| National Provider Identifier [NPI]: | 1194760611 |
| Last Name Of The Provider | SIPES |
| First Name Of The Provider | BOBBI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 14TH AVE SE |
| Street Address 2 Of The Provider | 407-14TH AVE. SE, POB 1247 |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983723770 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 602 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 264974 |
| Total Medicare Allowed Amount | 67633.55 |
| Total Medicare Payment Amount | 52788.99 |
| Total Medicare Standardized Payment Amount | 53697.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 602 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 264974 |
| Total Medical Medicare Allowed Amount | 67633.55 |
| Total Medical Medicare Payment Amount | 52788.99 |
| Total Medical Medicare Standardized Payment Amount | 53697.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 146 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9309 |