Najul Zambrana, Jose

Najul Zambrana, Jose was paid $125K by Medicaid between Jan 2018 and Sep 2024, across 8 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 40% of everything it billed.

33Billing provider infoNAJUL ZAMBRANA, JOSE
ARECIBO, PR 00612

33aNPI1912079203assigned 11/14/2006

33bProvider typeGastroenterology Physician

28Total paid$125K

24GClaims1,683

24DCodes billed8

24AFirst – last monthJan 2018 – Sep 2024

Compared with peers

Next to other Gastroenterology Physician providers in Puerto Rico

Rank by total paid#46 of 107

Median peer was paid$47K

This provider vs. median2.7×

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	495	$40K
2020	80	$3K
2021	253	$21K
2022	236	$17K
2023	311	$22K
2024incomplete	308	$23K

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	40%	783	737	$50K
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	27%	481	449	$34K
99070		11%	230	227	$13K
45378	Colonoscopy, flexible; diagnostic, including collection of specimen(s)	7.9%	34	34	$10K
99205	Prolong outpt/office vis	7.0%	78	74	$9K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	3.7%	52	52	$5K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	3.3%	13	13	$4K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	1.1%	12	12	$1K

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.