SHOPKO STORES OPERATING CO. LLC

NPI: 1336191311 · KENNEWICK, WA 99336 · Optometrist · NPI assigned 05/17/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$4K

Total Medicaid Paid

167

Total Claims

166

Beneficiaries

Codes Billed

2018-01

First Month

2018-08

Last Month

Provider Details

Authorized Official	BETTIGA, MICHAEL (SR. VICE PRESIDENT HEALTH SERVICES)
NPI Enumeration Date	05/17/2006

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	167	$4K

Code	Description	Claims	Beneficiaries	Total Paid
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	37	37	$2K
92015	Determination of refractive state	102	102	$1K
92340	Fitting of spectacles, except for aphakia; monofocal	28	27	$569.91