Procedure Volume Patient Data Patient Conditions Reviews General Payments Back to Top

Home > VA Providers > Pain Management Doctors & Specialists

Dr. Beth M. Winke, MD

(No ratings)

Specializes in: Pain Medicine

University of Iowa, Carver College of Medicine (1988)

154 Burnetts Way Suite 101
Suffolk, VA 23434

(757) 216-4030

Dr. Beth M. Winke, MD is a pain medicine specialist in Suffolk, VA specializing in pain medicine. She graduated from University of Iowa, Carver College of Medicine in 1988 and has 38 years of experience. Dr. Beth M. Winke, MD is affiliated with Sentara Health.

Office Locations

154 Burnetts Way Suite 101
Suffolk, VA 23434

(757) 216-4030

open_in_new

20209 Sentara Way Suite 104
Carrollton, VA 23314

(757) 216-4030

open_in_new

808 Eden Way N Suite 102
Chesapeake, VA 23320

(757) 216-4030

(757) 216-4029

open_in_new

Noteworthy Medicare Patient Procedures Performed by Dr. Beth M. Winke, MD in 2024

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 5%

By Volume:

acupuncture treatment

In 2024, Dr. Beth M. Winke, MD performed more acupuncture treatment procedures for Medicare patients than 95% of providers in related specialties within Virginia.

Top 10%

By Affordability:

pain management

trigger point injection

In 2024, Dr. Beth M. Winke, MD had a list price for pain management, and trigger point injection that was lower than the list prices billed to Medicare by 90% of providers in related specialties within Virginia. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Top 25%

By Affordability:

aspiration

aspiration procedures

epidural nerve block

epidural nerve block with local anesthetic

epidural steroid injection

injections

joint aspiration

joint injections

lumbar selective nerve root block

lumbar transforaminal epidural steroid injection

major joint aspiration

major joint injection

nerve block for pain

sacral selective nerve root block

sacral transforaminal epidural steroid injection

sacroiliac joint injection

selective nerve root block

spinal injection

spinal joint injection

spinal procedures

steroid injections

subarachnoid block

subarachnoid block with local anesthetic

transforaminal epidural steroid injection

In 2012, Dr. Beth M. Winke, MD had a list price for aspiration, aspiration procedures, epidural nerve block, epidural nerve block with local anesthetic (numbing medicine), epidural steroid injection, injections, joint aspiration, joint injections, lumbar (low-back) selective nerve root block, lumbar (low-back) transforaminal epidural steroid injection, major joint aspiration, major joint injection, nerve block for pain, sacral (low-back) selective nerve root block, sacral (low-back) transforaminal epidural steroid injection, sacroiliac (SI) joint injection, selective nerve root block (SNRB), spinal injection, spinal joint injection, spinal procedures, steroid injections, subarachnoid block, subarachnoid block with local anesthetic (numbing medicine), and transforaminal epidural steroid injection that was lower than the list prices billed to Medicare by 75% of providers in related specialties within Virginia. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2012 were injections, pain management, nerve block and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	58
doctor visit	2454
injections	438
nerve block	278
pain management	380
spinal procedures	278

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2013 were injections, pain management, nerve block and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	130
doctor visit	3005
injections	520
nerve block	221
pain management	390
spinal procedures	221

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	178
Female	375

**Ethnicity**
Non-Hispanic White	418
Black	121
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	175
From 75 to 84	77
85 and over	24
Less than 65	277

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2013

Hypertension	66
High Cholesterol	52
Stroke	3
Ischemic Heart Disease	25
Depression	41
Chronic Kidney Disease	17
Asthma	14
Osteoperosis	8
Atrial Fibrilation	5
Heart Failure	17
Chronic Obstructive Pulmonary Disease	22
Diabetes	35
Dementia	6
Cancer	6

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2014 were injections, pain management, spinal procedures and nerve block.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	135
doctor visit	3159
injections	587
lab tests	36
nerve block	263
pain management	452
spinal procedures	293

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	203
Female	369

**Ethnicity**
Non-Hispanic White	428
Black	128
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	193
From 75 to 84	72
85 and over	23
Less than 65	284

