DOOR COUNTY MEMORIAL HOSPITAL
NPI: 1578892857
· STURGEON BAY, WI 54235
· Rural Health Clinic/Center
· NPI assigned 12/15/2009
$1.02M
Total Medicaid Paid
Provider Details
| Authorized Official | LALUZERNE, ANDREW (CFO) |
| NPI Enumeration Date | 12/15/2009 |
Related Entities
Other providers sharing the same authorized official: LALUZERNE, ANDREW
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,986 |
$100K |
| 2019 |
4,587 |
$162K |
| 2020 |
3,074 |
$116K |
| 2021 |
3,718 |
$138K |
| 2022 |
4,667 |
$175K |
| 2023 |
4,595 |
$172K |
| 2024 |
3,183 |
$157K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
13,049 |
11,772 |
$438K |
| 99214 |
|
5,636 |
5,015 |
$278K |
| 90834 |
|
1,745 |
944 |
$72K |
| 99391 |
|
1,221 |
1,083 |
$68K |
| 99392 |
|
1,157 |
1,102 |
$66K |
| 99212 |
|
719 |
679 |
$20K |
| 99393 |
|
276 |
271 |
$15K |
| 99215 |
Prolong outpt/office vis |
178 |
157 |
$14K |
| 99308 |
|
295 |
288 |
$13K |
| 11721 |
|
329 |
310 |
$10K |
| 99309 |
|
165 |
162 |
$8K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
431 |
408 |
$7K |
| 96110 |
|
198 |
192 |
$3K |
| 90837 |
|
57 |
41 |
$3K |
| 0002A |
|
27 |
27 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
55 |
43 |
$849.85 |
| 90791 |
|
15 |
14 |
$830.80 |
| 0001A |
|
24 |
24 |
$809.37 |
| 0072A |
|
29 |
13 |
$532.51 |
| 99442 |
|
25 |
22 |
$487.11 |
| 90656 |
|
26 |
26 |
$320.10 |
| 90677 |
|
16 |
16 |
$199.20 |
| 90723 |
|
13 |
13 |
$198.90 |
| 96127 |
|
49 |
48 |
$155.81 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
23 |
20 |
$154.48 |
| 90647 |
|
12 |
12 |
$152.40 |
| 99188 |
|
13 |
12 |
$129.68 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
84 |
78 |
$54.60 |
| 94760 |
|
26 |
26 |
$34.90 |
| 90460 |
|
787 |
737 |
$0.00 |
| 91300 |
|
66 |
60 |
$0.00 |
| 90471 |
|
48 |
47 |
$0.00 |
| 91307 |
|
16 |
14 |
$0.00 |