Medicare Enrolled
Dr. Abhinav Koul, M.D.
Gastroenterology · Sacramento, CA
Practice pattern: Mixed Practice
— Diverse clinical practice across multiple procedure types
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Koul from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Koul
Dr. Abhinav Koul is a gastroenterology specialist in Sacramento, CA, with 13 years of NPI registration. Based on federal Medicare data, Dr. Koul performed 1,063 Medicare services across 994 unique beneficiaries.
Between the years covered by Open Payments, Dr. Koul received a total of $4,997 from 18 pharmaceutical and/or device companies across 87 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in gastroenterology. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Koul is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 13 years in practice
▲ Top 32% volume in CA
$4,997 industry payments
Medicare Practice Summary
Medicare Utilization ↗1,063
Medicare services
Top 32% in CA for gastroenterology
994
Unique beneficiaries
$102
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~82 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Upper GI endoscopy with biopsy A procedure to collect tissue samples from the esophagus, stomach, or upper small intestine using a flexible tube with a camera. The samples are examined to check for abnormalities. |
193 | $40 | $1,113 |
| Colon polyp removal with endoscopic snare This procedure removes polyps or growths from the large bowel using a flexible tube with a camera and a wire loop tool. The snare is used to cut off the growths during the examination. |
119 | $186 | $1,300 |
| Colonoscopy with biopsy A procedure to collect tissue samples from the large intestine using a flexible tube with a camera. The samples are examined to check for abnormalities or disease. |
96 | $32 | $1,260 |
| Endoscopic ultrasound of esophagus, stomach, or upper small bowel An ultrasound exam of the esophagus, stomach, and/or upper small bowel performed using a flexible endoscope. |
62 | $156 | $593 |
| Radiologist review of bile duct tube placement imaging A radiologist reviews images taken during the placement of a tube into the bile duct using an endoscope. |
61 | $19 | $712 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
59 | $94 | $345 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
57 | $139 | $514 |
| Endoscopic ultrasound-guided needle biopsy A procedure using an ultrasound-equipped endoscope to guide a needle for tissue sampling of the esophagus, stomach, or upper small bowel. |
55 | $184 | $705 |
| Endoscopic removal of bile or pancreatic duct stone A flexible endoscope is used to remove stones or debris from the bile or pancreatic ducts. |
54 | $53 | $959 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
51 | $65 | $185 |
| Moderate sedation during GI endoscopy Sedation services provided by the physician performing a gastrointestinal endoscopic procedure. This requires an independent trained observer to assist in monitoring the patient. |
51 | $3 | $163 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
39 | $127 | $447 |
| Pancreatic or bile duct stent insertion A flexible endoscope is used to place a stent into the pancreatic or bile duct to keep it open. |
30 | $361 | $1,285 |
| Initial hospital admission, moderate complexity Initial hospital inpatient or observation care for a new patient involving moderate-level medical decision making, with at least 55 minutes total time on the date of the encounter. |
27 | $102 | $350 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
26 | $61 | $302 |
| Removal of large bowel tissue using flexible endoscope A procedure to remove tissue from the large intestine using a flexible tube with a camera. The endoscope allows the provider to access and excise the tissue directly. |
24 | $286 | $947 |
| Balloon dilation of esophagus, stomach, or upper small bowel, less than 3.0 cm A procedure using a flexible endoscope to widen a narrowed section of the esophagus, stomach, or upper small bowel with a balloon that is less than 3.0 cm in length. |
23 | $56 | $3,327 |
| Colonoscopy for colorectal cancer screening A colonoscopy performed to screen for colorectal cancer in individuals who are not at high risk for the disease. |
13 | $183 | $970 |
| Endoscopic incision of pancreatic outlet A procedure where a flexible endoscope is used to make an incision in the pancreatic outlet. |
12 | $72 | $937 |
| Balloon dilation of pancreatic or bile duct A procedure using a flexible endoscope to widen a narrowed pancreatic or bile duct with a balloon. This helps restore the flow of digestive fluids. |
11 | $294 | $1,019 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
2.8% high complexity
50.0% medium
47.2% routine
Industry Payment Transparency
Open Payments through 2024 ↗$4,997
Total received (2018-2024)
Avg $833/year across 6 years
Top 30% in CA for gastroenterology
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
18
Companies
87
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$4,822 (96.5%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$174 (3.5%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$2,390
2023
$615
2022
$278
2020
$205
2019
$1,482
2018
$27
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Boston Scientific Corporation
$1,563
ABBVIE INC.
$275
Janssen Biotech, Inc.
$128
Olympus America Inc.
$82
Gilead Sciences, Inc.
$64
Takeda Pharmaceuticals U.S.A., Inc.
$57
Phathom Pharmaceuticals, Inc.
$53
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$45
Regeneron Healthcare Solutions, Inc.
$35
Fresenius Kabi USA, LLC
$33
PFIZER INC.
$28
Merck Sharp & Dohme LLC
$27
Top 3 companies account for 82.3% of 2024 payments
All-time payments by company (2018-2024) ›
Boston Scientific Corporation
$2,523
ABBVIE INC.
$543
Janssen Biotech, Inc.
$479
Janssen Scientific Affairs, LLC
$442
Takeda Pharmaceuticals U.S.A., Inc.
$235
Olympus America Inc.
$207
Gilead Sciences, Inc.
$88
Celgene Corporation
$72
Merck Sharp & Dohme LLC
$61
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$59
PFIZER INC.
$55
Phathom Pharmaceuticals, Inc.
$53
INTERCEPT PHARMACEUTICALS, INC.
$43
Regeneron Healthcare Solutions, Inc.
$35
Fresenius Kabi USA, LLC
$33
NESTLE HEALTHCARE NUTRITION INC.
$27
Ferring Pharmaceuticals Inc.
$21
GENZYME CORPORATION
$19
Top 3 companies account for 71.0% of all-time payments
Associated products mentioned in payments ›
Axios · CHANTIX · CREON · DIFICID · DUPIXENT · ENTYVIO · GENERAL THERAPIES · HUMIRA · IDACIO · LINZESS · MAVYRET · OCALIVA · Olympus Duodenoscopes · REBYOTA · REMICADE · RINVOQ · SKYRIZI · SPYGLASS · STELARA · Single Use Aspiration Needle NA-U200H · TREMFYA · VIBERZI · VOQUEZNA · XELJANZ · XIFAXAN · ZENPEP · ZEPOSIA
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (96%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Gastroenterologists within 10 mi
105
Per 100K population
6.6
County median income
$88,724
Nearest hospital
UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Koul is a mixed practice specialist, with moderate Medicare volume, with low-engagement industry engagement.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Koul experienced with upper gi endoscopy with biopsy?
Based on Medicare claims data, Dr. Koul performed 193 upper gi endoscopy with biopsy services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Koul receive payments from pharmaceutical companies?
Yes. Dr. Koul received a total of $4,997 from 18 companies across 87 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Koul's costs compare to other gastroenterologists in Sacramento?
Dr. Koul's average Medicare payment per service is $102. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Koul) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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