Clinic
Door County Memorial Hospital
Door County Memorial Hospital was paid $1.49M by Medicaid between Jan 2018 and Dec 2024, across 27 billing codes. Its largest line is D1110, Prophylaxis - adult — 16% of everything it billed.
33Billing provider infoDOOR COUNTY MEMORIAL HOSPITAL
STURGEON BAY, WI 54235
STURGEON BAY, WI 54235
33aNPI1497079784assigned 03/16/2010
33bProvider typeDental Clinic/Center
28Total paid$1.49M
24GClaims59,796
24DCodes billed27
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Dental Clinic/Center providers in Wisconsin
Rank by total paid#17 of 51
Median peer was paid$1.07M
This provider vs. median1.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 10,023 | $217K | |
| 2019 | 8,658 | $167K | |
| 2020 | 6,439 | $133K | |
| 2021 | 8,760 | $192K | |
| 2022 | 8,803 | $261K | |
| 2023 | 9,214 | $294K | |
| 2024incomplete | 7,899 | $225K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 16% | 7,753 | 7,698 | $234K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 15% | 3,469 | 2,409 | $219K |
| D1206 | Topical application of fluoride varnish | 9.1% | 9,396 | 9,278 | $136K |
| D1120 | Dental cleaning, childProphylaxis - child | 8.1% | 5,030 | 4,977 | $120K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 7.8% | 2,450 | 1,719 | $117K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 7.4% | 7,287 | 7,210 | $110K |
| D1351 | Sealant - per tooth | 6.6% | 4,910 | 1,198 | $99K |
| D0140 | Limited oral evaluation - problem focused | 5.0% | 3,459 | 3,314 | $74K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 4.9% | 943 | 782 | $73K |
| D0274 | Bitewings - four radiographic images | 4.2% | 3,213 | 3,193 | $62K |
| D0210 | Intraoral - complete series of radiographic images | 2.6% | 723 | 719 | $38K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.4% | 1,512 | 1,498 | $36K |
15 more codes
| D0272 | Bitewings - two radiographic images | 2.3% | 2,352 | $35K |
| D0330 | Panoramic radiographic image | 2.3% | 1,131 | $34K |
| D7140 | Extraction, erupted tooth or exposed root | 2.1% | 832 | $31K |
| D0220 | Intraoral - periapical first radiographic image | 1.5% | 2,621 | $22K |
| D2331 | 1.3% | 353 | $19K | |
| D1354 | <1% | 762 | $7K | |
| D2335 | <1% | 75 | $5K | |
| D2330 | <1% | 128 | $5K | |
| D4346 | <1% | 42 | $4K | |
| D2394 | <1% | 53 | $4K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 430 | $3K |
| D0270 | <1% | 213 | $2K | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 98 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 0% | 548 | $0.00 |
| D0145 | Oral evaluation for a patient under three years of age | 0% | 13 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLALUZERNE, ANDREW (CFO)
| Provider | Location | Paid |
|---|---|---|
| Door County Memorial Hospital | Sturgeon Bay, WI | $7.48M |
| Door County Memorial Hospital | Sturgeon Bay, WI | $1.02M |
| Door County Memorial Hospital | Sister Bay, WI | $17K |
| Door County Memorial Hospital | Algoma, WI | $12K |
| Door County Memorial Hospital | Sturgeon Bay, WI | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.