Physician
Legacy Community Health Services, INC
Legacy Community Health Services, INC was paid $406.51M by Medicaid between Jan 2018 and Dec 2024, across 217 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 83% of everything it billed.
33Billing provider infoLEGACY COMMUNITY HEALTH SERVICES, INC
HOUSTON, TX 77006
HOUSTON, TX 77006
33aNPI1679524961assigned 05/12/2006
33bProvider typePediatrics Physician
28Total paid$406.51M
24GClaims4,851,928
24DCodes billed217
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Texas
Rank by total paid#1 of 1,136
Median peer was paid$329K
This provider vs. median1,237×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official PALUSSEK, ROBERT controls 12+ related entities in our dataset. Read more
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 | 21,000 | $3.70M | |
| 2019 | 31,232 | $4.31M | |
| 2020 | 180,204 | $19.35M | |
| 2021 | 700,453 | $81.02M | |
| 2022 | 803,741 | $92.70M | |
| 2023 | 1,122,321 | $101.43M | |
| 2024incomplete | 1,992,977 | $104.01M |
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 | 83% | 1,306,970 | 937,694 | $336.74M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.1% | 514,954 | 419,830 | $20.78M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 91,519 | 88,531 | $9.11M |
| 99381 | 1.6% | 29,723 | 28,887 | $6.39M | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1.5% | 114,153 | 105,650 | $6.26M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.4% | 121,452 | 75,143 | $5.76M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 75,453 | 73,838 | $3.94M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 86,347 | 77,072 | $3.35M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 74,031 | 45,698 | $2.76M |
| D0999 | Unspecified diagnostic procedure, by report | <1% | 9,713 | 8,700 | $2.24M |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 36,912 | 35,982 | $1.89M |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 20,773 | 20,130 | $1.15M |
205 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 17,764 | $571K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 9,834 | $536K |
| G9012 | Other specified case management service not elsewhere classified | <1% | 3,889 | $533K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | <1% | 940 | $528K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 11,811 | $499K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 5,062 | $448K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 10,626 | $385K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 6,880 | $379K |
| 99383 | <1% | 4,262 | $376K | |
| 99382 | <1% | 2,733 | $280K | |
| 99384 | <1% | 3,541 | $263K | |
| 59430 | <1% | 8,380 | $259K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 5,876 | $175K |
| 99385 | <1% | 1,093 | $129K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,798 | $124K |
| G0467 | Community health center visit, returning patient | <1% | 2,612 | $99K |
| 97169 | <1% | 5,121 | $87K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 656 | $85K |
| 90837 | Psychotherapy session, about an hour | <1% | 1,151 | $71K |
| S0620 | Routine ophthalmological examination including refraction; new patient | <1% | 1,239 | $39K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 885 | $34K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 172,770 | $20K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,398 | $20K |
| 99205 | Prolong outpt/office vis | <1% | 303 | $15K |
| 99050 | <1% | 3,465 | $14K | |
| 90846 | Family psychotherapy without the patient present, 50 minutes | <1% | 122 | $13K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 681 | $12K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | <1% | 386 | $12K |
| S0621 | Routine ophthalmological examination including refraction; established patient | <1% | 344 | $9K |
| V2025 | Deluxe frame | <1% | 410 | $9K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 113,320 | $9K |
| 76801 | <1% | 12,245 | $8K | |
| 90686 | <1% | 50,627 | $8K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 31,645 | $8K |
| J7300 | Intrauterine copper contraceptive (paragard) | <1% | 12 | $8K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 25,752 | $5K |
