Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › MAPLE GROVE › DISTINCTIVE EYEWEAR, LLC

DISTINCTIVE EYEWEAR, LLC

NPI: 1043392632 · MAPLE GROVE, MN 55369 · Optician · NPI assigned 10/20/2006

$13K
Total Medicaid Paid
582
Total Claims
567
Beneficiaries
1
Codes Billed
2018-02
First Month
2022-09
Last Month

Provider Details

Authorized OfficialPETTENGILL, KELLY (CREDENTIALING AND DATA MANAGEMENT)
NPI Enumeration Date10/20/2006

Related Entities

Other providers sharing the same authorized official: PETTENGILL, KELLY

ProviderCityStateTotal Paid
DISTINCTIVE EYEWEAR, LLC GOLDEN VALLEY MN $2K
DISTINCTIVE EYEWEAR, LLC ST. ANTHONY MN $701.43
DISTINCTIVE EYEWEAR, LLC MINNETONKA MN $602.16

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 90 $497.58
2019 96 $3K
2020 46 $1K
2021 207 $5K
2022 143 $4K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92340 Fitting of spectacles, except for aphakia; monofocal 582 567 $13K