Physician

James A Upshaw, M.D.

According to 2025 Medicare claims, James Upshaw, M.D. (NPI: 1740252170) practices internal medicine in the Macon-Bibb County, GA market, with the plurality of this provider's patient population coming from Bibb, GA. This provider's primary affiliated billing organization is INTERNAL MEDICINE ASSOCIATES, P.C. (NPI: 1033180625; TIN: 58-1109078) and primary practice location at 31217-8034. Upshaw is affiliated with the Dependable Care Partners, Select (ACO ID: A5666), participating under the MSSP model.

Upshaw's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 549 traditional Medicare patients, billed 17,742 HCPCS/CPT codes, and received $476,663 in Medicare payments. The top billing code was 80061 (Blood test, lipids (cholesterol and triglycerides)). Part D data shows 12,564 prescription claims across 745 beneficiaries totaling $988,400 in drug costs, led by Eliquis (Apixaban). DME data shows 75 claims. Open Payments data shows 21 records totaling $425. 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 changed little. Concurrently, Part D prescription costs have risen steadily, from $659,635 to $988,400. In contrast, DME billing represents a smaller volume and moved up and down with repeated peaks and valleys, starting at $32,698 and ending at $28,898.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	699	20,104	$500,630
2016	688	18,127	$432,536
2017	667	17,002	$410,016
2018	737	17,767	$417,201
2019	737	18,446	$437,765
2020	688	18,229	$468,141
2021	671	19,423	$555,969
2022	604	18,526	$499,030
2023	578	19,540	$532,873
2024	549	17,742	$476,663

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	579	11,669	$659,635
2016	568	11,631	$652,757
2017	565	11,182	$626,805
2018	649	11,663	$718,054
2019	657	12,393	$803,217
2020	676	12,390	$782,771
2021	723	12,360	$922,845
2022	710	12,152	$983,014
2023	681	11,534	$1,054,186
2024	745	12,564	$988,400

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	95	425	$29,688
2016	91	376	$19,070
2017	57	310	$5,003
2018	51	201	$3,134
2019	46	249	$5,725
2020	31	309	$11,125
2021	25	202	$13,062
2022	16	190	$10,268
2023	26	146	$8,858
2024	N/R	75	$12,349

* / # = 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
80061	Blood test, lipids (cholesterol and triglycerides)	455	480	$13
80053	Blood test, comprehensive group of blood chemicals	465	570	$10
36415	Insertion of needle into vein for collection of blood sample	491	1,108	$9
85025	Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	461	634	$8
84550	Uric acid level, blood	466	574	$4

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	217	11,787	$222,335
Ozempic	Semaglutide	84	3,526	$111,160
Januvia	Sitagliptin Phosphate	66	4,432	$77,593
Rybelsus	Semaglutide	30	2,070	$65,240
Repatha Sureclick	Evolocumab	66	3,332	$62,995

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	N	N/R	24	$10,235
A7032	Cushion for use on nasal mask interface, replacement only, each	N	N/R	11	$1,168
A7034	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	N	N/R	13	$668
A7038	Filter, disposable, used with positive airway pressure device	N	N/R	13	$145
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	N	N/R	14	$133

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	21	$425	Novo Nordisk Inc
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 James A. Upshaw, M.D.?

Tedicare shows public-source Medicare data for James A. Upshaw, M.D. (NPI 1740252170), 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 James A. Upshaw, M.D. have ACO affiliation data?

James A. Upshaw, M.D. is shown with ACO affiliation data for Dependable Care Partners, Select (MSSP, ACO ID A5666).

What billing organization is linked to James A. Upshaw, M.D.?

James A. Upshaw, M.D. is linked to INTERNAL MEDICINE ASSOCIATES, P.C. (billing NPI 1033180625) in the available physician profile data.

Does James A. Upshaw, M.D. have Open Payments data?

James A. Upshaw, M.D. has 21 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.