Clinic
Western Sierra Medical Clinic, INC.
Western Sierra Medical Clinic, INC. was paid $14.83M by Medicaid between Jan 2018 and Dec 2024, across 91 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 75% of everything it billed.
33Billing provider infoWESTERN SIERRA MEDICAL CLINIC, INC.
DOWNIEVILLE, CA 95936
DOWNIEVILLE, CA 95936
33aNPI1851513469assigned 05/03/2007
33bProvider typeUrgent Care Clinic/Center
28Total paid$14.83M
24GClaims204,370
24DCodes billed91
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in California
Rank by total paid#14 of 284
Median peer was paid$147K
This provider vs. median101×
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 | 17,501 | $2.32M | |
| 2019 | 17,499 | $1.89M | |
| 2020 | 22,933 | $1.80M | |
| 2021 | 31,176 | $1.93M | |
| 2022 | 35,295 | $1.85M | |
| 2023 | 32,799 | $1.95M | |
| 2024incomplete | 47,167 | $3.09M |
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 | 75% | 67,281 | 59,668 | $11.05M |
| 00003 | Internal/system code - not a standard HCPCS code | 20% | 13,543 | 11,326 | $2.94M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.0% | 51,743 | 39,392 | $439K |
| 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 | 1.1% | 11,916 | 9,360 | $168K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 6,679 | 5,195 | $43K |
| H1001 | Prenatal care, at-risk enhanced service; antepartum management | <1% | 509 | 392 | $31K |
| 97803 | <1% | 3,022 | 2,054 | $21K | |
| 80305 | <1% | 4,340 | 3,155 | $16K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 420 | 236 | $14K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 698 | 481 | $10K |
| 96127 | <1% | 6,546 | 5,220 | $8K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,222 | 892 | $7K |
79 more codes
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 503 | $6K |
| 92551 | <1% | 1,682 | $6K | |
| 92015 | Determination of refractive state | <1% | 1,912 | $6K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 760 | $5K |
| 98940 | <1% | 649 | $5K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 295 | $4K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 244 | $4K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,562 | $4K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 283 | $3K |
| 86769 | <1% | 192 | $3K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 234 | $3K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 129 | $2K |
| 0012A | <1% | 158 | $2K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 172 | $2K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 223 | $2K |
| 99443 | <1% | 312 | $2K | |
| 90658 | <1% | 459 | $2K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 218 | $1K |
| 99173 | <1% | 1,167 | $1K | |
| G0467 | Community health center visit, returning patient | <1% | 1,178 | $1K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 82 | $879.13 |
| 90686 | <1% | 84 | $865.92 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 31 | $800.80 |
| 81025 | <1% | 694 | $765.13 | |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 53 | $741.00 |
| 99406 | <1% | 227 | $728.70 | |
| 0124A | <1% | 29 | $670.00 | |
| 90670 | <1% | 15 | $595.50 | |
| 90715 | <1% | 50 | $510.95 | |
| 0011A | <1% | 161 | $420.46 | |
| 0064A | <1% | 37 | $388.00 | |
| 91322 | <1% | 17 | $364.80 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 47 | $312.21 |
| H0049 | Alcohol and/or drug screening | <1% | 1,458 | $288.00 |
| 81002 | <1% | 318 | $229.49 | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 47 | $224.56 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,291 | $187.32 |
| 0004A | <1% | 14 | $187.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 29 | $180.00 |
| 93000 | <1% | 17 | $172.20 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 66 | $141.60 |
| 90688 | <1% | 28 | $140.78 | |
| 90480 | <1% | 17 | $100.00 | |
| 87081 | <1% | 15 | $85.20 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 42 | $62.84 |
| 82962 | <1% | 74 | $50.00 | |
| 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% | 77 | $46.96 |
| 82947 | <1% | 20 | $16.50 | |
| 82272 | <1% | 20 | $12.80 | |
| 85018 | <1% | 19 | $10.35 | |
| 99283 | Emergency room visit (moderate) | <1% | 956 | $5.87 |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 1,157 | $2.00 |
| 99401 | 0% | 564 | $0.00 | |
| 99408 | 0% | 5,468 | $0.00 | |
| 99442 | 0% | 226 | $0.00 | |
| 98960 | 0% | 1,271 | $0.00 | |
| 91312 | 0% | 21 | $0.00 | |
| 2028F | 0% | 64 | $0.00 | |
| 4004F | 0% | 309 | $0.00 | |
| G9920 | Screening performed and negative | 0% | 114 | $0.00 |
| Z6400 | 0% | 28 | $0.00 | |
| 3077F | 0% | 45 | $0.00 | |
| 90678 | 0% | 12 | $0.00 | |
| 3078F | 0% | 95 | $0.00 | |
| 86328 | 0% | 31 | $0.00 | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | 0% | 51 | $0.00 |
| 90791 | Psychiatric diagnostic evaluation | 0% | 29 | $0.00 |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 14 | $0.00 |
| 3008F | 0% | 5,174 | $0.00 | |
| Z1034 | 0% | 712 | $0.00 | |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 0% | 58 | $0.00 |
| 3079F | 0% | 33 | $0.00 | |
| 3074F | 0% | 137 | $0.00 | |
| 99441 | 0% | 88 | $0.00 | |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 1,005 | $0.00 |
| Z1032 | 0% | 29 | $0.00 | |
| Z1038 | 0% | 29 | $0.00 | |
| 91301 | 0% | 306 | $0.00 | |
| 3075F | 0% | 14 | $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 officialLANG, FRANK (EXECUTIVE DIRECTOR)