Zambrano, Pilar

Zambrano, Pilar was paid $1.16M by Medicaid between Jan 2018 and Dec 2024, across 1 billing code. Its largest line is H0036, community psychiatric support and treatment, per 15 minutes — 100% of everything it billed.

33Billing provider infoZAMBRANO, PILAR
CLIFTON, NJ 07013

33aNPI1407233190assigned 05/01/2015

33bProvider typeProfessional Counselor

28Total paid$1.16M

24GClaims5,628

24DCodes billed1

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Professional Counselor providers in New Jersey

Rank by total paid#17 of 62

Median peer was paid$444K

This provider vs. median2.6×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration100% of spending on code H0036 with only 1 total codes billed. Highly concentrated billing profile.

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	1,042	$215K
2019	1,212	$246K
2020	867	$152K
2021	774	$159K
2022	525	$108K
2023	510	$113K
2024incomplete	698	$170K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0036	Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes	100%	5,628	1,993	$1.16M

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.