Name	State	Tier	Primary site	45390 4Q	Trend	Email	Phone

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Drop a CSV exported from AcuityMD. Upserts on NPI — your tracking data (comms / VAC / next steps) is preserved.

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Expected columns

NPI (required), Name, Specialty, City, State, Med School, Grad Year, Primary Site, Societies, Labels, 45390 Q1/Q2/Q3/Q4 2025, 45390 4Q Total, Trend, 45381 4Q Total, Total Col/EGD Vol, Site Count, Phone, Email