SHOPKO STORES OPERATING CO. LLC
NPI: 1558313783
· BELLEVUE, NE 68005
· 332H00000X
$466K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
4,876 |
$161K |
| 2019 |
847 |
$30K |
| 2021 |
3,160 |
$117K |
| 2022 |
2,540 |
$97K |
| 2023 |
1,471 |
$62K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
2,588 |
2,541 |
$125K |
| V2020 |
Vision svcs frames purchases |
2,929 |
2,872 |
$122K |
| 92014 |
|
1,043 |
1,029 |
$60K |
| V2100 |
Lens spher single plano 4.00 |
1,964 |
1,926 |
$54K |
| 92004 |
|
589 |
582 |
$36K |
| 92015 |
|
2,007 |
1,970 |
$34K |
| V2784 |
Lens polycarb or equal |
1,073 |
1,066 |
$18K |
| V2101 |
Single visn sphere 4.12-7.00 |
401 |
400 |
$7K |
| 92002 |
|
124 |
124 |
$4K |
| 92012 |
|
95 |
92 |
$3K |
| V2200 |
Lens spher bifoc plano 4.00d |
68 |
65 |
$3K |
| 92341 |
|
13 |
12 |
$526.36 |