| V2020 | Frames, purchases | <1% | 550 | $5K |
| 91322 | <1% | 787 | $4K | |
| 81025 | <1% | 21,172 | $4K | |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 468 | $4K |
| 90715 | <1% | 20,250 | $4K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 5,202 | $3K |
| 90621 | <1% | 3,025 | $3K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 5,066 | $3K |
| 99401 | <1% | 26,980 | $2K | |
| 90480 | <1% | 1,134 | $2K | |
| 87428 | <1% | 57 | $2K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,086 | $2K |
| 11981 | <1% | 1,032 | $2K | |
| 90670 | <1% | 43,537 | $2K | |
| 90723 | <1% | 52,202 | $2K | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 12,756 | $2K |
| 99386 | <1% | 16 | $2K | |
| 90648 | <1% | 65,218 | $2K | |
| 3044F | <1% | 11,846 | $1K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 2,539 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 6,727 | $1K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 4,446 | $1K |
| 85018 | <1% | 14,566 | $1K | |
| 90633 | <1% | 25,696 | $1K | |
| 90710 | <1% | 7,808 | $1K | |
| 90681 | <1% | 32,086 | $886.29 | |
| 92551 | <1% | 12,970 | $872.07 | |
| 87807 | <1% | 2,973 | $865.04 | |
| A9150 | Non-prescription drugs | <1% | 3,825 | $864.51 |
| 99000 | <1% | 3,531 | $846.69 | |
| 90700 | <1% | 10,658 | $762.28 | |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 1,379 | $722.71 |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 15 | $721.36 |
| 3046F | <1% | 483 | $660.00 | |
| 90651 | <1% | 15,598 | $562.65 | |
| V2750 | Anti-reflective coating, per lens | <1% | 12 | $530.99 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,647 | $469.86 |
| 81002 | <1% | 5,856 | $446.77 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 2,519 | $436.00 |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 1,085 | $424.82 |
| 58300 | <1% | 288 | $417.08 | |
| 90734 | <1% | 9,160 | $404.35 | |
| 81003 | <1% | 5,392 | $391.20 | |
| 83026 | <1% | 8,545 | $388.45 | |
| 90716 | <1% | 12,468 | $368.55 | |
| 3051F | <1% | 148 | $360.00 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 11,400 | $349.63 |
| D0220 | Intraoral - periapical first radiographic image | <1% | 1,480 | $335.18 |
| J0561 | Injection, penicillin g benzathine, 100,000 units | <1% | 496 | $302.39 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,423 | $266.08 |
| 90696 | <1% | 7,255 | $254.19 | |
| D0274 | Bitewings - four radiographic images | <1% | 317 | $236.66 |
| D0120 | Dental checkup, returning patient | <1% | 727 | $199.10 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,127 | $135.61 |
| D1206 | Topical application of fluoride varnish | <1% | 1,472 | $117.60 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 315 | $93.35 |
| 0054A | <1% | 113 | $80.00 | |
| 0051A | <1% | 54 | $80.00 | |
| 17250 | <1% | 2,138 | $75.22 | |
| D1120 | Dental cleaning, child | <1% | 1,621 | $73.50 |
| 90707 | <1% | 12,226 | $66.49 | |
| 90656 | <1% | 9,557 | $66.47 | |
| D0330 | Panoramic radiographic image | <1% | 187 | $63.78 |
| 92557 | <1% | 47 | $62.88 | |
| 69209 | <1% | 447 | $61.75 | |
| D0140 | Limited oral evaluation - problem focused | <1% | 27 | $32.00 |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 210 | $27.17 |
| J8499 | Prescription drug, oral, non chemotherapeutic, nos | <1% | 6,224 | $25.40 |
| D0272 | Bitewings - two radiographic images | <1% | 312 | $23.38 |
| 82247 | <1% | 1,694 | $16.88 | |
| D1208 | Topical application of fluoride, excluding varnish | <1% | 106 | $14.70 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 649 | $14.59 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 257 | $14.31 |
| 86703 | <1% | 256 | $11.52 | |
| 99173 | <1% | 16,260 | $4.34 | |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 504 | $0.70 |
| 90461 | <1% | 3,639 | $0.09 | |
| 90746 | <1% | 372 | $0.02 | |
| 90677 | <1% | 23,114 | $0.02 | |
| 90474 | <1% | 6,399 | $0.01 | |
| 90785 | 0% | 1,287 | $0.00 | |
| 1160F | 0% | 158,304 | $0.00 | |
| 99051 | 0% | 12,462 | $0.00 | |
| 3725F | 0% | 250 | $0.00 | |
| 3078F | 0% | 114,832 | $0.00 | |
| 3077F | 0% | 3,796 | $0.00 | |
