| National Provider Identifier [NPI]: | 1427061381 |
| Last Name Of The Provider | BOMMASANI |
| First Name Of The Provider | REENA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13168 CENTERPOINTE WAY |
| Street Address 2 Of The Provider | SUITE #101 |
| City Of The Provider | WOODBRIDGE |
| Zip Code Of The Provider | 221935287 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 849 |
| Number Of Medicare Beneficiaries | 202 |
| Total Submitted Charge Amount | 90035.25 |
| Total Medicare Allowed Amount | 57519.5 |
| Total Medicare Payment Amount | 39176.32 |
| Total Medicare Standardized Payment Amount | 40092.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 375.25 |
| Total Drug Medicare AllowedAmount | 103.08 |
| Total Drug Medicare PaymentAmount | 97.83 |
| Total Drug Medicare Standardized Payment Amount | 97.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 807 |
| Number Of Medicare Beneficiaries With Medical Services | 202 |
| Total Medical Submitted Charge Amount | 89660 |
| Total Medical Medicare Allowed Amount | 57416.42 |
| Total Medical Medicare Payment Amount | 39078.49 |
| Total Medical Medicare Standardized Payment Amount | 39995.15 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 79 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8745 |