Clinic
Sunshine Pediatric Clinic
Sunshine Pediatric Clinic was paid $400K by Medicaid between Jan 2018 and May 2024, across 53 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoSUNSHINE PEDIATRIC CLINIC
HILO, HI 96720
HILO, HI 96720
33aNPI1558803668assigned 11/07/2016
33bProvider typePrimary Care Clinic/Center
28Total paid$400K
24GClaims48,363
24DCodes billed53
24AFirst – last monthJan 2018 – May 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Hawaii
Rank by total paid#3 of 37
Median peer was paid$33K
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 | 9,088 | $164K | |
| 2019 | 9,847 | $49K | |
| 2020 | 5,191 | $29K | |
| 2021 | 4,997 | $43K | |
| 2022 | 8,930 | $54K | |
| 2023 | 7,030 | $38K | |
| 2024incomplete | 3,280 | $23K |
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 | 34% | 9,747 | 7,945 | $137K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 17% | 2,646 | 2,018 | $68K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 13% | 1,847 | 1,263 | $52K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 8.5% | 2,370 | 1,872 | $34K |
| 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 | 7.0% | 1,080 | 978 | $28K |
| 99383 | 4.1% | 255 | 235 | $16K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.8% | 1,552 | 1,175 | $11K |
| 99382 | 2.3% | 119 | 111 | $9K | |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 2.2% | 302 | 249 | $9K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2.1% | 1,580 | 1,365 | $8K |
| 99381 | 1.3% | 92 | 79 | $5K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1.1% | 103 | 103 | $5K |
41 more codes
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.0% | 405 | $4K |
| 92552 | <1% | 1,637 | $3K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,572 | $3K |
| 96127 | <1% | 7,294 | $2K | |
| 90461 | <1% | 248 | $879.40 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 12 | $864.70 |
| 99384 | <1% | 16 | $828.51 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 82 | $813.35 |
| 90671 | <1% | 226 | $760.68 | |
| 86580 | <1% | 76 | $471.14 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 39 | $183.37 |
| 99173 | <1% | 1,770 | $139.07 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 32 | $103.07 |
| 90723 | <1% | 369 | $85.00 | |
| 90686 | <1% | 1,773 | $66.74 | |
| 96161 | <1% | 1,648 | $55.37 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 33 | $54.57 |
| 90698 | <1% | 218 | $48.00 | |
| 90680 | <1% | 472 | $8.00 | |
| 90744 | <1% | 91 | $4.00 | |
| 90670 | <1% | 1,094 | $4.00 | |
| 90633 | <1% | 723 | $4.00 | |
| 96160 | <1% | 48 | $3.11 | |
| 90651 | 0% | 161 | $0.00 | |
| 90688 | 0% | 693 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 962 | $0.00 |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 696 | $0.00 |
| 90716 | 0% | 166 | $0.00 | |
| G9459 | Currently a tobacco non-user | 0% | 241 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 101 | $0.00 |
| 90696 | 0% | 48 | $0.00 | |
| 90734 | 0% | 220 | $0.00 | |
| 90707 | 0% | 288 | $0.00 | |
| 90648 | 0% | 720 | $0.00 | |
| 90700 | 0% | 66 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 24 | $0.00 |
| S9999 | Sales tax | 0% | 53 | $0.00 |
| 90710 | 0% | 30 | $0.00 | |
| 90687 | 0% | 273 | $0.00 | |
| 90649 | 0% | 38 | $0.00 | |
| 90715 | 0% | 12 | $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 officialCRADDOCK, SHALLON (OWNER)