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.

Poppy's Promise LLC (NPI 1386234508)

Field	Value
Entity Type	Organization
Organization	Poppy's Promise LLC
Address	1615 Capitol Way
City	Bismarck
State	ND
ZIP	58501
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 21, 2021

Payer Source	Total Paid
Medicaid	$5.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available data: there is no Medicare billing on file and all reported federal payer revenue is Medicaid, with total Medicaid revenue of $5.6M. The absence of Medicare activity means analyses should treat POPPY'S PROMISE LLC as a Medicaid-focused operator rather than a mixed Medicare/Medicaid provider.

Revenue is highly concentrated in a very small set of time-based personal care codes: the precomputed top 3 Medicaid codes account for 99.5% of this provider's total Medicaid revenue. That extreme concentration indicates the organization's Medicaid business is dominated by a narrowly defined set of service lines rather than a diversified mix of procedure types.

The dominant service line is S5125 (Attendant care services; per 15 minutes), which generated $4.1M and represents 73.1% of the provider's Medicaid revenue. This share and dollar amount show the organization primarily operates as an attendant/personal care provider delivering time‑based hands‑on services rather than episodic clinical procedures.

A second major revenue driver is W0300, which generated $1.4M (25.2% of Medicaid revenue) despite the code description not being available in the feed. Because W0300 accounts for a quarter of Medicaid dollars, analysts should flag this code for further documentation or plan‑level review to understand what services or programs it maps to even though its in-state rank is modest (#10 of 13, 25th percentile).

Smaller contributors include S5150 (Unskilled respite care, not hospice; per 15 minutes) at $67.3K (1.2% of Medicaid revenue) and W0655 at $27.7K (0.5% of Medicaid revenue). Both codes rank in the middle or bottom of state peer lists (S5150 #6 of 10, 44th percentile; W0655 #3 of 3, 0th percentile), which indicates these service lines are present but not material to the provider's overall Medicaid footprint.

State competitive standing is mixed by code: for the primary code S5125 the provider ranks #4 of 18 (82th percentile), indicating an above‑average statewide presence for attendant care but not a dominant statewide market leader. In contrast, W0300's #10 of 13 (25th percentile) rank suggests that while the code contributes large dollars for this provider, it is not a common or leading code among in‑state peers and may reflect a specialized billing mix.

The provider's NPI was enumerated on 2021-01-21 (~5 years ago), making it a relatively recently enumerated entity in state and federal systems. Given the combination of recent enumeration and concentrated, time‑based Medicaid billing, the business profile is consistent with a newer community/behavioral health agency that scaled around attendant and respite services in the Medicaid market.

Operationally, heavy reliance on time‑based attendant and respite codes (S5125, S5150) implies labor‑intensive service delivery and exposure to workforce availability and wage pressures; payers and network managers should therefore watch utilization patterns and staffing considerations when evaluating capacity or negotiating rates.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	17,000	$240	$4.1M
W0300	N/A	780	$1,820	$1.4M
S5150	Unskilled respite care, not hospice; per 15 minutes	440	$150	$67.3K
W0655	N/A	330	$80	$27.7K

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

Poppy's Promise LLC — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W0300	N/A	10	10	2,370	$630	$4M
S5125	Attendant care services; per 15 minutes	4	20	10,750	$180	$2.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	6	10	540	$150	$119.6K
W0655	N/A	3	10	970	$100	$80.7K

Nearby Providers

Other providers in the same ZIP code as Poppy's Promise LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enable, Inc.	ND	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$40.8M
Heartview Foundation	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$13.6M
Sanford Bismarck	ND	General Acute Care Hospital	$0	$12.5M
Bismarck Public Schools Early Intervention	ND	Early Intervention Provider Agency	$0	$12M
West Central Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
D. Michael Goebel D.d.s., PC	ND	Pediatric Dentistry	$0	$5.8M
Sanford Bismarck	ND	Clinical Medical Laboratory	$726.9K	$4.3M
St. Alexius Medical Center	ND	Specialist	$0	$3.6M
Lasting Love Homecare	ND	In Home Supportive Care Agency	$0	$3.6M
St. Alexius Medical Center	ND	General Acute Care Hospital	$0	$3.5M

Poppy's Promise LLC — Billing Profile & Reimbursement Data

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Poppy's Promise LLC — 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