Physician

Melchor J Sipalay, MD

According to 2025 Medicare claims, Melchor Sipalay, MD (NPI: 1356390074) practices internal medicine in the Pueblo, CO market, with the plurality of this provider's patient population coming from Pueblo, CO. This provider's primary affiliated billing organization is HERITAGE INTERNAL MEDICINE, PC (NPI: 1669681581; TIN: 841450509) and primary practice location at 81004-3537. Sipalay is affiliated with the CommonSpirit ACO I (ACO ID: A2164) and Collaborative ACO 30, LLC (ACO ID: A5483), participating under the MSSP model.

Sipalay's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 493 traditional Medicare patients, billed 13,186 HCPCS/CPT codes, and received $226,713 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 9,648 prescription claims across 668 beneficiaries totaling $849,937 in drug costs, led by Eliquis (Apixaban). DME data shows 842 claims. Open Payments data shows 31 records totaling $632. 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. Similarly, Part D prescription costs have changed little. For DME billing, reported payments declined steadily, from $95,750 to $60,943.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	616	23,099	$245,938
2016	611	25,107	$266,078
2017	569	24,410	$241,661
2018	596	22,097	$238,657
2019	397	20,181	$150,227
2020	572	22,404	$201,966
2021	551	19,989	$244,207
2022	542	16,492	$237,726
2023	521	16,571	$241,832
2024	493	13,186	$226,713

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	569	11,278	$667,825
2016	571	12,307	$776,981
2017	582	13,319	$891,839
2018	656	13,523	$1,036,756
2019	636	12,867	$963,585
2020	676	11,254	$809,211
2021	625	9,999	$707,381
2022	654	9,453	$669,272
2023	669	9,765	$835,502
2024	668	9,648	$849,937

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	258	1,256	$83,352
2016	270	1,328	$79,740
2017	305	1,405	$74,121
2018	338	1,308	$58,101
2019	222	1,035	$44,153
2020	241	964	$48,251
2021	178	677	$41,376
2022	172	704	$44,821
2023	206	888	$78,395
2024	163	842	$72,476

* / # = 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
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	311	311	$123
90653	Influenza vaccine, inactivated	193	194	$82
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	448	1,244	$81
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	148	223	$55
G0008	Administration of influenza virus vaccine	199	202	$33

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	113	6,685	$128,365
Ozempic	Semaglutide	82	3,278	$105,742
Jardiance	Empagliflozin	71	3,660	$73,208
Trulicity	Dulaglutide	39	1,764	$58,803
Januvia	Sitagliptin Phosphate	47	2,910	$52,893

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
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	Y	N/R	26	$22,458
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	27	237	$16,840
J7677	Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram	N	N/R	21	$15,920
A7031	Face mask interface, replacement for full face mask, each	N	15	37	$2,909
A7030	Full face mask used with positive airway pressure device, each	N	15	36	$2,844

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	31	$632	AstraZeneca Pharmaceuticals LP
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 Melchor J. Sipalay, MD?

Tedicare shows public-source Medicare data for Melchor J. Sipalay, MD (NPI 1356390074), 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 Melchor J. Sipalay, MD have ACO affiliation data?

Melchor J. Sipalay, MD is shown with ACO affiliation data for CommonSpirit ACO I (MSSP, ACO ID A2164) and Collaborative ACO 30, LLC (MSSP, ACO ID A5483).

What billing organization is linked to Melchor J. Sipalay, MD?

Melchor J. Sipalay, MD is linked to HERITAGE INTERNAL MEDICINE, PC (billing NPI 1669681581) in the available physician profile data.

Does Melchor J. Sipalay, MD have Open Payments data?

Melchor J. Sipalay, MD has 31 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.