| National Provider Identifier [NPI]: | 1477858371 |
| Last Name Of The Provider | LEITE |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6201 LEESBURG PIKE |
| Street Address 2 Of The Provider | SUITE #410 |
| City Of The Provider | FALLS CHURCH |
| Zip Code Of The Provider | 220442201 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1320 |
| Number Of Medicare Beneficiaries | 411 |
| Total Submitted Charge Amount | 117201 |
| Total Medicare Allowed Amount | 46056.8 |
| Total Medicare Payment Amount | 33327.8 |
| Total Medicare Standardized Payment Amount | 38875.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 892 |
| Total Drug Medicare AllowedAmount | 323.45 |
| Total Drug Medicare PaymentAmount | 284.04 |
| Total Drug Medicare Standardized Payment Amount | 284.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 1238 |
| Number Of Medicare Beneficiaries With Medical Services | 411 |
| Total Medical Submitted Charge Amount | 116309 |
| Total Medical Medicare Allowed Amount | 45733.35 |
| Total Medical Medicare Payment Amount | 33043.76 |
| Total Medical Medicare Standardized Payment Amount | 38591.04 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 205 |
| Number Of Black or African American Beneficiaries | 189 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9663 |