SHOPKO STORES OPERATING CO. LLC
NPI: 1255384822
· BELOIT, WI 53511
· 332H00000X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
17,628 |
$33K |
| 2019 |
5,750 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
3,036 |
2,553 |
$17K |
| 92340 |
|
458 |
446 |
$9K |
| 92004 |
|
760 |
642 |
$7K |
| 92341 |
|
173 |
169 |
$5K |
| V2020 |
Vision svcs frames purchases |
6,071 |
4,843 |
$2K |
| V2100 |
Lens spher single plano 4.00 |
3,878 |
3,213 |
$990.86 |
| 92250 |
|
38 |
37 |
$868.75 |
| V2784 |
Lens polycarb or equal |
992 |
815 |
$254.60 |
| V2200 |
Lens spher bifoc plano 4.00d |
132 |
88 |
$187.52 |
| 92015 |
|
4,789 |
4,110 |
$19.94 |
| V2025 |
Eyeglasses delux frames |
3,025 |
2,454 |
$0.00 |
| V2520 |
Contact lens hydrophilic |
26 |
14 |
$0.00 |