Medicaid Provider Spending

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

DISTINCTIVE EYEWEAR, LLC

NPI: 1104908649 · MINNETONKA, MN 55343 · Optician · NPI assigned 10/20/2006

$602.16
Total Medicaid Paid
36
Total Claims
25
Beneficiaries
1
Codes Billed
2018-08
First Month
2022-01
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 MAPLE GROVE MN $13K
DISTINCTIVE EYEWEAR, LLC GOLDEN VALLEY MN $2K
DISTINCTIVE EYEWEAR, LLC ST. ANTHONY MN $701.43

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12 $0.00
2022 24 $602.16

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92340 Fitting of spectacles, except for aphakia; monofocal 36 25 $602.16