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#108 of 11K

92014

Ophthalmological exam, comprehensive, established patient

Ophthalmological exam, comprehensive, established patient is the #108 most-billed Medicaid procedure code, with $1.86B in payments across 34.7M claims from 2018–2024. The national median cost per claim is $47.08.

Total Paid

$1.86B

0.17% of all spending

Total Claims

34.7M

Providers

24K

Avg Cost/Claim

$53

National Cost Distribution

How much do providers bill per claim for 92014? Based on 23K providers billing this code nationally.

Median

$47.08

Average

$53.37

Std Dev

$37.60

Max

$734.14

Percentile Distribution (Cost per Claim)

p10
$18.79
p25
$34.95
Median
$47.08
p75
$67.92
p90
$91.28
p95
$102.46
p99
$140.57

50% of providers bill between $34.95 and $67.92 per claim for this code.

90% bill between $18.79 and $91.28.

Top 1% bill above $140.57.

About This Procedure

HCPCS code 92014 (Ophthalmological exam, comprehensive, established patient) was billed by 24K providers across 34.7M claims, totaling $1.86B in Medicaid payments from 2018–2024. This code was used for 32.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.08

Providers Billing

23K

National Spending

$1.86B

Avg/Median Ratio

1.13×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92014

#ProviderTotal Paid
1Premier Eye Care Of Florida Llc

Coral Gables, FL · Exclusive Provider Organization

$22.2M
21942644661$16.6M
31326472945$8.9M
41083660815$7.8M
5Phoenix Children's Hospital

Phoenix, AZ · Pediatrics

$6.6M
6Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$6.2M
7The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$5.9M
81104868520$5.0M
91164578894$4.7M
101649563636$4.7M
111356860811$4.7M
121760541569$4.4M
131487077483$4.3M
14Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$4.3M
15Cambridge Public Health Commission

Cambridge, MA · General Acute Care Hospital

$4.0M
161619959731$3.6M
171639339930$3.5M
181316146574$3.5M
191962762765$3.5M
201588703995$3.4M

Showing top 20 of 24K providers billing this code