediatrics Physician providers in Rhode Island
Rank by total paid#1 of 6
Median peer was paid$85K
This provider vs. median32×
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 | 4,367 | $199K | |
| 2019 | 12,436 | $530K | |
| 2020 | 4,955 | $220K | |
| 2021 | 5,685 | $279K | |
| 2022 | 6,995 | $436K | |
| 2023 | 8,772 | $607K | |
| 2024incomplete | 6,475 | $418K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 36% | 14,268 | 12,899 | $975K |
| 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 | 29% | 8,120 | 7,754 | $773K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.8% | 1,669 | 1,653 | $157K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.6% | 1,321 | 1,307 | $123K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.0% | 2,375 | 2,243 | $107K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.4% | 5,358 | 5,235 | $92K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.4% | 1,049 | 985 | $91K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.1% | 820 | 814 | $82K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 2.4% | 1,683 | 1,642 | $65K |
| 90461 | 2.3% | 1,875 | 1,841 | $61K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 1.8% | 3,685 | 3,409 | $49K |
| 99050 | 1.6% | 987 | 955 | $42K |
25 more codes
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 1,027 | $11K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 55 | $8K |
| 99442 | <1% | 265 | $8K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 437 | $7K |
| 94010 | <1% | 273 | $7K | |
| 96127 | <1% | 1,768 | $6K | |
| 99177 | <1% | 1,084 | $5K | |
| 69210 | <1% | 127 | $4K | |
| 99051 | <1% | 132 | $3K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 251 | $2K |
| 94664 | <1% | 119 | $1K | |
| 0071A | <1% | 38 | $1K | |
| 81025 | <1% | 240 | $1K | |
| 0001A | <1% | 26 | $1K | |
| 81002 | <1% | 438 | $1K | |
| 0002A | <1% | 16 | $666.08 | |
| 0072A | <1% | 12 | $499.56 | |
| 96136 | <1% | 14 | $320.88 | |
| 96161 | <1% | 26 | $96.06 | |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 12 | $33.48 |
| 90686 | <1% | 37 | $18.00 | |
| 90670 | <1% | 12 | $6.00 | |
| 91307 | <1% | 24 | $5.52 | |
| 1036F | <1% | 28 | $5.29 | |
| 90656 | <1% | 14 | $0.13 |
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 officialWEHBE, PAUL (OWNER)