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.

Villa Nazareth (NPI 1407443245)

Field	Value
Entity Type	Organization
Organization	Villa Nazareth
Address	801 Page Dr S
City	Fargo
State	ND
ZIP	58103
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 28, 2020

Payer Source	Total Paid
Medicaid	$84.2M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and total Medicaid revenue is $84.2M. The organization's NPI was enumerated on 2020-12-28 (~6 years ago), indicating roughly six years of recorded activity under the current enrollment.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes account for 82.4% of Medicaid revenue, led by T2016 at 43.2%, W0725 at 28.0%, and T2021 at 11.2%. This concentration means a large share of the provider’s financial performance depends on outcomes for those three codes.

The mix of top codes points to habilitation-focused operations: T2016 (Habilitation, residential, waiver; per diem) accounts for $36.3M from 83.7K claims and T2021 (Day habilitation, waiver; per 15 minutes) contributes $9.4M from 46.9K claims, indicating the provider runs both residential and day habilitation programs under waiver arrangements. Combined claim volumes and the per‑unit pricing patterns suggest services that are delivered continuously or in repeated time increments rather than one‑time, low-frequency procedures.

One non‑described code, W0725, is a major revenue driver with 2.8K claims at an $8509 avg paid/claim producing $23.6M (28.0% of Medicaid revenue). The high average paid per claim for W0725 (and other no‑description codes with high per‑claim averages such as W0230 at $8860 avg paid/claim and W0200 at $4518 avg paid/claim) suggests these payments are episodic or bundled high-dollar events rather than low‑unit-time habilitation services, and that a single high-cost code materially shapes overall revenue.

State-level competitive standing is mixed across the top codes: for residential habilitation T2016 the provider ranks #5 of 29 in-state (86th percentile), indicating a relatively strong statewide position for that service line. By contrast W0725 ranks #8 of 25 (71st percentile) and T2021 ranks #8 of 26 (72nd percentile), which are mid‑to‑upper tier placements consistent with the dataset’s characterization of typical, unremarkable volume for those codes.

Operational implications of the claims profile include high utilization and staffing intensity: 83.7K claims for T2016 and 46.9K claims for T2021 reflect frequent, repeated service delivery (per‑diem and per‑15‑minute billing models) that typically requires stable staffing, facility capacity, and administrative systems to manage large claim volumes. Payers and network partners evaluating capacity or contract negotiations should expect the provider to be centered on ongoing care delivery rather than episodic outpatient procedures.

There are several statistical extremes in unit economics and rank positions that deserve attention: W0260 appears at a 0th percentile rank in-state despite nontrivial average paid/claim ($5646), while other low‑volume codes with high avg paid/claim (W0230, W0200) contribute smaller shares of revenue but could represent outsized financial or regulatory exposure if policies change. Given that the top three codes drive 82.4% of Medicaid revenue, the provider faces measurable revenue concentration risk if reimbursement or utilization for those specific codes shifts.

Because there is no Medicare billing on file, this entity’s payer mix is effectively concentrated in Medicaid and its competitive dynamics, utilization patterns, and revenue risk should be evaluated primarily in a Medicaid context rather than a mixed Medicare/Medicaid model. Analysts looking to benchmark or model this provider should prioritize in-state Medicaid peers and the specific waiver habilitation services captured by T2016 and T2021 when assessing performance and market position.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	83,740	$430	$36.3M
W0725	N/A	2,770	$8,510	$23.6M
T2021	Day habilitation, waiver; per 15 minutes	46,940	$200	$9.4M
W0715	N/A	7,930	$560	$4.4M
T2019	Habilitation, supported employment, waiver; per 15 minutes	28,910	$80	$2.4M
W0700	N/A	6,140	$340	$2.1M
T2047	Habilitation, prevocational, waiver; per 15 minutes	14,730	$140	$2M
W0230	N/A	140	$8,860	$1.2M
W0705	N/A	5,780	$150	$860.8K
W0200	N/A	140	$4,520	$632.5K

Showing 1–10 of 14

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

Villa Nazareth — 0 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	5	30	21,220	$400	$14.1M
W0725	N/A	8	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	8	30	32,410	$170	$6.6M
W0715	N/A	9	30	6,250	$450	$3.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	4	20	11,310	$80	$1.2M
W0700	N/A	4	20	3,430	$280	$1.2M
W0260	N/A	15	20	150	$4,920	$1M
T2047	Habilitation, prevocational, waiver; per 15 minutes	2	10	8,770	$90	$988.3K
W0230	N/A	2	10	90	$6,740	$613K
W0710	N/A	6	10	3,170	$170	$605.8K

Showing 1–10 of 14

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Living Services, Inc	ND	Community/Behavioral Health Agency	$0	$104.6M
Psj Acquisition LLC	ND	Psychiatric Hospital	$0	$32.3M
Vocational Training Center, Inc.	ND	Community/Behavioral Health Agency	$0	$28.5M
Fm Ambulance Service, Inc	ND	Land Ambulance	$2M	$23.8M
Innovis Health, LLC	ND	General Acute Care Hospital	$0	$25.5M
Fraser, Ltd.	ND	Community/Behavioral Health Agency	$0	$13.9M
Community Medical Services Montana Private LLC	ND	Methadone Clinic	$214.7K	$8.9M
Southeast Behavioral Health Clinic	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8.8M
Village Family Service Center	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.8M
Doyle's Yellow Checker Cab, Inc	ND	Taxi	$0	$7.8M

Villa Nazareth — Billing Profile & Reimbursement Data

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Villa Nazareth — 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