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.

Open Door Center (NPI 1710585666)

Field	Value
Entity Type	Organization
Organization	Open Door Center
Address	129 3rd Ave Ne
City	Valley City
State	ND
ZIP	58072
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	October 13, 2020

Payer Source	Total Paid
Medicaid	$51.1M
Medicare	$0

Key Findings

OPEN DOOR CENTER is effectively a single-payer Medicaid provider: it reports no Medicare billing on file and $51.1M in lifetime Medicaid revenue. Its NPI was enumerated on 2020-10-13 (~6 years ago), indicating this scale of Medicaid activity emerged within a relatively recent enrollment period.

Revenue is highly concentrated in a small set of Medicaid service lines: the top three Medicaid codes (T2016, W0725, T2021) together account for 79.3% of the provider's total Medicaid revenue. Specifically, T2016 generated $19M (37.2% of Medicaid revenue), W0725 generated $13.4M (26.2%), and T2021 generated $8.1M (15.9%), underscoring that the business is driven by a handful of high-impact codes.

The code mix points to habilitation-focused operations: T2016 (Habilitation, residential, waiver; per diem) and T2021 (Day habilitation, waiver; per 15 minutes) together represent ongoing residential and day habilitation services rather than episodic clinical procedures. This suggests the provider’s delivery model centers on sustained community/behavioral health supports and waiver-funded habilitation programs.

Claims-volume and unit-value dynamics are divergent across the top codes: T2016 shows high volume (64.8K claims) with a modest avg paid/claim ($293) producing $19M in revenue, while W0725 has far fewer claims (2.5K) but a very high avg paid/claim ($5415) producing $13.4M in revenue. That mix indicates the organization captures revenue both through high-frequency, lower-unit services and a smaller number of high-dollar claims.

State-level competitive standing is mixed but generally above-average in core habilitation lines: T2016 ranks #7 of 29 providers in-state (79th percentile; typical, unremarkable volume for this code) and T2021 ranks #6 of 26 providers in-state (80th percentile; typical, unremarkable volume for this code), which positions the provider as a meaningful regional participant in residential and day habilitation. By contrast, W0725 ranks #10 of 25 providers in-state (63th percentile; typical, unremarkable volume for this code), indicating more middle-tier standing for that high-dollar code.

Several secondary Medicaid codes contribute modestly and are described as typical volumes: W0715 ($3.6M, 9.8K claims), W0700 ($2.6M, 8.3K claims; ranks #3 of 16, 87th percentile; typical, unremarkable volume for this code), and T2019 ($1.3M, 24.9K claims) together reflect an extended habilitation/service portfolio but do not materially alter the top-three concentration. These entries suggest some breadth in waiver and habilitation services while leaving overall revenue dependence on the top three codes.

The provider’s reliance on per-diem and per-15-minute waiver codes (e.g., T2016 per diem, T2021 per 15 minutes) implies operational exposure to utilization and rate changes in waiver programs; with 79.3% of Medicaid revenue coming from the top three codes, shifts in reimbursement policy or utilization for those specific services could materially affect financials. Monitoring state waiver policy, rate adjustments, and utilization trends for T2016, W0725, and T2021 would therefore be high priority for payer or partner negotiations.

Several codes are explicitly labeled as "typical, unremarkable volume for this code" in-state (for example, T2016, T2021, W0725 and others), indicating the provider’s volumes generally fall within expected ranges for North Dakota peers rather than representing extreme outlier behavior. The combination of above-average percentile ranks on key habilitation codes and the "typical, unremarkable" characterization suggests the organization is a stable, regionally significant habilitation provider rather than an unusual statistical outlier.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	64,840	$290	$19M
W0725	N/A	2,480	$5,420	$13.4M
T2021	Day habilitation, waiver; per 15 minutes	55,870	$150	$8.1M
W0715	N/A	9,790	$370	$3.6M
W0700	N/A	8,300	$310	$2.6M
T2019	Habilitation, supported employment, waiver; per 15 minutes	24,930	$50	$1.3M
W0260	N/A	150	$7,100	$1.1M
W0710	N/A	4,450	$150	$675.8K
T2047	Habilitation, prevocational, waiver; per 15 minutes	8,770	$70	$605K
W0200	N/A	210	$2,460	$509K

Showing 1–10 of 12

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

Open Door Center — 0 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	7	30	21,220	$400	$14.1M
W0725	N/A	10	30	1,380	$2,520	$9.9M
T2021	Day habilitation, waiver; per 15 minutes	6	30	32,410	$170	$6.6M
W0715	N/A	8	30	6,250	$450	$3.8M
T2019	Habilitation, supported employment, waiver; per 15 minutes	5	20	11,310	$80	$1.2M
W0700	N/A	3	20	3,430	$280	$1.2M
W0260	N/A	8	20	150	$4,920	$1M
T2047	Habilitation, prevocational, waiver; per 15 minutes	6	10	8,770	$90	$988.3K
W0710	N/A	5	10	3,170	$170	$605.8K
W0200	N/A	12	30	200	$1,670	$454.3K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Open Door Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Innovis Health, LLC	ND	Family Medicine Physician	$0	$752.9K
Barnes County Ambulance Inc	ND	Paramedic	$299.2K	$326.1K
Bridge City Dentistry P.C.	ND	General Practice Dentistry	$0	$351.6K
Mercy Hospital Of Valley City	ND	Critical Access Hospital	$0	$279.2K
Misty Anderson	ND	Internal Medicine Physician	$221.9K	$0
City County Health District	ND	Public Health or Welfare Agency	$149K	$59.5K
Genevieve Goven	ND	Family Medicine Physician	$126.8K	$0
Ashley Horner	ND	Family Medicine Physician	$101.5K	$0
Tanya Diegel	ND	Family Medicine Physician	$92.7K	$0
South Central Adult Services Council Inc.	ND	In Home Supportive Care Agency	$0	$68.5K

Open Door Center — Billing Profile & Reimbursement Data

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Open Door Center — 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