Sclama, Karen

Sclama, Karen was paid $29K by Medicaid between Mar 2018 and Oct 2024, across 4 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 73% of everything it billed.

33Billing provider infoSCLAMA, KAREN
LINCOLN, RI 02865

33aNPI1144297698assigned 03/03/2006

33bProvider typePhysician Assistant

28Total paid$29K

24GClaims592

24DCodes billed4

24AFirst – last monthMar 2018 – Oct 2024

Compared with peers

Next to other Physician Assistant providers in Rhode Island

Rank by total paid#84 of 215

Median peer was paid$17K

This provider vs. median1.7×

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	150	$7K
2020	117	$6K
2021	125	$6K
2022	94	$5K
2023	14	$771.15
2024incomplete	92	$4K

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	73%	443	413	$21K
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	26%	119	110	$8K
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%	14	12	$134.31
96127		<1%	16	12	$39.17

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.