Clinic
Western Sierra Medical Clinic, INC.
Western Sierra Medical Clinic, INC. was paid $27.68M by Medicaid between Jan 2018 and Dec 2024, across 136 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 74% of everything it billed.
33Billing provider infoWESTERN SIERRA MEDICAL CLINIC, INC.
GRASS VALLEY, CA 95945
GRASS VALLEY, CA 95945
33aNPI1063496396assigned 11/30/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$27.68M
24GClaims619,582
24DCodes billed136
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in California
Rank by total paid#133 of 826
Median peer was paid$4.05M
This provider vs. median6.8×
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 | 52,167 | $3.66M | |
| 2019 | 72,514 | $3.08M | |
| 2020 | 85,794 | $3.39M | |
| 2021 | 91,481 | $3.40M | |
| 2022 | 89,261 | $3.58M | |
| 2023 | 120,015 | $5.38M | |
| 2024incomplete | 108,350 | $5.20M |
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 | 74% | 166,332 | 145,823 | $20.60M |
| 00003 | Internal/system code - not a standard HCPCS code | 14% | 23,400 | 18,490 | $3.96M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.5% | 143,255 | 104,059 | $1.23M |
| 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 | 1.4% | 31,450 | 22,719 | $398K |
| 97803 | <1% | 21,930 | 15,276 | $191K | |
| 86769 | <1% | 8,457 | 6,224 | $120K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 17,196 | 12,541 | $116K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 6,830 | 4,832 | $105K |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | <1% | 3,438 | 2,435 | $104K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 4,507 | 3,092 | $83K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 4,833 | 2,962 | $70K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 3,791 | 2,689 | $65K |
124 more codes
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 4,329 | $57K |
| 59425 | <1% | 2,097 | $56K | |
| 92551 | <1% | 11,289 | $44K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 2,849 | $39K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 2,012 | $39K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 1,792 | $38K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 5,189 | $33K |
| 80305 | <1% | 8,552 | $30K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 4,933 | $27K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | <1% | 6,262 | $26K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 906 | $24K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 466 | $14K |
| 87081 | <1% | 6,558 | $14K | |
| 98940 | <1% | 2,165 | $14K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 6,161 | $11K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 613 | $11K |
| 90670 | <1% | 2,221 | $10K | |
| 99173 | <1% | 9,132 | $9K | |
| 96127 | <1% | 7,126 | $9K | |
| 81025 | <1% | 6,747 | $7K | |
| G0467 | Community health center visit, returning patient | <1% | 3,671 | $7K |
| 90688 | <1% | 1,718 | $6K | |
| 83655 | <1% | 1,444 | $6K | |
| 93000 | <1% | 434 | $5K | |
| 0012A | <1% | 620 | $5K | |
| 81002 | <1% | 7,090 | $5K | |
| 90658 | <1% | 795 | $5K | |
| 90633 | <1% | 1,280 | $4K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,212 | $4K |
| 0011A | <1% | 770 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,558 | $4K |
| 90648 | <1% | 984 | $4K | |
| 90723 | <1% | 1,002 | $4K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 10,358 | $3K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 137 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 674 | $3K |
| 17110 | <1% | 96 | $3K | |
| 90686 | <1% | 314 | $3K | |
| 90715 | <1% | 597 | $3K | |
| 91322 | <1% | 88 | $3K | |
| 90680 | <1% | 1,037 | $2K | |
| 90707 | <1% | 564 | $2K | |
| 90649 | <1% | 483 | $2K | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 256 | $2K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 1,840 | $2K |
| 90480 | <1% | 179 | $2K | |
| 90700 | <1% | 577 | $2K | |
| 90710 | <1% | 539 | $2K | |
| 90716 | <1% | 497 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 46 | $2K |
| 85018 | <1% | 1,990 | $2K | |
| 0004A | <1% | 43 | $2K | |
| 90657 | <1% | 421 | $1K | |
| 0064A | <1% | 122 | $1K | |
| 0002A | <1% | 97 | $1K | |
| 87070 | <1% | 638 | $1K | |
| 90696 | <1% | 438 | $1K | |
| 0001A | <1% | 92 | $1K | |
| 59430 | <1% | 74 | $1K | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 700 | $959.04 |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 99 | $826.00 |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 217 | $805.65 |
| 0031A | <1% | 47 | $804.00 | |
| 0071A | <1% | 30 | $804.00 | |
| 90734 | <1% | 259 | $768.33 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 453 | $730.82 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 171 | $716.74 |
| H1000 | Prenatal care, at-risk assessment | <1% | 16 | $631.55 |
| H0049 | Alcohol and/or drug screening | <1% | 2,449 | $624.00 |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 34 | $551.20 |
| 99381 | <1% | 21 | $518.90 | |
| 99283 | Emergency room visit (moderate) | <1% | 2,037 | $453.75 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 21 | $444.92 |
| 99205 | Prolong outpt/office vis | <1% | 74 | $433.51 |
| 82947 | <1% | 460 | $299.12 | |
| 87634 | <1% | 22 | $249.56 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 22 | $225.60 |
| 90744 | <1% | 71 | $216.00 | |
| G9920 | Screening performed and negative | <1% | 2,056 | $203.08 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 552 | $177.70 |
| 99406 | <1% | 48 | $166.56 | |
| 90656 | <1% | 13 | $166.34 | |
| 99201 | <1% | 28 | $162.76 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 71 | $143.58 |
| 86580 | <1% | 192 | $131.04 | |
| J3490 | Unclassified drugs | <1% | 30 | $130.16 |
| 90713 | <1% | 53 | $126.00 | |
| 69210 | <1% | 16 | $122.12 | |
| 98960 | <1% | 6,340 | $106.64 | |
| 82962 | <1% | 157 | $76.84 | |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 40 | $19.52 |
| 86328 | <1% | 59 | $12.00 | |
| 99000 | <1% | 193 | $7.26 | |
| 82272 | <1% | 19 | $2.56 | |
| 3008F | 0% | 5,333 | $0.00 | |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 8,281 | $0.00 |
| Z1034 | 0% | 4,249 | $0.00 | |
| 91301 | 0% | 1,551 | $0.00 | |
| 90677 | 0% | 409 | $0.00 | |
| 90697 | 0% | 876 | $0.00 | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | 0% | 41 | $0.00 |
| Z1038 | 0% | 117 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 185 | $0.00 |
| 3079F | 0% | 13 | $0.00 | |
| 3074F | 0% | 193 | $0.00 | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 0% | 14 | $0.00 |
| 90474 | 0% | 27 | $0.00 | |
| 99443 | 0% | 85 | $0.00 | |
| Z1032 | 0% | 94 | $0.00 | |
| 99441 | 0% | 13 | $0.00 | |
| 91307 | 0% | 36 | $0.00 | |
| 91303 | 0% | 36 | $0.00 | |
| 90381 | 0% | 14 | $0.00 | |
| 99408 | 0% | 4,899 | $0.00 | |
| 99401 | 0% | 692 | $0.00 | |
| 2028F | 0% | 1,040 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 1,688 | $0.00 |
| 4004F | 0% | 191 | $0.00 | |
| 91300 | 0% | 242 | $0.00 | |
| 99442 | 0% | 177 | $0.00 | |
| 3078F | 0% | 143 | $0.00 | |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 243 | $0.00 |
| 90473 | 0% | 18 | $0.00 | |
| 3077F | 0% | 19 | $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 officialNOVAK, FRANCINE (SENIOR DIRECTOR OF OPERATIONS)