Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Wisconsin (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Door County Memorial Hospital (NPI 1093743874)

Door County Memorial Hospital is a critical access hospital provider located in Sturgeon Bay, Wisconsin. This profile covers 0 Medicare and 146 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Door County Memorial Hospital
Address	323 S 18th Ave
City	Sturgeon Bay
State	WI
ZIP	54235
Taxonomy	Critical Access Hospital
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

146 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10,090	$170	$1.7M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3,200	$420	$1.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	5,200	$170	$905.3K
99281	The provider sees a patient for the lowest level emergency department visit.	2,950	$180	$538.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	1,420	$240	$344.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,330	$250	$335.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,260	$250	$310.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	5,180	$50	$243.6K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	9,110	$20	$191.3K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,200	$80	$180.4K

Showing 1–10 of 146

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Door County Memorial Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

146 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	69	140	3,200	$160	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	82	360	1,550	$70	$614.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	170	430	760	$60	$484.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	44	190	1,790	$90	$390.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	85	140	2,200	$90	$358.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	66	260	3,590	$20	$232.2K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	78	110	1,280	$90	$224.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	104	220	1,140	$70	$213.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	100	220	980	$80	$210.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	708	1,630	270	$40	$205.3K

Showing 1–10 of 146

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Door County Memorial Hospital	WI	Dental Clinic/Center	$0	$1.5M
Ajit Chary	IL	Pulmonary Disease Physician	$101.4K	$0
Delbert Rogers	WI	Family Medicine Physician	$84.7K	$0
Minoudokht Azimi-zavarei	WI	Internal Medicine Physician	$75.3K	$0
Scott Harter	AZ	Anesthesiology Physician	$47.9K	$0
Nima Hani	UT	Critical Care Medicine (Internal Medicine) Physician	$44.8K	$670
Victoria Burger	WI	Certified Registered Nurse Anesthetist	$10.5K	$0
Jose Ochoa	TX	Critical Care Medicine (Internal Medicine) Physician	$10.3K	$0
Karen Stanlaw	HI	Emergency Medicine Physician	$9.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Door-door County Library	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
County Of Door-door County Library	WI	Land Ambulance	$405.9K	$237.6K
Cathleen Keltgen	WI	Chiropractor	$74K	$383.2K
Diane Thaler	WI	Dermatology Physician	$194K	$0
Wisconsin Cvs Pharmacy, L.L.C.	WI	Pharmacy	$146.8K	$2.4K
Bradley Burkart	WI	Podiatrist	$108.9K	$6.6K
Kurt Harris	WI	Diagnostic Radiology Physician	$98.9K	$0
John Paulsen	WI	Optometrist	$70.5K	$0
Annika Paulsen	WI	Optometrist	$68.6K	$0
Luke Staudenmaier	WI	Chiropractor	$67.8K	$0

Door County Memorial Hospital — Billing Profile & Reimbursement Data

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Door County Memorial Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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