All Medicaid billing entities listing PETTENGILL, KELLY (CREDENTIALING AND DATA MANAGEMENT) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Minnesota | 4 | $16K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | DISTINCTIVE EYEWEAR, LLC | MAPLE GROVE, MN | Optician | $13K |
| 2 | DISTINCTIVE EYEWEAR, LLC | GOLDEN VALLEY, MN | Eyewear Supplier | $2K |
| 3 | DISTINCTIVE EYEWEAR, LLC | ST. ANTHONY, MN | Optician | $701.43 |
| 4 | DISTINCTIVE EYEWEAR, LLC | MINNETONKA, MN | Optician | $602.16 |