SHOPKO STORES OPERATING CO. LLC
NPI: 1467404699
· LINCOLN, NE 68510
· 332H00000X
$254K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
5,267 |
$181K |
| 2019 |
883 |
$34K |
| 2020 |
153 |
$6K |
| 2021 |
774 |
$28K |
| 2022 |
135 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
1,530 |
1,490 |
$76K |
| V2020 |
Vision svcs frames purchases |
1,734 |
1,685 |
$63K |
| 92014 |
|
681 |
673 |
$35K |
| V2100 |
Lens spher single plano 4.00 |
867 |
846 |
$24K |
| 92015 |
|
1,149 |
1,132 |
$18K |
| 92004 |
|
285 |
281 |
$15K |
| 92002 |
|
321 |
320 |
$12K |
| V2101 |
Single visn sphere 4.12-7.00 |
308 |
308 |
$5K |
| V2200 |
Lens spher bifoc plano 4.00d |
85 |
84 |
$3K |
| 92012 |
|
32 |
32 |
$1K |
| 92341 |
|
17 |
17 |
$900.85 |
| V2784 |
Lens polycarb or equal |
203 |
202 |
$660.16 |