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NPI 1104303858 · Lancaster, MA · Retina Specialist (Ophthalmology) Physician
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Elite Bor-shavit is a retina specialist (ophthalmology) physician provider located in Lancaster, Massachusetts. This profile covers 19 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Elite Bor-shavit |
| Address | 479 Old Union Tpke |
| City | Lancaster |
| State | MA |
| ZIP | 01523 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | July 25, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $5.4K |
ELITE BOR-SHAVIT is a retina specialist in LANCASTER, MA with an NPI enumerated on 2018-07-25 (~8 years ago). The provider’s lifetime Medicare revenue is $1.5M compared with $5.4K in Medicaid revenue, indicating Medicare overwhelmingly drives the practice’s billed volume and cash flow.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 81.3% of this provider’s total Medicare revenue, led by J0178 ($717.9K, 47.1% of Medicare revenue), J2777 ($431.7K, 28.3%), and 67028 ($90.3K, 5.9%). This concentration signals a procedure- and drug-centric retina operation focused on intravitreal therapies.
The code mix points to a high-volume intravitreal injection practice: J0178 (aflibercept) shows 1K claims and $717.9K revenue, and J2777 (faricimab) shows 14.9K claims and $431.7K revenue, with 67028 (intravitreal injection procedure) at 1K claims and $90.3K revenue. These figures, together with significant claims counts on injection drugs, indicate routine, repeated in-office biologic therapy delivery consistent with retina disease management.
Advanced and adjunct retinal diagnostics are a visible part of the workflow: Medicare 92134 has 1.6K claims and $48.8K revenue (3.2% of Medicare revenue) and ranks #1439 of 26868 providers nationally (95th percentile; notably above typical national volume), while the same imaging code on Medicaid accounts for 152 claims, $5.5K revenue and 100.0% of this provider’s Medicaid revenue (ranks #84 of 132 in-state, 37th percentile; typical, unremarkable volume). This contrast shows comparatively heavier use of retinal imaging in the provider’s Medicare population versus modest in-state Medicaid imaging volume.
Competitive standing on top drug codes is modest at the national level: J0178 ranks #1257 of 3204 providers nationally (61th percentile; typical, unremarkable volume) and J2777 ranks #719 of 2039 providers nationally (65th percentile; typical, unremarkable volume), so the provider is a routine participant in anti-VEGF and related biologic prescribing but not a national leader for these agents. In contrast, the provider is a statistical outlier on retinal imaging under Medicare (92134, 95th percentile; notably above typical national volume), indicating a relative strength in diagnostic imaging throughput.
The payer mix is effectively single-payer by revenue: Medicare accounts for $1.5M of lifetime revenue versus $5.4K from Medicaid, and Medicaid billing is narrowly concentrated (top Medicaid codes account for 100.0% of Medicaid revenue). Operationally this means any network or reimbursement changes from Medicare will have far greater financial impact than changes in Medicaid.
Evaluation-and-management activity supports ongoing clinical follow-up: 99214 shows 502 claims and $48.7K revenue (3.2% of Medicare revenue) and ranks #48611 of 479517 providers nationally (90th percentile; typical, unremarkable volume), while lower-level E/M codes (99213, 99215) produce smaller shares. This suggests a steady volume of moderate-complexity office visits consistent with recurrent injection clinics and ongoing retina disease management.
The presence of multiple intravitreal drug codes beyond aflibercept and faricimab — including J2781 (pegcetacoplan, $66.6K, 4.4% of Medicare revenue) and J2778 (ranibizumab, $57K, 3.7%) — indicates treatment of a range of retinal conditions such as wet AMD and potentially geographic atrophy, reinforcing a specialized, procedure-driven retina practice profile rather than a general ophthalmology mix.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,040 | $690 | $717.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 14,890 | $30 | $431.7K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 1,020 | $90 | $90.3K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 560 | $120 | $66.6K |
| J2778 | Injection, ranibizumab, 0.1 mg | 310 | $190 | $57K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1,570 | $30 | $48.8K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 500 | $100 | $48.7K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 210 | $60 | $12.7K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 10 | $900 | $11.7K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 90 | $110 | $10.4K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 35 | 90 | 790 | $690 | $826.5K |
| J2777 | 17 | 50 | 7,080 | $30 | $343.1K |
| J2778 | 24 | 30 | 560 | $180 | $200.7K |
| J2781 | 2 | 10 | 550 | $120 | $117.4K |
| 67028 | 36 | 120 | 570 | $100 | $80.7K |
| 92014 | 1,041 | 1,070 | 160 | $90 | $30.1K |
| 67042 | 17 | 30 | 20 | $1,170 | $25.7K |
| J9035 | 70 | 80 | 250 | $50 | $19.7K |
| 99214 | 1,180 | 15,410 | 110 | $80 | $15.6K |
| 92134 | 46 | 670 | 70 | $30 | $10.6K |
Showing 1–10 of 19
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 150 | $40 | $5.5K |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 84 | 130 | 430 | $10 | $39.3K |
Other providers in the same ZIP code as Elite Bor-shavit, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Allan Ramey | MA | Rheumatology Physician | $117.3K | $338.6K |
| Shudeshna Chen | MA | Optometrist | $62.2K | $14.1K |
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