Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › FAIRMONT › CUSTOM CLINIC, P.A.

CUSTOM CLINIC, P.A.

NPI: 1699859124 · FAIRMONT, MN 56031 · Family Medicine Physician · NPI assigned 10/24/2006

$26K
Total Medicaid Paid
938
Total Claims
617
Beneficiaries
4
Codes Billed
2018-01
First Month
2023-10
Last Month

Provider Details

Authorized OfficialBACHENBERG, TIMOTHY (PRESIDENT)
NPI Enumeration Date10/24/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 588 $4K
2019 62 $3K
2022 117 $7K
2023 171 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99349 171 81 $12K
99335 207 133 $11K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 545 391 $3K
99490 Ccm add 20min 15 12 $239.12