Medicaid Provider Spending

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

NPI: 1548342124 · ST. ANTHONY, MN 55421 · Optician · NPI assigned 10/20/2006

$701.43
Total Medicaid Paid
38
Total Claims
38
Beneficiaries
1
Codes Billed
2018-04
First Month
2019-08
Last Month

Provider Details

Authorized OfficialPETTENGILL, KELLY (CREDENTIALING & 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 MINNETONKA MN $602.16

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 25 $352.53
2019 13 $348.90

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
92340 Fitting of spectacles, except for aphakia; monofocal 38 38 $701.43