SHOPKO STORES OPERATING CO. LLC
NPI: 1942252465
· LINCOLN, NE 68512
· 332H00000X
$167K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,249 |
$129K |
| 2019 |
936 |
$35K |
| 2021 |
114 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
|
852 |
817 |
$52K |
| V2020 |
Vision svcs frames purchases |
1,125 |
1,069 |
$49K |
| 92014 |
|
384 |
370 |
$20K |
| V2100 |
Lens spher single plano 4.00 |
639 |
618 |
$17K |
| 92015 |
|
864 |
832 |
$13K |
| 92004 |
|
140 |
138 |
$8K |
| 92002 |
|
101 |
100 |
$4K |
| V2784 |
Lens polycarb or equal |
175 |
175 |
$4K |
| V2101 |
Single visn sphere 4.12-7.00 |
19 |
19 |
$323.40 |