Malcolm, Sheldon

Malcolm, Sheldon was paid $416K by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 43% of everything it billed.

33Billing provider infoMALCOLM, SHELDON
PROVIDENCE, RI 02905

33aNPI1104054261assigned 06/29/2009

33bProvider typeFamily Medicine Physician

28Total paid$416K

24GClaims9,745

24DCodes billed26

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Family Medicine Physician providers in Rhode Island

Rank by total paid#23 of 220

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

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	43%	2,816	2,558	$180K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	39%	3,676	3,283	$161K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	4.2%	595	521	$18K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	2.8%	171	164	$11K
G0467	Community health center visit, returning patientFederally 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	2.6%	60	54	$11K
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	2.2%	58	52	$9K
77067	Screening mammography, bilateral, including computer-aided detection	1.3%	43	43	$5K
83036	Hemoglobin; glycosylated (A1C)	<1%	488	476	$3K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	325	304	$3K
93000		<1%	165	145	$3K
77063	Screening digital breast tomosynthesis, bilateral	<1%	42	42	$2K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	144	104	$1K

14 more codes

G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	<1%	65	$1K
99203	Doctor's office visit, new patient (routine)	<1%	15	$1K
82962		<1%	499	$838.86
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	12	$783.79
99051		<1%	31	$719.88
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	55	$563.20
80050	General health panel	<1%	12	$556.56
80053	Comprehensive metabolic panel	<1%	30	$477.94
87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	15	$420.71
81002		<1%	183	$397.34
0012A		<1%	12	$387.12
99442		<1%	13	$376.61
96127		<1%	87	$252.20
36415	Collection of venous blood by venipuncture	<1%	133	$162.04

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.