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2014

Hypertension	67
High Cholesterol	54
Stroke	5
Ischemic Heart Disease	25
Depression	40
Chronic Kidney Disease	16
Asthma	16
Osteoperosis	9
Atrial Fibrilation	7
Heart Failure	15
Chronic Obstructive Pulmonary Disease	21
Diabetes	35
Dementia	8
Cancer	5

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2015 were injections, pain management, spinal procedures and nerve block.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	129
doctor visit	3473
injections	539
lab tests	72
nerve block	230
pain management	410
spinal procedures	262

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	392
Female	768

**Ethnicity**
Non-Hispanic White	832
Black	300
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	404
From 75 to 84	158
85 and over	38
Less than 65	560

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2015

Hypertension	68
High Cholesterol	55
Stroke	4
Ischemic Heart Disease	27
Depression	39
Chronic Kidney Disease	20
Asthma	20
Osteoperosis	11
Atrial Fibrilation	7
Heart Failure	15
Chronic Obstructive Pulmonary Disease	20
Diabetes	36
Dementia	7
Cancer	7

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2016 were injections, pain management, spinal procedures and nerve block.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	138
doctor visit	3509
injections	525
lab tests	33
nerve block	200
pain management	387
spinal procedures	227

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	209
Female	396

**Ethnicity**
Non-Hispanic White	438
Black	148
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	218
From 75 to 84	89
85 and over	23
Less than 65	275

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2016

Hypertension	70
High Cholesterol	52
Stroke	5
Ischemic Heart Disease	28
Depression	41
Chronic Kidney Disease	27
Asthma	28
Osteoperosis	9
Atrial Fibrilation	7
Heart Failure	17
Chronic Obstructive Pulmonary Disease	23
Diabetes	37
Dementia	9
Cancer	6

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2017 were injections, pain management, aspiration and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	165
doctor visit	4111
injections	428
nerve block	84
pain management	263
spinal procedures	113

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	267
Female	484

**Ethnicity**
Non-Hispanic White	543
Black	181
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	302
From 75 to 84	119
85 and over	39
Less than 65	291

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2017

Hypertension	73
High Cholesterol	49
Stroke	4
Ischemic Heart Disease	29
Depression	40
Chronic Kidney Disease	29
Asthma	14
Osteoperosis	8
Atrial Fibrilation	8
Heart Failure	18
Chronic Obstructive Pulmonary Disease	24
Diabetes	40
Dementia	7
Cancer	7

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2018 were injections, pain management, nerve block and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	222
doctor visit	5092
injections	700
minimally invasive procedures	21
nerve block	335
nerve procedures	21
pain management	499
spinal procedures	263

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	376
Female	715

**Ethnicity**
Non-Hispanic White	769
Black	285
Hispanic	21
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	448
From 75 to 84	220
85 and over	66
Less than 65	357

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2018

Hypertension	75
High Cholesterol	62
Stroke	5
Ischemic Heart Disease	30
Depression	37
Chronic Kidney Disease	33
Asthma	13
Osteoperosis	11
Atrial Fibrilation	8
Heart Failure	21
Chronic Obstructive Pulmonary Disease	22
Diabetes	40
Dementia	9
Cancer	8

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2019 were injections, pain management, aspiration and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	161
doctor visit	5236
injections	416
nerve block	115
pain management	255
spinal procedures	144

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	374
Female	732

**Ethnicity**
Non-Hispanic White	782
Black	277
Hispanic	20
Asian	0
Other	14
Native American	0

**Age**
From 65 to 74	473
From 75 to 84	233
85 and over	73
Less than 65	327

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2019

Hypertension	75
High Cholesterol	63
Stroke	4
Ischemic Heart Disease	31
Depression	39
Chronic Kidney Disease	35
Asthma	12
Osteoperosis	13
Atrial Fibrilation	8
Heart Failure	23
Chronic Obstructive Pulmonary Disease	22
Diabetes	39
Dementia	8
Cancer	10

