Medicare Enrolled
Dr. James Upshaw, M.D.
Internal Medicine · Macon, GA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
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. Upshaw 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. Upshaw
Dr. James Upshaw is an internal medicine specialist in Macon, GA, with 20 years of NPI registration. Based on federal Medicare data, Dr. Upshaw performed 19,202 Medicare services in 2023. These records do not provide a deduplicated patient total.
Between the years covered by Open Payments, Dr. Upshaw received a total of $2,312 from 31 pharmaceutical and/or device companies across 135 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Upshaw 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.
✓ 20 years of NPI registration
▲ Top 1% volume in GA
$2,312 industry payments
Medicare Practice Summary — 2023
Medicare Utilization ↗19,202
Medicare services
Top 1% in GA for internal medicine
Not available
Unique patients (not deduplicated)
$27
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
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 |
|---|---|---|---|
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
1,718 | $34 | $100 |
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
1,356 | $33 | $110 |
| Blood draw (venipuncture) Insertion of a needle into a vein to collect a blood sample. |
1,179 | $8 | $15 |
| Remote vital sign monitoring management, each additional 20 minutes This code covers the time spent by a provider managing patient data from remote vital sign monitoring devices. It applies to each additional 20-minute increment beyond the initial monthly service period. |
1,129 | $28 | $85 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
828 | $58 | $125 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
785 | $9 | $83 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
710 | $8 | $49 |
| Basic metabolic blood panel A blood test that measures a group of basic chemicals, including total calcium levels. |
642 | $8 | $61 |
| Uric acid level test A blood test that measures the level of uric acid in your body. Uric acid is a waste product formed when the body breaks down purines. |
625 | $4 | $50 |
| Comprehensive metabolic blood panel A blood test that measures a group of chemicals, including glucose, electrolytes, and kidney and liver function markers. |
623 | $10 | $88 |
| Thyroid stimulating hormone (TSH) test A blood test that measures the level of thyroid stimulating hormone to evaluate thyroid function. |
583 | $16 | $123 |
| Vitamin B-12 level test A blood test that measures the amount of vitamin B-12 in your body. |
555 | $15 | $126 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
516 | $46 | $126 |
| Lipid panel (cholesterol and triglycerides) A blood test that measures cholesterol and triglyceride levels. |
514 | $13 | $113 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
506 | $9 | $93 |
| Chest X-ray, 2 views An X-ray imaging test of the chest that captures two different angles to visualize the lungs, heart, and chest wall. |
504 | $14 | $170 |
| Vitamin D level test A blood test to measure the amount of Vitamin D-3 in your body. |
504 | $29 | $293 |
| Thyroxine (T4) level test A blood test that measures the total amount of thyroxine, a thyroid hormone, in your body. |
504 | $7 | $51 |
| Thyroid hormone evaluation A blood test to measure the levels of thyroid hormones in the body. This evaluation helps assess how well the thyroid gland is functioning. |
498 | $6 | $53 |
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
484 | $35 | $100 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
461 | $120 | $132 |
| Office visit for established patient An office visit for an existing patient that may not require the healthcare professional to be present. |
439 | $14 | $60 |
| Urinalysis with microscopic exam A urine test performed manually that includes examining the sample under a microscope to check for abnormalities. |
362 | $3 | $39 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
349 | $101 | $268 |
| Automated urinalysis An automated laboratory test performed on a urine sample to analyze its chemical and physical properties. The procedure uses machinery to detect various substances and cells within the urine. |
330 | $2 | $29 |
| 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. |
282 | $87 | $189 |
| COVID-19 antibody test A blood test that measures antibodies to severe acute respiratory syndrome coronavirus 2 (COVID-19). It detects the presence of immune response markers to the virus. |
267 | $41 | $150 |
| PSA test (prostate cancer screening) A blood test that measures the level of prostate-specific antigen to screen for prostate cancer. |
171 | $19 | $30 |
| Ferritin level test (iron stores) A blood test that measures the level of ferritin, a protein that stores iron in the body. |
167 | $13 | $136 |
| 3D screening mammography (tomosynthesis) A screening imaging test of the breast using 3D technology to detect potential abnormalities. |
142 | $21 | $323 |
| Screening mammography An X-ray of the breast used to detect breast cancer in women who have no signs or symptoms of the disease. |
142 | $80 | $401 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
109 | $26 | $27 |
| Urine microalbumin test A laboratory test that measures the amount of a specific protein called microalbumin in a urine sample. This analysis helps assess kidney function. |
106 | $6 | $50 |
