Physician

Abhinav Koul, M.D.

According to 2025 Medicare claims, Abhinav Koul, M.D. (NPI: 1700145661) practices gastroenterology in the Santa Rosa-Petaluma, CA market, with the plurality of this provider's patient population coming from Sonoma, CA. This provider's primary affiliated billing organization is PROVIDENCE MEDICAL FOUNDATION (NPI: 1740584473; TIN: 330185031) and primary practice location at 95405-4801. Koul is affiliated with the Health Connect Partners, LLC (ACO ID: A2342), participating under the MSSP model.

Koul's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 484 traditional Medicare patients, billed 1,405 HCPCS/CPT codes, and received $153,765 in Medicare payments. The top billing code was 45385 (Removal of polyps or growths of large bowel using an endoscope with mechanical snare). Part D data shows 823 prescription claims across 304 beneficiaries totaling $483,487 in drug costs, led by Creon (Lipase/Protease/Amylase). 2019 DME data shows 24 claims. Open Payments data shows 35 records totaling $2,390. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved up and down with repeated peaks and valleys, starting at $48,157 and ending at $153,765. Concurrently, Part D prescription costs have risen steadily, from $11,028 to $483,487. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	273	554	$48,157
2016	555	1,142	$95,637
2017	257	567	$43,578
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	58	109	$8,929
2021	210	472	$51,503
2022	455	1,264	$145,491
2023	451	1,264	$136,863
2024	484	1,405	$153,765

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	87	205	$11,028
2016	179	414	$18,367
2017	129	279	$12,965
2018	45	125	$76,120
2019	43	106	$65,535
2020	87	145	$32,468
2021	112	196	$25,871
2022	315	550	$155,424
2023	350	799	$429,314
2024	304	823	$483,487

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	35	$1,317
2018	N/R	22	$755
2019	N/R	24	$841
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
45385	Removal of polyps or growths of large bowel using an endoscope with mechanical snare	134	135	$182
43259	Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	70	72	$140
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	61	62	$140
43239	Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	219	232	$41
45380	Biopsy of large bowel using a flexible endoscope	107	109	$32

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Creon	Lipase/Protease/Amylase	34	1,146	$73,664
Xifaxan	Rifaximin	13	342	$37,832
Linzess	Linaclotide	22	720	$13,734
Ursodiol	Ursodiol	45	1,985	$3,007
Pantoprazole Sodium	Pantoprazole Sodium	212	10,372	$2,527

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	35	$2,390	Boston Scientific Corporation
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Abhinav Koul, M.D.?

Tedicare shows public-source Medicare data for Abhinav Koul, M.D. (NPI 1700145661), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Abhinav Koul, M.D. have ACO affiliation data?

Abhinav Koul, M.D. is shown with ACO affiliation data for Health Connect Partners, LLC (MSSP, ACO ID A2342).

What billing organization is linked to Abhinav Koul, M.D.?

Abhinav Koul, M.D. is linked to PROVIDENCE MEDICAL FOUNDATION (billing NPI 1740584473) in the available physician profile data.

Does Abhinav Koul, M.D. have Open Payments data?

Abhinav Koul, M.D. has 35 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.