| 91300 | 0% | 107 | $0.00 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 0% | 3,404 | $0.00 |
| S0119 | Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) | 0% | 552 | $0.00 |
| 0502F | 0% | 262 | $0.00 | |
| 90713 | 0% | 1,117 | $0.00 | |
| 90714 | 0% | 93 | $0.00 | |
| 3210F | 0% | 14,326 | $0.00 | |
| 96160 | 0% | 176 | $0.00 | |
| 91321 | 0% | 241 | $0.00 | |
| 1159F | 0% | 158,091 | $0.00 | |
| 1090F | 0% | 367 | $0.00 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 174 | $0.00 |
| 90380 | 0% | 426 | $0.00 | |
| 59426 | 0% | 13 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 13 | $0.00 |
| 83655 | 0% | 29 | $0.00 | |
| 76818 | 0% | 220 | $0.00 | |
| 97803 | 0% | 24 | $0.00 | |
| 90750 | 0% | 70 | $0.00 | |
| 96130 | 0% | 25 | $0.00 | |
| 90655 | 0% | 37 | $0.00 | |
| 0071A | 0% | 49 | $0.00 | |
| 2028F | 0% | 57 | $0.00 | |
| 80305 | 0% | 26 | $0.00 | |
| 92552 | 0% | 24 | $0.00 | |
| 69210 | 0% | 14 | $0.00 | |
| 96137 | 0% | 13 | $0.00 | |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 0% | 16 | $0.00 |
| 96136 | 0% | 13 | $0.00 | |
| 91312 | 0% | 15 | $0.00 | |
| 4000F | 0% | 3,706 | $0.00 | |
| D0602 | 0% | 1,655 | $0.00 | |
| 3074F | 0% | 125,675 | $0.00 | |
| 3079F | 0% | 19,352 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 4,883 | $0.00 |
| J8540 | Dexamethasone, oral, 0.25 mg | 0% | 435 | $0.00 |
| 36416 | 0% | 1,612 | $0.00 | |
| 2000F | 0% | 130,576 | $0.00 | |
| 91301 | 0% | 33 | $0.00 | |
| 82962 | 0% | 395 | $0.00 | |
| 3075F | 0% | 7,234 | $0.00 | |
| J3490 | Unclassified drugs | 0% | 651 | $0.00 |
| 1000F | 0% | 88,479 | $0.00 | |
| 3008F | 0% | 85,699 | $0.00 | |
| 90688 | 0% | 78 | $0.00 | |
| D0603 | 0% | 2,337 | $0.00 | |
| 90381 | 0% | 640 | $0.00 | |
| 90744 | 0% | 1,103 | $0.00 | |
| 3080F | 0% | 2,829 | $0.00 | |
| 1111F | 0% | 135 | $0.00 | |
| 1125F | 0% | 7,308 | $0.00 | |
| D0601 | 0% | 1,028 | $0.00 | |
| 2001F | 0% | 185,850 | $0.00 | |
| J3535 | Drug administered through a metered dose inhaler | 0% | 166 | $0.00 |
| 91307 | 0% | 29 | $0.00 | |
| 1126F | 0% | 50,235 | $0.00 | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 16 | $0.00 |
| D1330 | 0% | 78 | $0.00 | |
| 1220F | 0% | 75,369 | $0.00 | |
| 97802 | 0% | 69 | $0.00 | |
| 1036F | 0% | 394 | $0.00 | |
| D1351 | Sealant - per tooth | 0% | 58 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 99 | $0.00 |
| 88720 | 0% | 19 | $0.00 | |
| 90636 | 0% | 26 | $0.00 | |
| J2790 | Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) | 0% | 249 | $0.00 |
| 90698 | 0% | 100 | $0.00 | |
| 0052A | 0% | 13 | $0.00 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 28 | $0.00 |
| 86803 | 0% | 14 | $0.00 | |
| 87081 | 0% | 59 | $0.00 | |
| 93000 | 0% | 19 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 47 | $0.00 |
| 96127 | 0% | 47 | $0.00 | |
| 96131 | 0% | 12 | $0.00 | |
| 86780 | 0% | 54 | $0.00 | |
| 90680 | 0% | 101 | $0.00 | |
| 91305 | 0% | 12 | $0.00 | |
| J7609 | Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg | 0% | 61 | $0.00 |
| 1170F | 0% | 23 | $0.00 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 0% | 21 | $0.00 |
| 1034F | 0% | 14 | $0.00 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 0% | 16 | $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 officialPALUSSEK, ROBERT (COO)
| Provider | Location | Paid |
|---|---|---|
| Legacy Community Health Services, INC | Houston, TX | $796K |
| Legacy Community Health Services, INC | Baytown, TX | $451K |
| Legacy Community Health Services, INC | Houston, TX | $400K |
| Legacy Community Health Services, INC | Houston, TX | $361K |
| Legacy Community Health Services, INC | Houston, TX | $300K |
| Legacy Community Health Services, INC | Beaumont, TX | $250K |
| Legacy Community Health Services, INC. | Deer Park, TX | $163K |
| Legacy Community Health Services, INC | Houston, TX | $126K |
| Legacy Community Health Services, INC. | Houston, TX | $117K |
| Legacy Community Health Services, INC | Houston, TX | $75K |
| Legacy Community Health Services, INC | Houston, TX | $48K |
| Legacy Community Health Services, INC | Houston, TX | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.