| Flu vaccine, high-dose High-dose seasonal influenza vaccine for adults aged 65 and older. Contains four times the antigen of standard-dose flu vaccines (60 mcg per strain), split-virus formulation, preservative-free, single-dose syringe. |
105 | $72 | $118 |
| Iron level test | 84 | $6 | $57 |
| Folic acid level test A blood test that measures the amount of folic acid in the serum. |
77 | $14 | $117 |
| Prothrombin time test (blood clotting) A laboratory test that measures how long it takes for blood to clot. This procedure evaluates the body's coagulation process. |
74 | $4 | $38 |
| Bone density scan (DEXA) A test that uses low-dose X-rays to measure bone mineral density in the hip, pelvis, and spine. It helps assess bone strength and risk of fractures. |
68 | $34 | $394 |
| Remote physiologic monitoring setup and education Initial setup of remote monitoring equipment and patient education on its use. |
57 | $13 | $40 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
49 | $10 | $55 |
| CT scan of chest, without contrast A computed tomography scan of the chest area that uses X-rays to create detailed images without the use of contrast dye. |
48 | $55 | $1,007 |
| Manual white blood cell count A laboratory test that involves examining a sample under a microscope to manually count the number of white blood cells present. |
44 | $4 | $29 |
| Complete blood count (CBC), automated An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood. |
44 | $6 | $45 |
| Vaccine administration The process of giving a vaccine to a patient. This code covers the administration service only and does not include the cost of the vaccine itself. |
42 | $13 | $42 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
41 | $133 | $1,052 |
| CT scan of head/brain, without contrast A CT scan uses X-rays to create detailed images of the head or brain without the use of contrast dye. |
34 | $43 | $838 |
| Liver enzyme (SGPT) level test A blood test that measures the level of the liver enzyme SGPT to assess liver function. |
28 | $5 | $37 |
| Ketorolac injection, per 15 mg An injection of ketorolac tromethamine, a nonsteroidal anti-inflammatory drug, administered in doses measured per 15 mg. |
28 | $0 | $50 |
| Dexamethasone injection (steroid) An injection of dexamethasone sodium phosphate, a corticosteroid medication, administered in a dose of 1 milligram. |
21 | $0 | $26 |
| Complete ultrasound of retroperitoneum An ultrasound examination of the structures located behind the abdominal cavity. |
19 | $52 | $418 |
| Liver enzyme (SGOT) level test A blood test that measures the level of the liver enzyme SGOT to help assess liver health. |
19 | $5 | $29 |
| X-ray of lower and sacral spine, minimum of 4 views An X-ray imaging test of the lower back and sacrum using at least four different angles to visualize the bones and joints. |
18 | $26 | $189 |
| Ultrasound of head and neck soft tissue This procedure uses sound waves to create images of the soft tissues in the head and neck area. It allows for the visualization of structures beneath the skin without using radiation. |
18 | $57 | $305 |
| PSA test (prostate cancer screening) | 18 | $18 | $130 |
| Limited abdominal ultrasound A focused ultrasound examination of the abdomen to evaluate specific organs or areas. This procedure uses sound waves to create images of internal structures. |
16 | $40 | $308 |
| Adm sarscv2 bvl 50mcg/.5ml a | 15 | $38 | $45 |
| Annual wellness visit, initial visit A yearly appointment to review your health and create a personalized prevention plan. This initial visit focuses on preventive care and health assessment. |
14 | $155 | $171 |
| CT scan of chest with contrast A computed tomography scan of the chest using a contrast dye to enhance the visibility of internal structures. |
13 | $78 | $1,166 |
| Low dose CT scan of chest for lung cancer screening A specialized CT scan of the chest using a lower radiation dose to screen for lung cancer. |
13 | $80 | $1,005 |
| X-ray of upper spine, 4-5 views An X-ray imaging test of the upper spine using 4 to 5 different views to visualize the bones and structures in that area. |
13 | $28 | $180 |
| Complete breast ultrasound, 1 breast A complete ultrasound examination of one breast to visualize internal structures. |
12 | $51 | $315 |
| Pneumococcal conjugate vaccine (PCV20) An intramuscular injection of the 20-valent pneumococcal conjugate vaccine. It is used to protect against diseases caused by Streptococcus pneumoniae bacteria. |
12 | $281 | $400 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
12 | $193 | $686 |
| Digital breast tomosynthesis (3D mammogram) A specialized imaging test that creates three-dimensional pictures of the breast tissue to help detect abnormalities. |
12 | $17 | $90 |
| Shoulder X-ray, 2+ views An X-ray imaging test of the shoulder joint using at least two different angles to visualize the bones and surrounding structures. |
11 | $18 | $127 |
| Diagnostic mammography of 1 breast An X-ray examination of one breast to evaluate specific breast symptoms or abnormalities. |
11 | $61 | $267 |
| Stool test for blood to screen for colon tumors A test that analyzes a stool sample to detect hidden blood, which is used to screen for colon tumors. |
11 | $4 | $30 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
11 | $26 | $27 |
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. These counts do not measure clinical quality or years of experience.
