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.

North Dakota Autism Center, Inc (NPI 1366032955)

Field	Value
Entity Type	Organization
Organization	North Dakota Autism Center, Inc
Address	647 13th Ave E Ste A
City	West Fargo
State	ND
ZIP	58078
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 19, 2021

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $5.7M in lifetime Medicaid revenue, so its financial footprint is effectively single-payer Medicaid rather than a mixed Medicare/Medicaid operation. That payer concentration aligns with its taxonomy as a Community/Behavioral Health Agency and suggests the business primarily serves populations covered by Medicaid.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue. Such concentration implies a narrow service mix where changes to a small number of codes, rates, or utilization patterns could materially affect overall revenue.

Code W0300 is the single largest Medicaid revenue driver with 5.4K claims, a $602 avg paid/claim, and $3.3M in revenue, representing 57.3% of this provider's total Medicaid revenue. The file notes no description is available for W0300, limiting precise clinical interpretation, but the relatively high $602 avg paid/claim indicates it is a high-dollar-per-claim component of the agency's Medicaid business; this code ranks #5 of 13 providers in-state (67th percentile; typical, unremarkable volume for this code).

S5125 (Attendant care services; per 15 minutes) accounts for 16.5K claims, a $148 avg paid/claim, and $2.4M in revenue, representing 42.7% of this provider's total Medicaid revenue. The per-15-minute billing cadence and the large claim count point to a labor-intensive, time-based service delivery model typical of attendant/home-and-community-based supports; S5125 ranks #5 of 18 providers in-state (76th percentile; typical, unremarkable volume for this code).

Taken together, W0300 (57.3%) and S5125 (42.7%) explain the entirety of the provider's Medicaid revenue mix reported here, indicating the agency operates with a narrow set of high-dependency service lines rather than a diversified portfolio of billable codes. For payer or provider analysts, that pattern flags concentrated operational dependencies—particularly workforce and code-definition stability—as central to financial performance.

State competitive standing is modestly above median for these key codes: the provider is mid-ranked statewide (67th percentile for W0300 and 76th percentile for S5125) but is not a dominant outlier. These ranks characterize the agency as a solid mid-tier participant in its in-state market for both codes rather than a leading statewide provider.

The billing mix (heavy S5125 utilization plus a high-dollar W0300) implies an operational model focused on direct care delivery and time-based attendant services, consistent with an autism-focused behavioral health agency. Analysts should expect operational drivers such as staffing levels, visit volume, and documentation to be primary levers affecting revenue performance.

The provider's NPI was enumerated on 2021-01-19 (~5 years ago), indicating relatively recent enrollment compared with longer-established institutions; this tenure suggests it may still be in an earlier growth or stabilization phase of its Medicaid business. Given the narrow revenue base and Medicaid-only billing, monitoring enrollment trends, state policy changes affecting attendant care, and any future diversification of billed codes will be important for assessing medium-term stability.

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
W0300	N/A	5,430	$600	$3.3M
S5125	Attendant care services; per 15 minutes	16,450	$150	$2.4M

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

North Dakota Autism Center, 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
W0300	N/A	5	10	2,370	$630	$4M
S5125	Attendant care services; per 15 minutes	5	20	10,750	$180	$2.7M

Nearby Providers

Other providers in the same ZIP code as North Dakota Autism Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
West Fargo Public School District 6	ND	Home Health Registered Nurse	$0	$2.6M
Fm Endoscopy Center LLC	ND	Ambulatory Surgical Clinic/Center	$2.5M	$0
Michael Greenwood	ND	Ophthalmology Physician	$530.7K	$0
Innovis Health, LLC	ND	Multi-Specialty Clinic/Center	$0	$235K
Alex Wohl	ND	Physical Therapist	$222.1K	$0
Optimal Chiropractic PLLC	ND	Chiropractor	$0	$221K
Kci Usa, Inc.	ND	Durable Medical Equipment & Medical Supplies	$0	$185.9K
Innovis Health LLC	ND	Family Medicine Physician	$0	$157.3K
Matthew Friederichs	ND	Sports Medicine (Orthopaedic Surgery) Physician	$126K	$0

North Dakota Autism Center, Inc — Billing Profile & Reimbursement Data

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North Dakota Autism Center, 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