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    OpenPayerNPI Medicare & MedicaidTheresa Cole
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    Theresa Cole — Billing Profile & Reimbursement Data

    NPI 1922357318 · Fairfield, OH · Family Nurse Practitioner

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    Theresa Cole is a family nurse practitioner provider located in Fairfield, Ohio. This profile covers 10 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationTheresa Cole
    Address3050 Mack Rd
    CityFairfield
    StateOH
    ZIP45014
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedAugust 31, 2012

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$11.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…60$60$3.4K
    25609The provider surgically repairs a fracture of the lower radius, the larger of the two lower arm bones, beyond the joint or a separation of the radius from the joint through an incision and fixes…30$110$3K
    73110The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.40$30$950
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…20$50$860
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…10$60$850
    73502In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…30$20$670
    73630In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.30$20$620
    73610In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.20$20$460
    73562In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.10$20$210
    J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg90$1$90

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    2560921010$1,930$32.9K
    9921310,99320,00070$50$6.6K
    206101,4371,64060$50$4.7K
    992035,2546,38030$60$2.9K
    7356283289040$20$1.3K
    735027781,21040$20$1.1K
    736306921,15040$20$1K
    7361043774030$10$540
    7311018162030$10$490
    J33011,0771,530180$1$320

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Theresa Cole, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mercy Health Physicians Cincinnati, LLCOHFamily Medicine Physician$0$27.9M
    Bon Secours Medical Group Richmond Primary Care LLCVAFamily Medicine Physician$0$15.1M
    Mercy Health Physicians Cincinnati Specialty Care LLCOHSurgery Physician$0$7.1M
    Tara AdhikariOHRheumatology Physician$1.6M$0
    Soha MousaOHRheumatology Physician$979.7K$0
    Nelson WattsOHEndocrinology, Diabetes & Metabolism Physician$878.7K$0
    Emily FisherOHDermatology Physician$437K$0
    Rajinder SinghCAClinical Cardiac Electrophysiology Physician$380.2K$0
    Suresh NayakOHOrthopaedic Surgery Physician$362K$0
    Timothy SchoonoverOHNeurology Physician$356.8K$0

    Nearby Providers

    Other providers in the same ZIP code as Theresa Cole, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mercy Health - Fairfield Hospital LLCOHGeneral Acute Care Hospital$0$25.2M
    Preferred Home Health Care LLCOHHome Health Agency$0$10.9M
    City Of FairfieldOHLand Ambulance$378.1K$1.1M
    Jeffrey GrassOHRadiation Oncology Physician$1.2M$0
    Prasad KudalkarOHHematology & Oncology Physician$1M$0
    Peter FriedOHRadiation Oncology Physician$904.7K$0
    Rite Care Medical Transport LLCOHLand Ambulance$276.4K$625.6K
    Marwan AbdulaalOHOphthalmology Physician$890.7K$0
    Scott GreveyOHDermatology Physician$667.7K$0
    Imran ChowdhuryOHRadiation Oncology Physician$442.3K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Ohio Distribution
    Theresa Cole — 0 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Ohio