Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

MALCOLM, SHELDON

NPI: 1104054261 · PROVIDENCE, RI 02905 · Family Medicine Physician · NPI assigned 06/29/2009

$416K
Total Medicaid Paid
9,745
Total Claims
8,808
Beneficiaries
26
Codes Billed
2018-01
First Month
2024-12
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 2,206 $92K
2019 135 $8K
2020 1,677 $71K
2021 1,299 $58K
2022 1,332 $55K
2023 1,878 $77K
2024 1,218 $54K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 2,816 2,558 $180K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,676 3,283 $161K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 595 521 $18K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 171 164 $11K
G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit 60 54 $11K
T1015 Clinic visit/encounter, all-inclusive 58 52 $9K
77067 Screening mammography, bilateral, including computer-aided detection 43 43 $5K
83036 Hemoglobin; glycosylated (A1C) 488 476 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 325 304 $3K
93000 165 145 $3K
77063 Screening digital breast tomosynthesis, bilateral 42 42 $2K
85025 Blood count; complete (CBC), automated, and automated differential WBC count 144 104 $1K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 65 60 $1K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 15 13 $1K
82962 499 487 $838.86
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 12 12 $783.79
99051 31 30 $719.88
87804 Infectious agent antigen detection by immunoassay; Influenza, each type 55 27 $563.20
80050 General health panel 12 12 $556.56
80053 Comprehensive metabolic panel 30 26 $477.94
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 15 15 $420.71
81002 183 165 $397.34
0012A 12 12 $387.12
99442 13 13 $376.61
96127 87 85 $252.20
36415 Collection of venous blood by venipuncture 133 105 $162.04