SHOPKO STORES OPERATING CO LLC

NPI: 1316108376 · SUSSEX, WI 53089 · Eyewear Supplier · NPI assigned 06/23/2008

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official BETTIGA, MICHAEL controls 20+ related entities in our dataset. Read more

$211K

Total Medicaid Paid

6,254

Total Claims

6,228

Beneficiaries

Codes Billed

2018-01

First Month

2019-04

Last Month

Provider Details

Authorized Official	BETTIGA, MICHAEL (SR. VICE PRESIDENT HEALTH SERVICES)
NPI Enumeration Date	06/23/2008

Other providers sharing the same authorized official: BETTIGA, MICHAEL

Provider	City	State	Total Paid
SHOPKO STORES OPERATING CO. LLC	BELLEVUE	NE	$466K
SHOPKO STORES OPERATING CO. LLC	NORTH PLATTE	NE	$305K
SHOPKO STORES OPERATING CO. LLC	LINCOLN	NE	$254K
SHOPKO STORES OPERATING CO. LLC	OMAHA	NE	$225K
SHOPKO STORES OPERATING CO. LLC	LINCOLN	NE	$167K
SHOPKO STORES OPERATING CO. LLC	TWIN FALLS	ID	$97K
SHOPKO STORES OPERATING CO. LLC	LINCOLN	NE	$91K
SHOPKO STORES OPERATING CO. LLC	SAINT CLOUD	MN	$57K
SHOPKO STORES OPERATING CO. LLC	LINCOLN	NE	$56K
SHOPKO STORES OPERATING CO. LLC	RACINE	WI	$51K
SHOPKO STORES OPERATING CO. LLC	GRAND ISLAND	NE	$47K
SHOPKO STORES OPERATING CO LLC	SALEM	OR	$46K
SHOPKO STORES OPERATING CO. LLC	MARSHFIELD	WI	$43K
SHOPKO STORES OPERATING CO. LLC	EAU CLAIRE	WI	$33K
SHOPKO STORES OPERATING CO. LLC	BEAVER DAM	WI	$29K
SHOPKO STORES OPERATING CO. LLC	NORFOLK	NE	$26K
SHOPKO STORES OPERATING CO. LLC	GREEN BAY	WI	$23K
SHOPKO STORES OPERATING CO. LLC	BOISE	ID	$18K
SHOPKO STORES OPERATING CO. LLC	MONONA	WI	$18K
SHOPKO STORES OPERATING CO. LLC	WORTHINGTON	MN	$13K

Year	Claims	Total Paid
2018	4,321	$145K
2019	1,933	$66K

Code	Description	Claims	Beneficiaries	Total Paid
V2020	Frames, purchases	2,529	2,519	$84K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	1,581	1,574	$69K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	1,634	1,626	$43K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	200	200	$9K
V2784	Lens, polycarbonate or equal, any index, per lens	279	279	$6K
92340	Fitting of spectacles, except for aphakia; monofocal	31	30	$647.66