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 1356453484)

Field	Value
Entity Type	Organization
Organization	Pride Inc.
Address	1200 Missouri Ave
City	Bismarck
State	ND
ZIP	58504
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$71.1M
Medicare	$0

Key Findings

PRIDE INC. is effectively a single‑payer provider: there is no Medicare billing on file while total reported Medicaid revenue is $71.1M. This concentration means the organization’s financial footprint and payer negotiations are driven almost entirely by Medicaid program rules and reimbursement, not Medicare participation.

Revenue is highly concentrated in a small set of Medicaid procedure lines: the top three codes (T2016, W0725, T2021) together account for 79.1% of the provider’s total Medicaid revenue. Individually, T2016 accounts for $31M (43.6%), W0725 for $16M (22.5%), and T2021 for $9.3M (13.1%), so changes to reimbursement or utilization for any of these three codes would materially affect overall revenue.

The code mix indicates PRIDE INC. operates predominately as a developmental disability habilitation and residential services provider. High revenue from T2016 (Habilitation, residential, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes), together with meaningful volumes in T2019 (supported employment) and prevocational code T2047, points to a program portfolio focused on day‑to‑day habilitation, residential waiver placement, supported employment, and attendant/ respite services rather than episodic medical care.

PRIDE INC. shows a strong competitive position in several in‑state habilitation codes: T2016 ranks #4 of 29 providers in-state (89th percentile; notably above typical state volume for this code) and T2021 ranks #4 of 26 providers in-state (88th percentile; typical, unremarkable volume for this code). These rankings indicate PRIDE is a major state player for both residential and day habilitation services, while W0725 ($16M, 22.5% of revenue) is a mid‑level performer (ranks #7 of 25, 75th percentile; typical, unremarkable volume for this code).

Beyond the top three, PRIDE posts several other above‑median in‑state positions that reinforce specialization: T2019 ($3.1M, 4.3% of revenue) ranks #3 of 20 (89th percentile; typical, unremarkable volume), W0710 ($1.7M, 2.4% of revenue) ranks #2 of 14 (92th percentile; typical, unremarkable volume), and S5150 (respite) ranks #2 of 10 (89th percentile; typical, unremarkable volume). These placements suggest the provider captures strong share in multiple waiver‑related service lines within North Dakota.

The payment/unit mix shows a blend of per‑diem and minute‑based billing driving revenue: T2016 is per diem and is the single largest revenue driver, while T2021, T2019, S5125 and T2047 are billed per 15 minutes. This pattern is consistent with high volumes of ongoing day‑to‑day habilitation and residential care where staffing time and daily placements determine revenue more than discrete clinical episodes.

PRIDE’s NPI tenure is long‑standing — enumerated on 2006-08-31 (~20 years ago) — which, combined with its concentrated Medicaid revenue and high in‑state ranks on core waiver habilitation codes, suggests an established presence in state waiver program networks and provider markets. The duration of enrollment increases the likelihood that observed code volumes reflect mature program offerings rather than a short‑term entrant’s mix.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	97,360	$320	$31M
W0725	N/A	2,810	$5,690	$16M
T2021	Day habilitation, waiver; per 15 minutes	62,930	$150	$9.3M
W0715	N/A	11,600	$440	$5.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	31,840	$100	$3.1M
W0710	N/A	6,420	$270	$1.7M
S5125	Attendant care services; per 15 minutes	7,660	$130	$988.3K
T2047	Habilitation, prevocational, waiver; per 15 minutes	10,680	$90	$961.3K
W0720	N/A	3,290	$290	$955.3K
W0700	N/A	4,270	$190	$799.1K

Showing 1–10 of 16

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 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	4	30	21,220	$400	$14.1M
W0725	N/A	7	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	4	30	32,410	$170	$6.6M
W0715	N/A	6	30	6,250	$450	$3.8M
S5125	Attendant care services; per 15 minutes	12	20	10,750	$180	$2.7M
T2019	Habilitation, supported employment, waiver; per 15 minutes	3	20	11,310	$80	$1.2M
W0700	N/A	6	20	3,430	$280	$1.2M
T2017	Habilitation, residential, waiver; 15 minutes	11	10	4,870	$100	$1M
T2047	Habilitation, prevocational, waiver; per 15 minutes	4	10	8,770	$90	$988.3K
W0720	N/A	4	10	2,730	$190	$847.3K

Showing 1–10 of 16

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
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	$6.6M
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