Cornell J Shelton MD PLLC

Cornell J Shelton MD PLLC was paid $106K by Medicaid between Feb 2018 and Nov 2024, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 85% of everything it billed.

33Billing provider infoCORNELL J SHELTON MD PLLC
FREDERICKSBURG, VA 22408

33aNPI1164935631assigned 11/07/2017

33bProvider typePhysical Medicine & Rehabilitation Physician

28Total paid$106K

24GClaims4,857

24DCodes billed7

24AFirst – last monthFeb 2018 – Nov 2024

Compared with peers

Next to other Physical Medicine & Rehabilitation Physician providers in Virginia

Rank by total paid#7 of 39

Median peer was paid$13K

This provider vs. median7.9×

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	849	$8K
2019	972	$18K
2020	592	$12K
2021	596	$11K
2022	650	$19K
2023	707	$22K
2024incomplete	491	$15K

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	85%	4,000	1,945	$90K
11042	Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm	4.4%	273	146	$5K
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	3.6%	114	89	$4K
99309	Subsequent nursing facility care, per day, low to moderate complexity	3.4%	287	94	$4K
99205	Prolong outpt/office vis	3.0%	42	38	$3K
99308	Subsequent nursing facility care, per day, straightforward	<1%	102	59	$774.93
G0179	Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care	<1%	39	24	$143.14

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 officialSHELTON, CORNELL (DOCTOR)