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CMS public data · NPI 1043313083

Dr. Paul G Avadanian: Medicare prescribing and billing data

CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.

CMS display name

Paul G Avadanian, DO

Credential

DO

NPI

1043313083

Primary source state

PA

Data retrieval date

July 28, 2026

Pennsylvania doctorsState Doctor hubGeneral PracticeState-specialty hubEphrata, PAPrimary city link if this route exists

Where these numbers come from, and what they cannot tell you

Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.

How should you read this Doctor page?

This page shows Medicare billing and Part D prescribing data for Paul G Avadanian, DO from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.

A licensed agent, not a call center

Do your doctors and prescriptions fit before you enroll?

Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.

What Medicare source indicators are listed for this NPI?

Medicare participating

Yes

Individual assignment

Yes

Group assignment

Yes

CMS opt-out records

0

Which practice locations appear in CMS files?

When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.

Medicare billing address

CMS Medicare provider billing file

136 A&B Lake Street
Lake Street Family Practice
Ephrata, PA 17522

WELLSPAN MEDICAL GROUP

CMS Doctors & Clinicians file

136 Lake St
Ephrata, PA 17522

(717) 721-7718

What does the Medicare billing file show?

In the 2024 CMS provider billing file, this NPI had 362 Medicare beneficiaries and 1,449 total services. The average beneficiary age was 74, and the average HCC risk score was 1.

Total Medicare allowed amount

$108,241.16

Total Medicare payment amount

$78,546.33

Medicare beneficiaries

362

Total services

1,449

Which patient-panel condition fields does CMS report?

These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.

Hypertension

69%

CMS beneficiary-panel share

Hyperlipidemia

66%

CMS beneficiary-panel share

Diabetes

35%

CMS beneficiary-panel share

Ischemic heart disease

31%

CMS beneficiary-panel share

Mood disorders

22%

CMS beneficiary-panel share

Depression

21%

CMS beneficiary-panel share

Where these service numbers come from, and what they cannot tell you

Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.

Which Medicare services appear most often?

Highest-volume Medicare services, 2024 reporting year
CMS service descriptionServicesAvg allowed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more327$121.63
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more295$85.39
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's131$15.69
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit92$122.43
Administration of influenza virus vaccine80$30.77
Influenza vaccine split virus, preservative free77$80.66
Admn sarscov2 vacc 1 dose29$41.03
Sarscv2 vac 30mcg trs-suc im29$141.89
Transitional care management services for problem of at least moderate complexity19$194.36
Testing for presence of drug, read by direct observation18$12.35

Where these Part D numbers come from, and what they cannot tell you

CMS data reports historical prescription drug events attributed to NPI 1043313083. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.

Which drugs did Paul G Avadanian, DO prescribe most often under Medicare Part D?

Top 10 Medicare Part D drugs for NPI 1043313083, ranked by total claims in the CMS 2024 provider-and-drug file
RankDrugGeneric nameTotal claims30-day fillsTotal drug cost
1Amlodipine BesylateAmlodipine Besylate4541,284.2$1,910.60
2Atorvastatin CalciumAtorvastatin Calcium4421,200$3,880.31
3Rosuvastatin CalciumRosuvastatin Calcium3971,124$5,258.28
4LisinoprilLisinopril3911,074.5$1,939.65
5Losartan PotassiumLosartan Potassium3811,075$2,947.47
6Levothyroxine SodiumLevothyroxine Sodium329903$2,738.09
7Metformin HclMetformin Hcl312891.3$1,885.67
8Pantoprazole SodiumPantoprazole Sodium297783.3$4,302.37
9SimvastatinSimvastatin293853$2,073.18
10Metoprolol SuccinateMetoprolol Succinate274725.3$4,371.71

CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.

What background fields does CMS report?

Medical school

Nova Southeastern College Of Osteo Medicine

Graduation year

1994

Group/practice field

Wellspan Medical Group

Telehealth reported

Yes

What can this data not tell us?

  • Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
  • Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
  • Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
  • CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
  • CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
  • Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.

What should you verify separately?

Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.

Which CMS sources support this page?

The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.

What caveats apply to this page?
  • CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
  • Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
  • Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.