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    OpenPayerNPI Medicare & MedicaidAlex Kartvelishvili
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    Alex Kartvelishvili — Billing Profile & Reimbursement Data

    NPI 1215124706 · Iowa City, IA · Ophthalmology Physician

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    Alex Kartvelishvili is a ophthalmology physician provider located in Iowa City, Iowa. This profile covers 21 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAlex Kartvelishvili
    Address2225 Mormon Trek Blvd Ste 100
    CityIowa City
    StateIA
    ZIP52246
    TaxonomyOphthalmology Physician
    NPI EnumeratedSeptember 27, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$8.1M
    Medicaid$0

    Key Findings

    This provider is heavily specialized in intravitreal biologic injections and retina services: the top revenue codes are J2777 ($4.8M), J0178 ($2.3M), and 67028 ($361.4K). Those three codes alone account for 92.2% of the provider's Medicare revenue, indicating operations are dominated by high-volume anti-VEGF/faricimab administration and isolated intravitreal procedures rather than a broad mix of general ophthalmology services.

    Medicare is effectively the sole payer of record: Total Medicare revenue is $8.1M and Total Medicaid revenue is none (no Medicaid billing on file). This makes the practice financially dependent on Medicare fee-for-service volumes and market access to Medicare beneficiaries, with no Medicaid-derived revenue to diversify payer risk.

    The provider is an extreme national outlier on faricimab volume: J2777 accounts for $4.8M (59.3% of Medicare revenue) and ranks #6 of 2039 providers nationally (100th percentile; extreme outlier). This level of concentration and national rank suggests the provider is among the very highest-volume users of faricimab in the country, signaling either a large referral base for anti-VEGF therapy or a focused retina injection practice.

    Aflibercept administration is also a major revenue driver but less extreme: J0178 generates $2.3M (28.4% of Medicare revenue) and ranks #123 of 3204 providers nationally (96th percentile; notably above typical national volume). Together with J2777, these biologic injections make up the bulk of the clinical footprint and explain the large Medicare revenue total relative to typical ophthalmology practices.

    Isolated intravitreal injection as a procedure is materially elevated: 67028 produced $361.4K (4.4% of Medicare revenue) and ranks #16 of 4255 providers nationally (100th percentile; extreme outlier). High ranking on 67028 reinforces that the practice bills many standalone injection encounters rather than injections bundled into surgical visits.

    Imaging and diagnostic codes are present but secondary to injection work: 92134 shows 4.6K claims and $124.7K (1.5% of Medicare revenue) and ranks #72 of 26868 providers nationally (100th percentile; extreme outlier), while 92250 generated $20.1K and ranks #487 of 25087 providers (98th percentile; extreme outlier). These elevated ranks for retinal imaging indicate a substantial diagnostic throughput that supports a high-volume injection practice and likely follow-up monitoring for retinal disease.

    General ophthalmology E/M volume is modest relative to injection work: 99214 and 99213 together account for small portions of revenue ($37.6K and $28.5K respectively) and both sit at typical to high-percentile national ranks (89th and 93rd percentiles). This mix suggests the provider focuses clinical effort on procedure-driven revenue rather than a high-volume general clinic of comprehensive office visits.

    Provider tenure is long-standing: NPI enumerated on 2007-09-27 (~19 years ago), indicating an established presence in the market. Combined with extreme national rankings on key retinal therapeutics, the tenure supports a picture of an experienced specialist with entrenched referrals and a procedure-centric business model.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J2777Injection, faricimab‑svoa, 0.1 mg166,260$30$4.8M
    J0178Injection, aflibercept, 1 mg3,380$690$2.3M
    67028The 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.4,410$80$361.4K
    J2778Injection, ranibizumab, 0.1 mg1,430$180$260.3K
    92134The 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.4,620$30$124.7K
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…780$80$62.7K
    J3590Unclassified biologics390$120$44.7K
    99214The 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…470$80$37.6K
    99213The 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…470$60$28.5K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…770$30$20.1K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    21 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J277722043,140$30$1.7M
    J0178240640$690$760.2K
    J2778720780$180$259.9K
    67028260420$80$80.6K
    J3590630140$100$26.7K
    9201420500200$70$19.8K
    67108202020$830$15K
    992145324,690100$70$14.4K
    6704131010$980$11.7K
    992132534,740100$50$8K

    Showing 1–10 of 21

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Alex Kartvelishvili, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wolfe Clinic IncIAOphthalmology Physician$0$18.2M
    Thomas BurokerIAMedical Oncology Physician$9.4M$0
    Kyle AllimanIAOphthalmology Physician$8.7M$0
    Paul BoekeIAOphthalmology Physician$7.1M$0
    Austin StrohbehnIARetina Specialist (Ophthalmology) Physician$5.8M$0
    Jeremy DeutschKSHematology & Oncology Physician$5.7M$0
    Robert BehrensIAMedical Oncology Physician$5.2M$0
    Matthew McknightIAFoot & Ankle Surgery Podiatrist$4.7M$23.5K
    James SingerIARetina Specialist (Ophthalmology) Physician$4.1M$0
    Christopher HaupertIARetina Specialist (Ophthalmology) Physician$3.9M$0

    Nearby Providers

    Other providers in the same ZIP code as Alex Kartvelishvili, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Successful LivingIADevelopmentally Disabled Services Day Training Agency$0$16.7M
    Chatham Oaks, Inc.IAMental Illness Community Based Residential Treatment Facility$0$5.4M
    Planned Parenthood Of The Heartland, IncIANon-Surgical Family Planning Clinic/Center$0$2.9M
    Emerson Point Limited PartnershipIAAssisted Living Facility$0$1.3M
    Care Ambulance, LLCIAAmbulance$505.3K$518.7K
    Ian HuiIAOptometrist$33.4K$21.5K
    Christian MannIAFamily Medicine Physician$20.2K$21.2K
    Therese MolloyIAOccupational Therapist$17.4K$0
    James MyersIAAnesthesiology Physician$6.9K$0
    Bradley VanvoorhisIAReproductive Endocrinology Physician$2.2K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Iowa Distribution
    Alex Kartvelishvili — 7 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa