Physician
Upton, Edwin
Upton, Edwin was paid $87K by Medicaid between Nov 2020 and Dec 2024, across 11 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 75% of everything it billed.
33Billing provider infoUPTON, EDWIN
DAYTON, TX 77535
DAYTON, TX 77535
33aNPI1932130440assigned 07/05/2006
33bProvider typeInternal Medicine Physician
28Total paid$87K
24GClaims2,944
24DCodes billed11
24AFirst – last monthNov 2020 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Texas
Rank by total paid#242 of 1,028
Median peer was paid$10K
This provider vs. median8.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 61 | $2K | |
| 2021 | 785 | $22K | |
| 2022 | 1,145 | $31K | |
| 2023 | 551 | $18K | |
| 2024incomplete | 402 | $14K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 75% | 1,842 | 1,640 | $65K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 7.2% | 123 | 115 | $6K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 4.6% | 444 | 173 | $4K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 4.4% | 92 | 90 | $4K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 3.6% | 226 | 108 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.8% | 25 | 25 | $2K |
| 90461 | <1% | 76 | 65 | $669.21 | |
| 97169 | <1% | 12 | 12 | $410.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 29 | 27 | $363.92 |
| 87807 | <1% | 25 | 25 | $254.68 | |
| 92552 | 0% | 50 | 50 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.