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

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

Legacy Community Health Services, Inc (NPI 1679524961)

Field	Value
Entity Type	Organization
Organization	Legacy Community Health Services, Inc
Address	1415 California St
City	Houston
State	TX
ZIP	77006
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$406.7M
Medicare	$0

Key Findings

LEGACY COMMUNITY HEALTH SERVICES, INC is effectively a Medicaid-centric provider: total Medicaid revenue on file is $406.7M and there is no Medicare billing on file. The practice has been NPI-enumerated since 2006-05-12 (~20 years ago), indicating long tenure in its market and sustained Medicaid activity over time.

Revenue is extremely concentrated: the top three Medicaid codes alone account for 90.4% of the provider's Medicaid revenue, driven overwhelmingly by T1015 which generates $337.2M (83.1% of Medicaid revenue). This narrow code mix shows the organization’s financial picture depends heavily on a single all-inclusive clinic visit code.

The dominant use of T1015 (Clinic visit/encounter, all-inclusive) together with the provider’s Federally Qualified Health Center (FQHC) taxonomy indicates an operational model centered on high-volume, bundled primary-care encounters and comprehensive clinic services. The prevalence of preventive and well-visit codes in the top billing (for example 99391 and 99392) supports that the center operates as a broad primary care and preventive care hub rather than a specialty or procedure-driven facility.

Competitive standing within Texas is concentrated and extreme for several codes: T1015 ranks #1 of 766 providers in-state (100th percentile, extreme outlier), and 99213 ranks #3 of 6037 providers (100th percentile, extreme outlier). Across a wide range of E/M and preventive codes the provider sits at or near the top of statewide volume, signaling market dominance for clinic-based Medicaid services.

Pediatric and preventive services form a large portion of clinical activity: 99391 has 91.5K claims and $9.2M revenue (2.3% of Medicaid revenue) and 99381 has 29.7K claims and $6.4M revenue (1.6%). Multiple well-child and adolescent visit codes (99392, 99393, 99395, 99394, etc.) appear at extreme outlier ranks, indicating a sizable pediatric and family-care footprint within the Medicaid population.

Behavioral health is also a meaningful service line: 90834 shows 121.5K claims and $5.7M revenue (1.4%) with a rank of #2 (100th percentile, extreme outlier), and shorter psychotherapy codes 90832 and group therapy 90853 also appear with high statewide ranks. The combination of high psychotherapy and psychiatric evaluation codes (90791, 90792) indicates integrated behavioral-health offerings alongside primary care.

Reproductive and postpartum services are present at notable levels: J7307 (contraceptive implant) produced $528.3K and ranks #3 in-state, and 59430 (outpatient postpartum care) has 8.4K claims with $259.8K revenue and ranks #1 in-state (100th percentile, extreme outlier). These code-level signals point to substantial women’s health and family-planning activity within the Medicaid population served.

From a risk and strategy perspective, the provider’s dependence on Medicaid revenue overall and on T1015 in particular (83.1% from T1015; top three codes 90.4%) creates concentration risk: any policy, eligibility, or rate changes affecting FQHC-style all-inclusive clinic visit reimbursement could materially affect revenue. For payers and network analysts, this profile suggests negotiations and utilization management should focus on clinic-encounter rules, bundled visit definitions, and pediatric/preventive care pathways where this provider is a statewide volume leader.

Medicaid: Complete Services Breakdown

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

217 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	1,306,970	$260	$337.2M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	514,950	$40	$20.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	91,520	$100	$9.2M
99381	The provider performs a well–baby visit for a child under the age of one.	29,720	$220	$6.4M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	114,150	$60	$6.3M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	121,450	$50	$5.7M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	75,450	$50	$3.9M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	86,350	$40	$3.4M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	74,030	$40	$2.7M
D0999	N/A	9,710	$230	$2.2M

Showing 1–10 of 217

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Legacy Community Health Services, Inc — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

217 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	1	770	2,990	$170	$2.6M
D0999	N/A	10	180	390	$190	$405.3K
G9012	Other specified case management service not elsewhere classified	5	30	500	$120	$306.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	80	370	550	$80	$249.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	3	6,040	710	$40	$232.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	243	290	410	$20	$225K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	184	300	410	$20	$223.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3	1,500	880	$80	$185.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2	1,360	800	$80	$185.6K
D2392	Post 2 surface resin‑based composite	2,585	2,600	490	$90	$164.2K

Showing 1–10 of 217

Related Providers

Other providers that share a Tax Identification Number (TIN) with Legacy Community Health Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bhs Physicians Network, Inc	TX	Family Medicine Physician	$0	$32.1M
Heidi Mandl	TX	Clinical Social Worker	$254.6K	$0
Michelle Onorato	TX	Infectious Disease Physician	$117.6K	$0
Howard Kussman	TX	Infectious Disease Physician	$48.6K	$0

Nearby Providers

Other providers in the same ZIP code as Legacy Community Health Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tayfun Karakoc	TX	Psychiatry Physician	$274.7K	$0
Kevin Smith	TX	Clinical Psychologist	$52K	$230

Legacy Community Health Services, Inc — Billing Profile & Reimbursement Data

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Legacy Community Health Services, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References