Physician
Cole, Andrew
Cole, Andrew was paid $1.15M by Medicaid between May 2020 and Dec 2024, across 15 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 93% of everything it billed.
33Billing provider infoCOLE, ANDREW
NEW CASTLE, PA 16101
NEW CASTLE, PA 16101
33aNPI1669465886assigned 08/23/2005
33bProvider typeFamily Medicine Physician
28Total paid$1.15M
24GClaims20,640
24DCodes billed15
24AFirst – last monthMay 2020 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Pennsylvania
Rank by total paid#51 of 2,756
Median peer was paid$19K
This provider vs. median60×
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 | |
|---|---|---|---|
| 2020 | 2,252 | $109K | |
| 2021 | 5,555 | $299K | |
| 2022 | 4,480 | $236K | |
| 2023 | 4,066 | $259K | |
| 2024incomplete | 4,287 | $246K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 93% | 5,917 | 5,722 | $1.07M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.1% | 5,304 | 5,194 | $35K |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | 2.4% | 875 | 871 | $28K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 144 | 142 | $9K |
| 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 | <1% | 82 | 81 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 371 | 362 | $72.76 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 132 | 131 | $15.40 |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 0% | 642 | 622 | $0.00 |
| 3079F | 0% | 453 | 450 | $0.00 | |
| 3008F | 0% | 3,693 | 3,613 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 1,988 | 1,961 | $0.00 |
| 3075F | 0% | 203 | 201 | $0.00 |
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.