Joseph Roland Espiritu, MD
Sleep Medicine · St. Louis, MONPI 1578650362
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 92.5% of the total across 228 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 17 manufacturers reported payments, led by Harmony Biosciences LLC at 27.6% of the total. Among sleep medicine clinicians in MO with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 228 payments — averaging $30.12 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Harmony Biosciences LLC$2K
- GSK$1K
- Jazz Pharmaceuticals Inc.$948
- Johnson & Johnson$574
- Sanofi$530
- Regeneron Healthcare Solutions, Inc.$522
- plus $1K from 11 others
What the payments were for
- Food & beverage$6,35393%
- Education$5147%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Harmony Biosciences LLC | 46 | $1,893 |
| GSK | 48 | $1,046 |
| Jazz Pharmaceuticals Inc. | 39 | $948 |
| Johnson & Johnson | 5 | $574 |
| Sanofi | 14 | $530 |
| Regeneron Healthcare Solutions, Inc. | 17 | $522 |
| Avadel CNS Pharmaceuticals, LLC | 22 | $432 |
| Inspire Medical Systems, Inc. | 18 | $389 |
| Inari Medical, Inc. | 1 | $181 |
| Axsome Therapeutics, Inc. | 7 | $140 |
| Amgen | 3 | $55 |
| Merck | 2 | $46 |
| Philips North America LLC | 2 | $34 |
| Actelion Pharmaceuticals US, Inc. | 1 | $27 |
| AstraZeneca | 1 | $19 |
| Fisher & Paykel Healthcare Inc | 1 | $18 |
| Idorsia Pharmaceuticals US Inc | 1 | $15 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- XARELTO$574
- NUCALA$369
- FLOWTRIEVER CATHETER, S$181
- CT THROMBECTOMY SYSTEM KIT$181
- DUPIXENT$139
- Wakix$112
- XYWAV$108
How this compares
$6,868 in reported general payments places this provider in the 90th percentile of 33 sleep medicine providers in Missouri.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Sodium Oxybate | 12 | $207,815 |
| Aralast NpAlpha-1-Proteinase Inhibitor | 13 | $180,904 |
| WakixPitolisant Hcl | 17 | $166,887 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 67 | $46,076 |
| BelsomraSuvorexant | 45 | $19,730 |
| Incruse ElliptaUmeclidinium Bromide | 33 | $18,510 |
| Spiriva RespimatTiotropium Bromide | 20 | $18,302 |
| Spiriva HandihalerTiotropium Bromide | 11 | $10,184 |
| Arnuity ElliptaFluticasone Furoate | 20 | $8,664 |
| Breo ElliptaFluticasone/Vilanterol | 21 | $7,838 |
| EliquisApixaban | 12 | $6,826 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 32 | $6,791 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 13 | $5,785 |
| OxycontinOxycodone Hcl | 11 | $5,314 |
| Varenicline Tartrate | 13 | $3,837 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Harmony Biosciences LLCWakix | $1,893 | $166,88717 claims |
| GSKTrelegy Ellipta, Incruse Ellipta, Arnuity Ellipta, Breo Ellipta, Anoro Ellipta | $1,046 | $90,622169 claims |
| MerckBelsomra | $46 | $19,73045 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 90th percentile of 33 sleep medicine providers in Missouri.
Other sleep medicine in St. Louis
- Rocio Zeballos-ChavezSt. Louis$2K
- Steven GradneySpringfield$926K
- Raman MalhotraSaint Louis$7K
- David IngramKansas City$7K
- Rutwik PatelSaint Louis$4K
- Essam ElkadyJoplin$3K
- David KuhlmannSedalia$3K
- Oscar SchwartzSaint Louis$3K
- Beth WardChesterfield$2K
- Scott ShortenNorth Kansas City$2K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.