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NPI 1396745105 · Orlando, FL · Ophthalmology Physician
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Elia Mavrofrides is a ophthalmology physician provider located in Orlando, Florida. This profile covers 29 Medicare and 2 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 | Elia Mavrofrides |
| Address | 95 Columbia St |
| City | Orlando |
| State | FL |
| ZIP | 32806 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.2M |
| Medicaid | $240 |
The provider’s Medicare billing mix is dominated by intravitreal biologic therapies and related drug codes, with J0178 (aflibercept), J2777 (faricimab), and J3490 (unclassified drugs) appearing as the top revenue drivers. Coupled with frequent use of retinal imaging codes (for example, 92134 and 92250), the pattern is consistent with a retina-focused ophthalmology practice that performs high-volume injection therapy supported by in-house diagnostics and imaging.
Revenue concentration on Medicare is high: the precomputed top-3 Medicare codes account for 72.5% of this provider’s total Medicare revenue, and J0178 alone represents 42.3% of Medicare revenue ($2.6M). This indicates material dependence on a small set of high-revenue injectables and drug-administration services for overall Medicare income.
On competitive standing for drug administration, the provider is a national high-volume reporter for J0178 (rank #80 of 3204, 98th percentile) and reports substantial activity in J2777 and J3490, though the dataset labels J2777 and J3490 as typical/unremarkable volume for those codes. The strong national rank for J0178 specifically marks this provider as a major administrator of aflibercept compared with peers.
Several non-drug codes are statistical outliers nationally, reflecting very high imaging and outpatient throughput: 92014 (1.7K claims) is an extreme outlier at the 99th percentile, 92134 (4.6K claims) is an extreme outlier at the 100th percentile, 92250 (2.3K claims) is an extreme outlier at the 100th percentile, and 99213 (1.4K claims) is an extreme outlier at the 99th percentile. Those extreme-volume labels suggest significant clinic capacity for diagnostic imaging and frequent follow-up visits, consistent with a high-volume retina clinic workflow.
Medicaid activity is negligible in scale relative to Medicare: total Medicaid revenue is $236 versus $6.2M in Medicare revenue, and Medicaid billing is narrowly focused on imaging codes. The Medicaid top codes 92134 and 92250 together account for 100.0% of Medicaid revenue, with 92134 contributing $198 (63.9%) and 92250 contributing $112 (36.1%), and in-state ranks that indicate only modest Medicaid market presence (48th and 5th percentiles respectively).
The provider’s drug-reimbursement profile includes high per-claim payments for unclassified/expensive drugs (J3490 at $1829 avg paid/claim) alongside mid-range per-claim payments for commonly used biologics (J0178 at $682 avg paid/claim and J2777 at $29 avg paid/claim as reported). This mix amplifies revenue concentration: relatively few high-cost drug claims contribute disproportionate Medicare dollars while numerous lower-paid imaging and injection claims support volume.
NPI tenure is long: the provider was enumerated 2005-07-22 (~21 years ago). That long enumeration combined with the high-volume imaging and injection footprint suggests an established practice with sustained service lines in the Orlando ophthalmology market.
Taken together, the profile shows an effectively Medicare-centric ophthalmology practice with high national standing for select intravitreal drug administration (notably J0178) and extreme local/national throughput for retinal imaging and routine follow-up E/M visits; Medicaid participation is minimal and confined to low-value imaging claims. This combination signals a mature, injection- and imaging-led retina service line that derives the bulk of its revenue from a small set of high-impact Medicare codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
29 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3,850 | $680 | $2.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 42,660 | $30 | $1.2M |
| J3490 | Unclassified drugs | 350 | $1,830 | $638.3K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,900 | $220 | $413.2K |
| 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. | 3,330 | $100 | $325.9K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,490 | $120 | $178.2K |
| 92014 | An 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… | 1,710 | $90 | $148.9K |
| 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. | 4,580 | $30 | $137.3K |
| J2778 | Injection, ranibizumab, 0.1 mg | 690 | $180 | $121.4K |
| 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… | 1,360 | $70 | $89.6K |
Showing 1–10 of 29
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
29 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 12 | 250 | 800 | $690 | $817.6K |
| J2777 | 18 | 170 | 12,810 | $30 | $549.2K |
| J2778 | 54 | 110 | 660 | $180 | $234.1K |
| Q5128 | 7 | 40 | 770 | $220 | $216.3K |
| J2781 | 6 | 50 | 500 | $120 | $102K |
| 67028 | 12 | 300 | 710 | $90 | $91.1K |
| J3490 | 25 | 180 | 70 | $280 | $87.5K |
| J7312 | 7 | 40 | 230 | $160 | $45.5K |
| 67042 | 41 | 80 | 20 | $1,180 | $36.5K |
| 67036 | 20 | 70 | 20 | $1,050 | $31.4K |
Showing 1–10 of 29
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 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. | 200 | $1 | $200 |
| 92250 | Code 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,… | 10 | $10 | $110 |
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
2 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. | 90 | 170 | 200 | $10 | $10.5K |
| 92250 | Code 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,… | 178 | 190 | 130 | $10 | $5.4K |
Other providers in the same ZIP code as Elia Mavrofrides, ranked by combined Medicare and Medicaid revenue.
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