ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

NPI: 1780938753 · ELMHURST, NY 11373 · Internal Medicine Physician · NPI assigned 10/30/2012

$359.53

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-06

First Month

2018-06

Last Month

Provider Details

Authorized Official	GONZALEZ JIMENEZ, MARIA PILAR (DIRECTOR, FACULTY PRACTICE GROUP)
NPI Enumeration Date	10/30/2012

Other providers sharing the same authorized official: GONZALEZ JIMENEZ, MARIA PILAR

Provider	City	State	Total Paid
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$2.75M
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$1.35M
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$294K
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$176K
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$97K
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$62K
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$2K
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ELMHURST	NY	$183.85

Year	Claims	Total Paid
2018	12	$359.53

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	12	12	$359.53