Medicaid Provider Spending

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

DISTINCTIVE EYEWEAR, LLC

NPI: 1457690133 · GOLDEN VALLEY, MN 55427 · Eyewear Supplier · NPI assigned 01/31/2013

$2K
Total Medicaid Paid
84
Total Claims
83
Beneficiaries
1
Codes Billed
2019-04
First Month
2022-06
Last Month

Provider Details

Authorized OfficialPETTENGILL, KELLY (CREDENTIALING AND DATA MANAGEMENT)
NPI Enumeration Date01/31/2013

Related Entities

Other providers sharing the same authorized official: PETTENGILL, KELLY

ProviderCityStateTotal Paid
DISTINCTIVE EYEWEAR, LLC MAPLE GROVE MN $13K
DISTINCTIVE EYEWEAR, LLC ST. ANTHONY MN $701.43
DISTINCTIVE EYEWEAR, LLC MINNETONKA MN $602.16

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 15 $356.96
2020 17 $431.25
2021 24 $578.58
2022 28 $702.52

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92340 Fitting of spectacles, except for aphakia; monofocal 84 83 $2K