0.2% high complexity
1.4% medium
98.4% routine
Industry Payment Transparency
Open Payments through 2024 ↗$2,312
Total received (2018-2024)
Avg $330/year across 7 years
Top 28% in GA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
31
Companies
135
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →
Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$425
2023
$326
2022
$299
2021
$337
2020
$163
2019
$386
2018
$376
Payments by company (2024)
Novo Nordisk Inc
$105
PFIZER INC.
$90
Amgen Inc.
$59
McKesson Medical-Surgical, Inc.
$40
GlaxoSmithKline, LLC.
$30
Edwards Lifesciences Corporation
$24
ABBVIE INC.
$17
Abbott Laboratories
$16
E.R. Squibb & Sons, L.L.C.
$15
Novartis Pharmaceuticals Corporation
$15
Dexcom, Inc.
$13
Top 3 companies account for 59.9% of 2024 payments
All-time payments by company (2018-2024) ›
Astellas Pharma US Inc
$459
Novo Nordisk Inc
$428
PFIZER INC.
$200
Amgen Inc.
$134
GlaxoSmithKline, LLC.
$98
McKesson Medical-Surgical, Inc.
$87
E.R. Squibb & Sons, L.L.C.
$82
Janssen Pharmaceuticals, Inc
$81
AbbVie Inc.
$73
ABBVIE INC.
$70
Abbott Laboratories
$63
Merck Sharp & Dohme Corporation
$61
Allergan, Inc.
$52
AstraZeneca Pharmaceuticals LP
$52
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$44
Allergan Inc.
$42
Medtronic, Inc.
$30
Novartis Pharmaceuticals Corporation
$27
Ironwood Pharmaceuticals, Inc
$27
Edwards Lifesciences Corporation
$24
Boehringer Ingelheim Pharmaceuticals, Inc.
$23
Medtronic USA, Inc.
$21
SANOFI-AVENTIS U.S. LLC
$20
Cook Medical LLC
$18
Biogen, Inc.
$16
Sumitomo Pharma America, Inc.
$16
Horizon Pharma plc
$15
Dexcom, Inc.
$13
Takeda Pharmaceuticals U.S.A., Inc.
$12
Seqirus USA Inc
$12
Amarin Pharma Inc.
$11
Top 3 companies account for 47.0% of all-time payments
Associated products mentioned in payments ›
ADUHELM · AREXVY · Aimovig · CHANTIX · COOK MEDICAL STENTS · DUZALLO · Dexcom G6 Transmitter · ELIQUIS · ENTRESTO · Edwards SAPIEN 3 Ultra Transcatheter Heart Valve · FARXIGA · FREESTYLE LIBRE · FREESTYLE LIBRE 2 · FREESTYLE LIBRE 3 · Fluad Quadrivalent · GEMTESA · INVOKANA · JANUVIA · JARDIANCE · KRYSTEXXA · KYPHON Balloon Kyphoplasty · LEQVIO · LINZESS · MYRBETRIQ · NURTEC ODT · Otezla · Ozempic · PREVNAR 20 · Prolia · QULIPTA · Repatha · Rybelsus · SHINGRIX · TRELEGY ELLIPTA · TRINTELLIX · Tresiba · UBRELVY · VRAYLAR · Vascepa · Victoza · Wegovy · XARELTO · XIFAXAN
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. 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 →
Geographic Context
Internal medicine physicians in nearby ZIP areas
196
County median income
$68,259
Nearest hospital to ZIP centroid (approximate)
COLISEUM MEDICAL CENTERS, LLC, DBA
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | NPPES snapshot; verify current record |
| Medicare Enrollment | ✓ PECOS | PECOS snapshot |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not included | 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. Upshaw is a clinical cardiology specialist, with above-average Medicare volume (top 1% in GA), with 20 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Upshaw experienced with remote patient monitoring management, 20 min/month?
Based on Medicare claims data, Dr. Upshaw performed 1,718 remote patient monitoring management, 20 min/month services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Upshaw receive payments from pharmaceutical companies?
Yes. Dr. Upshaw received a total of $2,312 from 31 companies across 135 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. 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. Upshaw's costs compare to other internal medicine physicians in Macon?
Dr. Upshaw's average Medicare payment per service is $27. 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. Upshaw) 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 the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. 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?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
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About this page
This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: 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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