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 1477153146)

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	$4.9M
Medicare	$0

Key Findings

PRIDE INC is registered as a Community/Behavioral Health Agency in BISMARCK, ND with an NPI enumerated 2020-10-30 (~6 years ago), indicating roughly six years of enrollment and operational tenure under this NPI record. This tenure suggests it is a relatively recent entrant compared with longer-established behavioral health organizations in many markets.

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $4.9M, so Medicaid accounts for the entirety of the billed public-payor activity documented here. Analysts should treat the provider as Medicaid-dependent for the period covered.

Revenue is highly concentrated by code: precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, indicating that a very small set of services drives the provider’s entire Medicaid revenue base. That concentration implies operational and reimbursement vulnerability if one of those service lines experiences rate changes or utilization shifts.

T2016 (T2016 – Habilitation, residential, waiver; per diem) is a clear operational volume driver: 7.7K claims, $309 avg paid/claim, $2.4M revenue (48.6% of this provider's total Medicaid revenue). The per-diem habilitation/residential waiver description and high claim count indicate this provider’s core service line is ongoing residential habilitation or waiver-based residential supports rather than episodic outpatient care.

W0725 (no description available) accounts for $2.5M revenue (51.4% of this provider's total Medicaid revenue) on 549 claims with a $4599 avg paid/claim, signifying very high per-claim payments for that code. Although the description is not provided in the data, the much higher avg paid/claim relative to T2016 suggests W0725 represents an intensive, higher-dollar service or bundled payment event and is a primary revenue source for the provider.

State-level competitive standing on these revenue-driving codes is modest rather than dominant: W0725 ranks #22 of 25 providers in-state (13th percentile; typical, unremarkable volume for this code) and T2016 ranks #19 of 29 providers in-state (36th percentile; typical, unremarkable volume for this code). These percentiles and ranks indicate PRIDE INC is not a leading statewide provider for either code despite those codes comprising virtually all its Medicaid revenue.

Both top codes are explicitly labeled in the source as having "typical, unremarkable volume," which means neither appears as a statistical outlier in terms of state-level volume even though they together represent 100.0% of PRIDE INC’s Medicaid revenue. This combination—large internal revenue concentration paired with typical statewide ranking—points to a localized or specialized program footprint rather than broad market dominance, a nuance payers and competitors should consider when assessing contracting leverage or network adequacy.

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	550	$4,600	$2.5M
T2016	Habilitation, residential, waiver; per diem	7,730	$310	$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

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	19	30	21,220	$400	$14.1M
W0725	N/A	22	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	$6.6M
Pride Inc.	ND	Community/Behavioral Health Agency	$0	$5.7M
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