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 North Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Edgewood Sartell LLC (NPI 1093253346)

Field	Value
Entity Type	Organization
Organization	Edgewood Sartell LLC
Address	322 Demers Ave
City	Grand Forks
State	ND
ZIP	58201
Taxonomy	Assisted Living Facility
NPI Enumerated	February 7, 2017

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Key Findings

EDGEWOOD SARTELL LLC is categorized as an Assisted Living Facility and has an NPI enumeration date of 2017-02-07 (~9 years ago), indicating several years of operational tenure under the current registration. This longevity supports that the billing patterns observed reflect an established service line rather than a short-lived provider activity.

This provider has no Medicare billing on file, making its revenue base effectively single-payer; all documented federal billing activity is through Medicaid with total Medicaid revenue of $7.1M. The absence of Medicare activity means analyses of payer mix and reimbursement exposure should focus on Medicaid policy and waiver program dynamics for this entity.

Revenue is extremely concentrated: the precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and in practice that concentration is entirely captured by a single code. Such concentration means the provider’s financial profile is driven by a single service line rather than a diversified set of Medicaid billable services.

T2031 (Assisted living; waiver, per diem) is the dominant and sole reported Medicaid driver for this provider, with 48.2K claims, $147 avg paid/claim, and $7.1M revenue (100.0% of this provider's total Medicaid revenue). This code mix and the per-diem reimbursement pattern are consistent with ongoing residential assisted-living waiver services rather than episodic medical procedures or short-term therapy episodes.

On a statewide competitive basis, EDGEWOOD SARTELL LLC ranks #1 of 5 providers in-state for T2031 (100th percentile; notably above typical state volume for this code), signaling a dominant market position among in-state assisted-living waiver per-diem billers. That ranking suggests the provider is a major participant in North Dakota’s waiver-funded assisted living space and a key peer to monitor for capacity and rate changes.

The dataset labels this provider as “notably above typical” for state volume on T2031, which corroborates the rank and volume figures and identifies it as a statistical high-volume outlier in Medicaid assisted-living per-diem billing. Analysts should treat reported volumes for T2031 as materially different from the state norm when benchmarking utilization or average paid-per-claim metrics.

Operational and reimbursement risk is concentrated: because T2031 accounts for 100.0% of Medicaid revenue and there is no Medicare activity, the provider’s financial exposures are highly sensitive to changes in waiver eligibility, per-diem Medicaid rates, or state-level policy adjustments affecting assisted living services. Monitoring state waiver policy, Medicaid rate-setting, and any shifts in in-state competitor behavior will be essential to assessing future revenue stability.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2031	Assisted living; waiver, per diem	48,200	$150	$7.1M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Edgewood Sartell LLC — 1 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2031	Assisted living; waiver, per diem	1	10	9,490	$120	$2.4M

Nearby Providers

Other providers in the same ZIP code as Edgewood Sartell LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Development Homes Inc	ND	Community/Behavioral Health Agency	$0	$53.9M
Altru Health System	ND	Clinic/Center	$0	$29.7M
Altru Health System	ND	General Acute Care Hospital	$0	$18.7M
L.i.s.t.e.n. Inc	ND	Community/Behavioral Health Agency	$0	$9.4M
Peterson Medical Clinics, LLC	ND	Multi-Specialty Clinic/Center	$0	$8.8M
Northeast Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.7M
Spectra Health	ND	Federally Qualified Health Center (FQHC)	$0	$5.5M
Little Miracles, Inc.	ND	Multi-Specialty Clinic/Center	$0	$5.5M
Anil Potti	ND	Hematology & Oncology Physician	$4.9M	$0
Valley Oral & Facial Surgery PC	ND	Oral and Maxillofacial Surgery Clinic/Center	$0	$4.5M

Edgewood Sartell LLC — Billing Profile & Reimbursement Data

Sign up for Edgewood Sartell LLC — Billing Profile & Reimbursement Data policy alerts

Edgewood Sartell LLC — Billing Profile & Reimbursement Data

Sign up for Edgewood Sartell LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References