Physician

Andrew Upchurch, MD

According to 2025 Medicare claims, Andrew Upchurch, MD (NPI: 1124550330) practices sleep medicine, with the plurality of this provider's patient population coming from Northumberlnd, PA. This provider's primary affiliated billing organization is GEISINGER CLINIC (NPI: 1255382784; TIN: 236291113) and primary practice location at 17822-9800. Upchurch is affiliated with the Keystone ACO (ACO ID: A1552), participating under the MSSP model.

Upchurch's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 405 traditional Medicare patients, billed 684 HCPCS/CPT codes, and received $36,401 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 274 prescription claims across 70 beneficiaries totaling $329,351 in drug costs, led by Wakix (Pitolisant Hcl). DME data shows 4,429 claims. Open Payments data shows 1 records totaling $14. 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 has fewer than 5 years of reported Medicare Part B carrier billing data, so a reliable trend cannot be assigned. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $479 to $329,351. 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.

Part B Carrier Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: Tot_Mdcr_Pymt_Amt. Source: Medicare Physician & Other Practitioners by Provider.0$18K$36K2021 Medicare payment: $14,028 (USD; Tot_Mdcr_Pymt_Amt)2022 Medicare payment: $33,854 (USD; Tot_Mdcr_Pymt_Amt)2023 Medicare payment: $33,782 (USD; Tot_Mdcr_Pymt_Amt)2024 Medicare payment: $36,401 (USD; Tot_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClm LinesPayment
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
2018N/RN/RN/R
2019N/RN/RN/R
2020N/RN/RN/R
2021150171$14,028
2022344502$33,854
2023387518$33,782
2024405684$36,401

Part D Events Trend

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

Part D Events Trend. X-axis: year 2015-2024. Y-axis: Drug cost, unit: USD. Field: Tot_Drug_Cst. Source: Medicare Part D Prescribers by Provider.0$172K$344K2020 Drug cost: $479 (USD; Tot_Drug_Cst)2021 Drug cost: $85,710 (USD; Tot_Drug_Cst)2022 Drug cost: $344,133 (USD; Tot_Drug_Cst)2023 Drug cost: $310,625 (USD; Tot_Drug_Cst)2024 Drug cost: $329,351 (USD; Tot_Drug_Cst)2015201620172018201920202021202220232024
YearPatientsClaimsDrug Cost
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
2018N/RN/RN/R
2019N/RN/RN/R
2020N/R30$479
20211323$85,710
202247145$344,133
202379269$310,625
202470274$329,351

DME Billing Trend

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

DME Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: DME_Suplr_Mdcr_Pymt_Amt. Source: Medicare DME, Devices & Supplies by Referring Provider.0$133K$266K2021 Medicare payment: $8,740 (USD; DME_Suplr_Mdcr_Pymt_Amt)2022 Medicare payment: $103,464 (USD; DME_Suplr_Mdcr_Pymt_Amt)2023 Medicare payment: $194,547 (USD; DME_Suplr_Mdcr_Pymt_Amt)2024 Medicare payment: $265,631 (USD; DME_Suplr_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClaimsPayment
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
2018N/RN/RN/R
2019N/RN/RN/R
2020N/RN/RN/R
2021116155$8,740
20228621,836$103,464
20231,4053,429$194,547
20241,8344,429$265,631

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

Top 5 Part B carrier billing codes in 2024

By total payments.

CodeDescriptionPatientsClm LinesTotal Payment
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more6464$99
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more7477$72
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more128142$49
G0400Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels7070$29
G2211Visit 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's127141$12

Top 5 Part D drugs in 2024

By total drug costs.

DrugGenericClaimsTotal Day SupplyTotal Drug Cost
WakixPitolisant Hcl12360$176,232
Sodium OxybateSodium Oxybate12350$146,484
Pramipexole ErPramipexole Di-Hcl11322$2,452
Trazodone HclTrazodone Hcl663,034$615
RamelteonRamelteon12310$592

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS CodeHCPCS DescriptionSupplier Rental IndicatorTotal Supplier BeneficiariesTotal Supplier ClaimsTotal Medicare Payment Amount
A7030Full face mask used with positive airway pressure device, eachN152305$37,222
E0601Continuous positive airway pressure (cpap) deviceY128727$35,915
A7031Face mask interface, replacement for full face mask, eachN134285$34,535
E0470Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)Y38222$25,863
A7032Cushion for use on nasal mask interface, replacement only, eachN72196$24,153

Open Payments Summary in 2024

CategoryDefinitionRecordsTotal Reported AmountTop Related Entity
General PaymentsReported payment or transfer-of-value amount.1$14Inspire Medical Systems, Inc.
Research PaymentsReported research-related payment or transfer-of-value amount.0$0N/R
Ownership / Investment InterestsReported value of ownership or investment interests.0$0N/R

FAQ

What Medicare data is available for Andrew Upchurch, MD?

Tedicare shows public-source Medicare data for Andrew Upchurch, MD (NPI 1124550330), 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 Andrew Upchurch, MD have ACO affiliation data?

Andrew Upchurch, MD is shown with ACO affiliation data for Keystone ACO (MSSP, ACO ID A1552).

What billing organization is linked to Andrew Upchurch, MD?

Andrew Upchurch, MD is linked to GEISINGER CLINIC (billing NPI 1255382784) in the available physician profile data.

Does Andrew Upchurch, MD have Open Payments data?

Andrew Upchurch, MD has 1 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.