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2020 were injections, pain management, aspiration and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	103
blood draw	13
doctor visit	4272
injections	227
nerve block	35
pain management	124
spinal procedures	56

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	311
Female	641

**Ethnicity**
Non-Hispanic White	676
Black	249
Hispanic	14
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	405
From 75 to 84	208
85 and over	51
Less than 65	288

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2020

Hypertension	72
High Cholesterol	59
Stroke	3
Ischemic Heart Disease	29
Depression	36
Chronic Kidney Disease	36
Asthma	12
Osteoperosis	10
Atrial Fibrilation	10
Heart Failure	22
Chronic Obstructive Pulmonary Disease	20
Diabetes	40
Dementia	9
Cancer	9

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2021 were injections, pain management, complementary or alternative therapy and aspiration.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	99
complementary or alternative therapy	135
doctor visit	4701
injections	281
nerve block	72
pain management	182
spinal procedures	91

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	345
Female	682

**Ethnicity**
Non-Hispanic White	743
Black	247
Hispanic	17
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	438
From 75 to 84	244
85 and over	73
Less than 65	272

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2021

Hypertension	74
High Cholesterol	63
Stroke	5
Ischemic Heart Disease	30
Depression	36
Chronic Kidney Disease	36
Asthma	14
Osteoperosis	13
Atrial Fibrilation	11
Heart Failure	23
Chronic Obstructive Pulmonary Disease	19
Diabetes	40
Dementia	8
Cancer	12

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2022 were injections, pain management, complementary or alternative therapy and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	49
complementary or alternative therapy	144
doctor visit	4610
injections	208
nerve block	86
pain management	159
spinal procedures	104

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	330
Female	633

**Ethnicity**
Non-Hispanic White	708
Black	222
Hispanic	15
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	407
From 75 to 84	241
85 and over	69
Less than 65	246

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2022

Hypertension	75
High Cholesterol	75
Stroke	8
Ischemic Heart Disease	23
Depression	36
Chronic Kidney Disease	24
Asthma	18
Osteoperosis	18
Atrial Fibrilation	15
Heart Failure	19
Chronic Obstructive Pulmonary Disease	23
Diabetes	38
Dementia	5
Cancer	13

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2023 were injections, complementary or alternative therapy, pain management and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	33
complementary or alternative therapy	161
doctor visit	4107
injections	189
nerve block	102
pain management	156
spinal procedures	122

2023 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	294
Female	583

**Ethnicity**
Non-Hispanic White	645
Black	199
Hispanic	14
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	378
From 75 to 84	242
85 and over	57
Less than 65	200

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2023

Hypertension	75
High Cholesterol	75
Stroke	8
Ischemic Heart Disease	23
Depression	39
Chronic Kidney Disease	24
Asthma	21
Osteoperosis	18
Atrial Fibrilation	16
Heart Failure	20
Chronic Obstructive Pulmonary Disease	24
Diabetes	39
Dementia	5
Cancer	12

Medicare Procedure and Patient Information

2024 Medicare Procedure Volume

The top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA during 2024 were complementary or alternative therapy, injections, pain management and spinal procedures.

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

aspiration	44
complementary or alternative therapy	192
doctor visit	3748
injections	164
nerve block	71
pain management	120
spinal procedures	93

2024 Medicare Patient Data

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	290
Female	541

**Ethnicity**
Non-Hispanic White	624
Black	173
Hispanic	15
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	367
From 75 to 84	230
85 and over	70
Less than 65	164

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2024

Hypertension	75
High Cholesterol	75
Stroke	8
Ischemic Heart Disease	26
Depression	40
Chronic Kidney Disease	24
Asthma	20
Osteoperosis	19
Atrial Fibrilation	18
Heart Failure	22
Chronic Obstructive Pulmonary Disease	27
Diabetes	40
Dementia	6
Cancer	12

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2024

Volume of procedures performed by Dr. Beth M. Winke, MD for Medicare patients.

