Gavilanes, Edison

Gavilanes, Edison was paid $35K by Medicaid between May 2019 and Oct 2024, across 5 billing codes. Its largest line is 99308, Subsequent nursing facility care, per day, straightforward — 31% of everything it billed.

33Billing provider infoGAVILANES, EDISON
AMITYVILLE, NY 11701

33aNPI1992967731assigned 07/01/2008

33bProvider typeInternal Medicine Physician

28Total paid$35K

24GClaims3,175

24DCodes billed5

24AFirst – last monthMay 2019 – Oct 2024

Compared with peers

Next to other Internal Medicine Physician providers in New York

Rank by total paid#2,009 of 6,049

Median peer was paid$11K

This provider vs. median3.1×

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
2019	285	$4K
2020	1,030	$15K
2021	600	$6K
2022	649	$4K
2023	397	$4K
2024incomplete	214	$1K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99308	Subsequent nursing facility care, per day, straightforward	31%	1,348	782	$11K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	30%	723	333	$10K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	28%	924	268	$10K
99223	Prolong inpt eval add15 m	9.5%	120	116	$3K
99305		1.1%	60	56	$378.76

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.