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.

Pride Inc (NPI 1225638992)

Field	Value
Entity Type	Organization
Organization	Pride Inc
Address	1200 Missouri Ave
City	Bismarck
State	ND
ZIP	58504
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 30, 2020

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

Key Findings

PRIDE INC reports no Medicare billing on file and $6.6M in lifetime Medicaid revenue, making it effectively a single‑payer (Medicaid) operator in the available dataset. Its NPI was enumerated on 2020-10-30 (~6 years ago), indicating a relatively recent enrollment date compared with longer-tenured competitors.

Revenue for this provider is extremely concentrated: the precomputed top 3 Medicaid codes account for 100.0% of its total Medicaid revenue, with two listed codes—W0725 and T2016—each contributing roughly half of the $6.6M. W0725 is reported at $3.3M (50.5% of Medicaid revenue) and T2016 is reported at $3.3M (49.5% of Medicaid revenue).

The provider taxonomy is Community/Behavioral Health Agency and the code mix reinforces a residential habilitation focus: T2016 is explicitly labeled “Habilitation, residential, waiver; per diem,” suggesting day-to-day residential or waiver habilitation services are the core service line. W0725 has no description available in the file, but its presence alongside T2016 and the payment pattern suggests complementary higher‑cost residential or bundled services rather than outpatient therapy.

Code‑level activity shows distinct operational patterns: W0725 has 918 claims with a $3630 avg paid/claim yielding $3.3M in revenue, while T2016 has 11K claims with a $298 avg paid/claim also yielding $3.3M. This pair indicates a mix of relatively low-frequency, high-dollar claims (W0725) and high-frequency, low-dollar per‑diem claims (T2016), consistent with residential habilitation models that combine per‑diem staffing with episodic higher-cost events.

Competitive standing within the state is modest for both principal codes: W0725 ranks #14 of 25 providers in-state (46th percentile; labeled “typical, unremarkable volume”) and T2016 ranks #17 of 29 providers in-state (43th percentile; labeled “typical, unremarkable volume”). These ranks imply PRIDE INC is not a dominant market leader for these codes but participates at a middle‑tier level compared with in‑state peers.

The financial profile shows notable concentration risk: essentially all Medicaid revenue is tied to two codes that reflect the same residential habilitation service line. Any significant policy, rate, or utilization changes affecting per‑diem waiver habilitation or the high-dollar service represented by W0725 could materially impact PRIDE INC’s revenue given the lack of Medicare diversification and narrow service mix.

Despite being enumerated ~6 years ago, PRIDE INC has established steady Medicaid billing flows sufficient to generate $6.6M in lifetime Medicaid revenue concentrated in residential habilitation services. The combination of its taxonomy, code mix, and payment patterns suggests an operational focus on sustained per‑diem care supplemented by higher‑value events rather than broad outpatient or Medicare-facing service lines.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W0725	N/A	920	$3,630	$3.3M
T2016	Habilitation, residential, waiver; per diem	10,970	$300	$3.3M

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

Pride Inc — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	17	30	21,220	$400	$14.1M
W0725	N/A	14	30	1,380	$2,520	$9.9M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pride Inc.	ND	Developmentally Disabled Services Day Training Agency	$0	$71.1M
Sanford Bismarck	ND	Multi-Specialty Clinic/Center	$0	$43.9M
Support Systems, Inc.	ND	Community/Behavioral Health Agency	$0	$37.7M
Bridging The Dental Gap Inc	ND	Dental Clinic/Center	$0	$6.8M
Pride Inc.	ND	Community/Behavioral Health Agency	$0	$5.7M
Pride Inc	ND	Community/Behavioral Health Agency	$0	$4.9M
Dakota Surgery & Laser Center LLC	ND	Ambulatory Surgical Clinic/Center	$1.7M	$28.4K
The Kid's Therapy Center LLC	ND	Community/Behavioral Health Agency	$0	$1.5M
City Of Bismarck	ND	State or Local Public Health Clinic/Center	$111.3K	$1.3M
Dakota Eye Institute PC	ND	Ophthalmology Physician	$0	$1.2M

Pride Inc — Billing Profile & Reimbursement Data

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Pride 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