Clinic
Door County Memorial Hospital
Door County Memorial Hospital was paid $1.02M by Medicaid between Jan 2018 and Dec 2024, across 33 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% of everything it billed.
33Billing provider infoDOOR COUNTY MEMORIAL HOSPITAL
STURGEON BAY, WI 54235
STURGEON BAY, WI 54235
33aNPI1578892857assigned 12/15/2009
33bProvider typeRural Health Clinic/Center
28Total paid$1.02M
24GClaims26,810
24DCodes billed33
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Wisconsin
Rank by total paid#9 of 84
Median peer was paid$117K
This provider vs. median8.7×
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 | 2,986 | $100K | |
| 2019 | 4,587 | $162K | |
| 2020 | 3,074 | $116K | |
| 2021 | 3,718 | $138K | |
| 2022 | 4,667 | $175K | |
| 2023 | 4,595 | $172K | |
| 2024incomplete | 3,183 | $157K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 43% | 13,049 | 11,772 | $438K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 27% | 5,636 | 5,015 | $278K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 7.0% | 1,745 | 944 | $72K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 6.6% | 1,221 | 1,083 | $68K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.4% | 1,157 | 1,102 | $66K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.9% | 719 | 679 | $20K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.5% | 276 | 271 | $15K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.4% | 178 | 157 | $14K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 1.3% | 295 | 288 | $13K |
| 11721 | <1% | 329 | 310 | $10K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 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 | <1% | 431 | 408 | $7K |
21 more codes
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 198 | $3K |
| 90837 | Psychotherapy session, about an hour | <1% | 57 | $3K |
| 0002A | <1% | 27 | $1K | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 55 | $849.85 |
| 90791 | Psychiatric diagnostic evaluation | <1% | 15 | $830.80 |
| 0001A | <1% | 24 | $809.37 | |
| 0072A | <1% | 29 | $532.51 | |
| 99442 | <1% | 25 | $487.11 | |
| 90656 | <1% | 26 | $320.10 | |
| 90677 | <1% | 16 | $199.20 | |
| 90723 | <1% | 13 | $198.90 | |
| 96127 | <1% | 49 | $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 | <1% | 23 | $154.48 |
| 90647 | <1% | 12 | $152.40 | |
| 99188 | <1% | 13 | $129.68 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 84 | $54.60 |
| 94760 | <1% | 26 | $34.90 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 787 | $0.00 |
| 91300 | 0% | 66 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 48 | $0.00 |
| 91307 | 0% | 16 | $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 | $1.49M |
| 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.