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    OpenPayerNPI Medicare & MedicaidLegacy Medical Supply LLC
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    Legacy Medical Supply LLC — Billing Profile & Reimbursement Data

    NPI 1538680160 · Pearl City, HI · Durable Medical Equipment & Medical Supplies

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    Legacy Medical Supply LLC is a durable medical equipment & medical supplies provider located in Pearl City, Hawaii. This profile covers 0 Medicare and 11 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationLegacy Medical Supply LLC
    Address98-138 Hila Pl # Pa05
    CityPearl City
    StateHI
    ZIP96782
    TaxonomyDurable Medical Equipment & Medical Supplies
    NPI EnumeratedJuly 5, 2017

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$150.6K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    B4100Food thickener, administered orally, per ounce280$160$46.2K
    B4150Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100…380$70$25.6K
    T4526Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each260$70$17.3K
    T4523Adult sized disposable incontinence product, brief/diaper, large, each200$80$16.5K
    T4541Incontinence product, disposable underpad, large, each860$10$12.1K
    E0260Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress130$80$9.6K
    T4527Adult sized disposable incontinence product, protective underwear/pull-on, large size, each90$90$7.7K
    A4927Gloves, non-sterile, per 100820$10$7.4K
    T4522Adult sized disposable incontinence product, brief/diaper, medium, each50$100$4.9K
    B4154Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or…10$190$2.3K

    Showing 1–10 of 11

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Hawaii median

    11 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T4527Adult sized disposable incontinence product, protective underwear/pull-on, large size, each1210930$100$160.3K
    T4526Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each1010920$80$128.8K
    B4150Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100…510380$40$81.9K
    E0260Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress910480$60$75.8K
    B4154Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or…510530$80$71.1K
    T4523Adult sized disposable incontinence product, brief/diaper, large, each810630$90$70.3K
    T4541Incontinence product, disposable underpad, large, each12202,560$10$61.6K
    T4522Adult sized disposable incontinence product, brief/diaper, medium, each910480$80$53.9K
    B4100Food thickener, administered orally, per ounce210230$120$52.6K
    A4927Gloves, non-sterile, per 10011201,670$10$50K

    Showing 1–10 of 11

    Nearby Providers

    Other providers in the same ZIP code as Legacy Medical Supply LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    David C. Ching,d.m.d.,llcHIPediatric Dentistry$0$5.1M
    Apria Healthcare LLCHIDurable Medical Equipment & Medical Supplies$0$2.7M
    Pacific Endoscopy Center, LLCHIAmbulatory Surgical Clinic/Center$610.3K$2M
    Jason R. Ching Dds LLCHIDentist$0$2.4M
    Jojie ReyesHICase Management Registered Nurse$0$824.1K
    Above And Beyond Case ManagementHICase Management Registered Nurse$0$475.1K
    Travis NishiokaHIGeneral Practice Dentistry$0$467.1K
    Longs Drug Stores California LLCHICommunity/Retail Pharmacy$426K$32.2K
    Pearl Family Dental Care, IncHIGeneral Practice Dentistry$0$421.7K
    Longs Drug Stores California, L.L.C.HIPharmacy$278.5K$30.2K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Hawaii Providers
    0 of 3 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Hawaii Distribution
    Legacy Medical Supply LLC — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Hawaii