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 Maine for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maine 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. Maine (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.

Legends Residential Care LLC (NPI 1104574169)

Field	Value
Entity Type	Organization
Organization	Legends Residential Care LLC
Address	41 Dakota Dr
City	Windham
State	ME
ZIP	04062
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	March 17, 2022

Payer Source	Total Paid
Medicaid	$32.9M
Medicare	$0

Key Findings

LEGENDS RESIDENTIAL CARE LLC (Taxonomy: In Home Supportive Care Agency) is based in WINDHAM, ME and reports lifetime Medicaid revenue of $32.9M with none in Medicare billing on file. This combination of taxonomy and payer profile indicates the operation is focused squarely on Medicaid-funded long-term/supportive care rather than Medicare-covered services.

All of the provider's reported Medicaid revenue is driven by a single code, T2016 (Habilitation, residential, waiver; per diem). The dominance of a residential habilitation per-diem code is consistent with a service model that centers on waiver-funded residential supports rather than episodic clinical procedures or outpatient therapy.

Revenue concentration is extreme: the precomputed top-3 share shows 100.0% of Medicaid revenue is attributable to the provider's top codes, and T2016 alone accounts for $32.9M and 100.0% of its Medicaid revenue. This level of dependence on a single Medicaid per-diem code creates exposure to program or rate changes in waiver funding for residential habilitation.

Claim volume and unit economics show 3.6K claims at a $9140 avg paid/claim producing the $32.9M Medicaid total. That mix—moderate claim counts combined with a high average payment per claim—indicates revenue is driven by relatively high-cost per-diem placements rather than high-frequency low-dollar services.

On a statewide competitive basis the provider ranks #51 of 75 providers in-state (32th percentile; typical, unremarkable volume for this code). That ranking and the explicit label 'typical, unremarkable volume for this code' signal that LEGENDS RESIDENTIAL CARE is a modest participant in Maine's market for T2016 services, not a leading or regional consolidator.

Payer mix is effectively single-payer: Medicaid is the source of all recorded public-payer revenue and Medicare activity is listed as none, so the entity's financial and growth trajectory will be closely tied to Medicaid waiver program policy and rate-setting. Analysts should treat this provider as highly Medicaid-dependent with limited diversification via Medicare.

The NPI was enumerated 2022-03-17 (~4 years ago), making this a relatively recent entrant by enrollment date; accumulating $32.9M in Medicaid revenue since enumeration suggests a rapid build-out of waiver residential placements after initial registration. Given the short tenure, stakeholders should monitor whether the provider maintains the same concentrated code mix or diversifies services over time.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	3,600	$9,140	$32.9M

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maine Distribution

Legends Residential Care LLC — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	51	80	7,300	$1,670	$30.8M

Nearby Providers

Other providers in the same ZIP code as Legends Residential Care LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crossroads For Women, Inc.	ME	Substance Abuse Rehabilitation Facility	$0	$10.4M
Southern Maine Chidlren's Academy, LLC	ME	Community/Behavioral Health Agency	$0	$9.4M
All Med Staffing Of New England	ME	In Home Supportive Care Agency	$0	$9.1M
Day One	ME	Children's Substance Abuse Rehabilitation Facility	$0	$5.2M
Home Support Services, LLC	ME	In Home Supportive Care Agency	$0	$2.8M
Caring Counseling For You Inc.	ME	Mental Health Counselor	$0	$1.8M
Mainehealth	ME	Internal Medicine Physician	$0	$1.3M
Town Of Windham	ME	Land Ambulance	$161.2K	$984.4K
Maine Medical Partners	ME	Family Medicine Physician	$0	$347.3K
Riverview Physical Therapy Limited Partnership	ME	Physical Therapy Clinic/Center	$0	$333.2K

Legends Residential Care LLC — Billing Profile & Reimbursement Data

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Legends Residential Care 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