The highest averages for the top procedures that Dr. Beth M. Winke, MD treated as a pain medicine specialist in Suffolk, VA were injections, pain management, spinal procedures and nerve block.

aspiration	112
blood draw	13
complementary or alternative therapy	158
doctor visit	3959
injections	401
lab tests	47
minimally invasive procedures	21
nerve block	160
nerve procedures	21
pain management	290
spinal procedures	174

Average Medicare Patient Data From 2012 - 2024

Information about Medicare patients treated by Dr. Beth M. Winke, MD.

**Gender**
Male	274
Female	532

**Ethnicity**
Black / African American	194
Asian / Pacific Islander	0
Non-Hispanic White	585
Native American / Alaskan Native	0
Hispanic	8
Other	1

**Age**
75 to 84	164
85 and over	46
Less than 65	272
65 to 74	323

Average of Total of Conditions of Medicare patients treated by Dr. Beth M. Winke, MD From 2012 - 2024

The highest averages of the most common conditions of Medicare patients that Dr. Beth M. Winke, MD treated were hypertension, high cholesterol, depression and diabetes.

Hypertension	66
High Cholesterol	56
Stroke	4
Ischemic Heart Disease	25
Depression	35
Chronic Kidney Disease	24
Asthma	15
Osteoporosis	11
Heart Failure	17
Chronic Obstructive Pulmonary Disease	20
Diabetes	35
Atrial Fibrillation	9
Dementia	6
Cancer	8

Education & Training

Dr. Beth M. Winke, MD graduated from University of Iowa, Carver College of Medicine in 1988. She completed residency at UP Health System - Portage. She is certified by the Certified - American Board of Internal Medicine - Physical Medicine & Rehabilitation and has a state license in Virginia.

Medical School: University of Iowa, Carver College of Medicine (1988)

Residency: UP Health System - Portage (1989)

Board Certification: Certified - American Board of Internal Medicine - Physical Medicine & Rehabilitation (2027)

Licensed In: Virginia

Ratings & Reviews

Dr. Beth M. Winke, MD does not have any reviews yet, be the first to leave a review of Dr. Beth M. Winke, MD here: Leave a Review

(No ratings)

Leave a Review

General Payments

These charts describe general payments received by Dr. Beth M. Winke, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Collegium Pharmaceutical, Inc.	$801 XTAMPZA $513	BELBUCA $192	Xtampza ER $80	Nucynta $15
Depomed, Inc.	$381 Nucynta $288	Zipsor $81	Gralise $11
Daiichi Sankyo Inc.	$366 Morphabond ER $274	MOVANTIK $92
Pfizer Inc.	$287 EMBEDA $180	LYRICA $55	FLECTOR PATCH $39	CELEBREX $13
Electronic Waveform Lab, Inc.	$287 $287
Other	$3,639 Relistor $264	ZOHYDRO ER $220	Evzio $186	ZTLido 30 POUCH in 1 CARTON 1 PATCH in 1 POUCH $139	Nucynta $138	Other $2,693

**Types of Payments**
Food and Beverage	$5,558
Education	$202

Biography

Dr. Beth Winke's medical specialty is interventional pain medicine. Dr. Winke studied medicine at the University of Iowa, Carver College of Medicine and Eastern Virginia Medical School. She is affiliated with Sentara Health.

Select Year:

Dr. Beth M. Winke, MD

Office Locations

Noteworthy Medicare Patient Procedures Performed by Dr. Beth M. Winke, MD in 2024

By Volume:

By Affordability:

By Affordability:

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

2013 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2013

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

2014 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2014

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

2015 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2015

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

2016 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2016

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

2017 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2017

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

2018 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2018

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

2019 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2019

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

2020 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2020

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

2021 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2021

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

2022 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2022

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

2023 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2023

Medicare Procedure and Patient Information

2024 Medicare Procedure Volume

2024 Medicare Patient Data

Conditions of Medicare patients treated by Dr. Beth M. Winke, MD in 2024

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2024

Average Medicare Patient Data From 2012 - 2024

Average of Total of Conditions of Medicare patients treated by Dr. Beth M. Winke, MD From 2012 - 2024

Education & Training

Ratings & Reviews

General Payments

Biography

Pain Management Doctors & Specialists in Nearby Locations

Other Providers in Suffolk, VA