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.

Opportunity Foundation Inc (NPI 1215442231)

Field	Value
Entity Type	Organization
Organization	Opportunity Foundation Inc
Address	612 E Broadway
City	Williston
State	ND
ZIP	58801
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	December 13, 2017

Payer Source	Total Paid
Medicaid	$26.3M
Medicare	$0

Key Findings

OPPORTUNITY FOUNDATION INC is registered under the Developmentally Disabled Services Day Training Agency taxonomy and has an NPI enumerated 2017-12-13 (~9 years ago), indicating it has been operating with billing visibility for nearly a decade. The taxonomy and tenure are consistent with a provider offering long-term habilitation and day-training services to individuals with developmental disabilities.

This provider reports no Medicare billing on file and $26.3M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) operation in the available claims data. Analysts should treat Medicaid policy and state waiver rules as the primary external factors influencing this provider’s revenue.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 64.9% of the provider’s total Medicaid revenue. Those top drivers are T2016 ($9.3M, 35.5% of Medicaid revenue), T2021 ($4M, 15.1% of Medicaid revenue), and W0725 ($3.8M, 14.3% of Medicaid revenue), showing the bulk of receipts come from a small set of service lines.

The code mix and code descriptions point to core operations in habilitation and day services: T2016 (Habilitation, residential, waiver; per diem), T2021 (Day habilitation, waiver; per 15 minutes) and T2019 (Habilitation, supported employment, waiver; per 15 minutes) together imply the provider delivers residential habilitation, day habilitation and supported employment supports to waiver-enrolled beneficiaries. This aligns with its Developmentally Disabled Services Day Training Agency taxonomy and suggests operations centered on programmatic, time-based supports rather than episodic medical procedures.

State-level competitive standing on the top revenue codes is modest rather than dominant. For T2016 the provider ranks #11 of 29 (64th percentile, described as typical, unremarkable volume), for T2021 it ranks #17 of 26 (36th percentile, typical), and for W0725 it ranks #18 of 25 (29th percentile, typical); these percentiles indicate it is a regular regional participant but not a top outlier in North Dakota.

There are pockets of relatively stronger standing within the Medicaid mix: T2019 (supported employment) generated $2.4M (9.2% of Medicaid revenue) and ranks #6 of 20 (74th percentile), indicating above-typical placement statewide for supported employment services. This suggests the provider may have competitive capabilities or program emphasis in supported employment relative to peers.

Unit-price patterns show some high-dollar-per-claim services within the mix that materially affect revenue despite lower claim counts. For example, W0725 had 770 claims with a $4882 avg paid/claim producing $3.8M, and other codes such as W0260 ($4191 avg paid/claim, $331.1K) and W0200 ($1728 avg paid/claim, $330K) reflect concentrated, high-unit payments that contribute meaningfully to total Medicaid revenue. These high unit rates combined with modest claim counts indicate revenue drivers are not purely volumetric but also rate-dependent.

Operationally, the combination of Medicaid-only revenue ($26.3M) and a top-three-code concentration of 64.9% implies exposure to state Medicaid reimbursement changes and waiver policy shifts. For payer/provider analysts, this profile signals that monitoring state waiver rules, per-diem and per-15-minute rate adjustments, and the provider’s ability to sustain or diversify service lines will be key 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.

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	35,620	$260	$9.3M
T2021	Day habilitation, waiver; per 15 minutes	25,530	$160	$4M
W0725	N/A	770	$4,880	$3.8M
W0715	N/A	7,140	$420	$3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	23,680	$100	$2.4M
W0710	N/A	4,460	$190	$855.7K
W0500	N/A	4,070	$190	$752.2K
W0300	N/A	510	$1,010	$511.1K
W0510	N/A	1,780	$280	$504.1K
W0260	N/A	80	$4,190	$331.1K

Showing 1–10 of 15

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

Opportunity Foundation Inc — 0 of 15 codes 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	11	30	21,220	$400	$14.1M
W0725	N/A	18	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	17	30	32,410	$170	$6.6M
W0300	N/A	11	10	2,370	$630	$4M
W0715	N/A	11	30	6,250	$450	$3.8M
S5125	Attendant care services; per 15 minutes	14	20	10,750	$180	$2.7M
W0500	N/A	6	10	10,780	$140	$2M
T2019	Habilitation, supported employment, waiver; per 15 minutes	6	20	11,310	$80	$1.2M
W0700	N/A	16	20	3,430	$280	$1.2M
W0260	N/A	14	20	150	$4,920	$1M

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Opportunity Foundation Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medscan Laboratory Inc	ND	Clinical Medical Laboratory	$7.2M	$14.8M
Mercy Medical Center	ND	Critical Access Hospital	$0	$4M
City Of Williston	ND	Land Ambulance	$398.3K	$2M
Opportunity Foundation Inc	ND	Early Intervention Provider Agency	$0	$1.8M
Mark Raymond	ND	Ophthalmology Physician	$1.7M	$0
Mercy Medical Center	ND	Clinic/Center	$0	$1.3M
Summit Counseling Inc	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.2M
Northwest Behavioral Health Clinic	ND	Adult Mental Health Clinic/Center	$0	$872.7K
Nathan Smith	ND	Pediatric Dentistry	$0	$712.5K
Ideal Option, PLLC	ND	Clinic/Center	$0	$690.9K

Opportunity Foundation Inc — Billing Profile & Reimbursement Data

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Opportunity Foundation Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References