Ajay Koshy, MD
Family Medicine · Bedford, NHNPI 1932184603
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $5,289 of the $5,827 with a category attached, or 90.8%. AbbVie accounts for 93.8% of it on its own, with 3 other manufacturers making up the rest. Reporting peaked in 2023 at $2,776 and has fallen 98.5% since, to $42 in 2025. Among family medicine clinicians in NH with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 24 payments — averaging $242.78 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$5K
- Novo Nordisk$198
- Medtronic$102
- Merz North America, Inc.$63
What the payments were for
- Speaking & faculty fees$5,28991%
- Food & beverage$5379%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| AbbVie(2 entities) | 15 | $5,463 |
| Novo Nordisk | 7 | $198 |
| Medtronic | 1 | $102 |
| Merz North America, Inc. | 1 | $63 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Signia$102
How this compares
$5,827 in reported general payments places this provider in the 95th percentile of 397 family medicine providers in New Hampshire.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| MounjaroTirzepatide | 85 | $109,009 |
| EliquisApixaban | 85 | $84,014 |
| JardianceEmpagliflozin | 56 | $55,023 |
| OzempicSemaglutide | 42 | $53,165 |
| JanuviaSitagliptin Phosphate | 23 | $23,356 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 14 | $21,223 |
| MyrbetriqMirabegron | 20 | $18,295 |
| Breo ElliptaFluticasone/Vilanterol | 28 | $15,727 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 13 | $9,421 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 13 | $6,646 |
| SymbicortBudesonide/Formoterol Fumarate | 12 | $5,218 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 26 | $3,962 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 21 | $3,888 |
| Wixela InhubFluticasone Propion/Salmeterol | 22 | $2,964 |
| Verapamil Er PmVerapamil Hcl | 12 | $2,824 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Novo NordiskOzempic | $198 | $53,16542 claims |
| AbbVieSynthroid | $5,463 | $1,57035 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 95th percentile of 397 family medicine providers in New Hampshire.
Other family medicine in Bedford
- Howard SulsBedford$3K
- Mark BallentynePortsmouth$135K
- M LauterPortsmouth$21K
- Brian SponsellerNorth Conway$15K
- Cecilia Vicuna KeadyCharlestown$13K
- Keenan Al-HojerryPortsmouth$11K
- Peter LoeserConcord$10K
- Robyn StewartDerry$8K
- Robert KellyExeter$8K
- Dennis BadmanSanbornville$7K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.