Clinic
Legacy Medical Care INC
Legacy Medical Care INC was paid $42.59M by Medicaid between Jan 2018 and Dec 2024, across 74 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoLEGACY MEDICAL CARE INC
ARLINGTON HEIGHTS, IL 60005
ARLINGTON HEIGHTS, IL 60005
33aNPI1497181697assigned 09/19/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$42.59M
24GClaims808,047
24DCodes billed74
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Illinois
Rank by total paid#12 of 296
Median peer was paid$1.43M
This provider vs. median30×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 319,093 | $14.25M | |
| 2019 | 75,209 | $3.36M | |
| 2020 | 84,867 | $4.21M | |
| 2021 | 82,634 | $4.46M | |
| 2022 | 79,369 | $5.12M | |
| 2023 | 86,710 | $5.53M | |
| 2024incomplete | 80,165 | $5.65M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 99% | 285,222 | 189,211 | $42.15M |
| 90651 | <1% | 8,853 | 7,592 | $99K | |
| 90734 | <1% | 9,558 | 8,360 | $86K | |
| 90620 | <1% | 7,588 | 6,713 | $83K | |
| 90716 | <1% | 4,123 | 3,139 | $36K | |
| 90686 | <1% | 19,437 | 17,193 | $30K | |
| 90670 | <1% | 9,142 | 7,627 | $22K | |
| 90707 | <1% | 3,865 | 2,972 | $20K | |
| 90696 | <1% | 3,661 | 3,162 | $12K | |
| 90715 | <1% | 4,673 | 4,087 | $11K | |
| 90633 | <1% | 6,915 | 5,777 | $9K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 132,282 | 92,283 | $8K |
62 more codes
| 90723 | <1% | 7,953 | $4K | |
| 90700 | <1% | 2,860 | $3K | |
| 90648 | <1% | 10,341 | $2K | |
| 90680 | <1% | 6,389 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 33,328 | $2K |
| 0500F | <1% | 3,551 | $2K | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 6,274 | $1K |
| 0071A | <1% | 27 | $1K | |
| 0502F | <1% | 17,306 | $1K | |
| 0503F | <1% | 767 | $825.00 | |
| 90744 | <1% | 193 | $579.86 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 21,158 | $475.30 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 31,878 | $442.18 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 4,001 | $408.81 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 38 | $296.21 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 12,381 | $282.53 |
| 90713 | <1% | 127 | $278.63 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 16,078 | $278.33 |
| 96127 | <1% | 14,969 | $219.00 | |
| 90710 | <1% | 2,810 | $179.20 | |
| 99173 | <1% | 33,430 | $178.80 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 21,913 | $153.68 |
| 99381 | <1% | 1,974 | $141.51 | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 530 | $71.90 |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 210 | $31.10 |
| 96160 | <1% | 1,582 | $29.20 | |
| 86580 | <1% | 4,826 | $2.00 | |
| 94664 | <1% | 7,061 | $1.00 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | 0% | 1,704 | $0.00 |
| 94760 | 0% | 191 | $0.00 | |
| 99058 | 0% | 20,445 | $0.00 | |
| 99385 | 0% | 757 | $0.00 | |
| 82962 | 0% | 376 | $0.00 | |
| 99384 | 0% | 2,383 | $0.00 | |
| 59430 | 0% | 188 | $0.00 | |
| 99383 | 0% | 3,176 | $0.00 | |
| 76801 | 0% | 195 | $0.00 | |
| 90656 | 0% | 1,635 | $0.00 | |
| 99386 | 0% | 326 | $0.00 | |
| 97802 | 0% | 1,689 | $0.00 | |
| 85018 | 0% | 367 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 215 | $0.00 |
| 92558 | 0% | 36 | $0.00 | |
| 99382 | 0% | 1,171 | $0.00 | |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | 0% | 1,036 | $0.00 |
| 98960 | 0% | 300 | $0.00 | |
| 94060 | 0% | 599 | $0.00 | |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 0% | 175 | $0.00 |
| 81002 | 0% | 480 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 5,048 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 312 | $0.00 |
| H1000 | Prenatal care, at-risk assessment | 0% | 3,430 | $0.00 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 102 | $0.00 |
| 81025 | 0% | 240 | $0.00 | |
| 99215 | Doctor's office visit, returning patient (complex) | 0% | 28 | $0.00 |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 227 | $0.00 |
| 94726 | 0% | 536 | $0.00 | |
| 94728 | 0% | 147 | $0.00 | |
| 97803 | 0% | 1,128 | $0.00 | |
| 90649 | 0% | 13 | $0.00 | |
| 90671 | 0% | 78 | $0.00 | |
| 69210 | 0% | 40 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialD'ONORIO, MELISSA (CEO)
| Provider | Location | Paid |
|---|---|---|
| Legacy Medical Care INC | Elgin, IL | $1.79M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.