Clinic
Gaston Family Health Services, INC.
Gaston Family Health Services, INC. was paid $9.40M by Medicaid between Jan 2018 and Dec 2024, across 81 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 66% of everything it billed.
33Billing provider infoGASTON FAMILY HEALTH SERVICES, INC.
GASTONIA, NC 28052
GASTONIA, NC 28052
33aNPI1215932215assigned 06/16/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$9.40M
24GClaims437,873
24DCodes billed81
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in North Carolina
Rank by total paid#5 of 324
Median peer was paid$279K
This provider vs. median34×
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 ANDERSON, SHARMILA controls 20+ 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 | 24,549 | $873K | |
| 2019 | 23,085 | $890K | |
| 2020 | 20,504 | $839K | |
| 2021 | 45,434 | $1.35M | |
| 2022 | 97,642 | $1.53M | |
| 2023 | 92,735 | $1.44M | |
| 2024incomplete | 133,924 | $2.49M |
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 | 66% | 62,765 | 46,544 | $6.22M |
| 99199 | Unlisted special service, procedure or report | 15% | 259,718 | 187,366 | $1.41M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.7% | 6,448 | 4,366 | $438K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 4.6% | 5,707 | 4,342 | $437K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.2% | 3,872 | 2,977 | $304K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.7% | 2,587 | 1,751 | $162K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 7,617 | 5,804 | $83K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 11,674 | 8,818 | $76K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 971 | 834 | $28K |
| 90697 | <1% | 1,572 | 1,209 | $19K | |
| 92551 | <1% | 10,337 | 7,768 | $16K | |
| 99384 | <1% | 257 | 180 | $16K |
69 more codes
| 99381 | <1% | 285 | $15K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 559 | $14K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 422 | $14K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 2,171 | $14K |
| D1206 | Topical application of fluoride varnish | <1% | 955 | $12K |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,320 | $12K |
| 90677 | <1% | 769 | $12K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 755 | $9K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 926 | $8K |
| 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% | 904 | $8K |
| 99173 | <1% | 10,586 | $7K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 600 | $7K |
| 90670 | <1% | 2,980 | $7K | |
| 99383 | <1% | 111 | $6K | |
| 96160 | <1% | 2,587 | $6K | |
| 85018 | <1% | 4,200 | $5K | |
| 90619 | <1% | 185 | $4K | |
| 82948 | <1% | 1,177 | $4K | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 212 | $3K |
| 87428 | <1% | 43 | $3K | |
| 87807 | <1% | 136 | $2K | |
| 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% | 94 | $2K |
| 99401 | <1% | 300 | $2K | |
| 90474 | <1% | 227 | $1K | |
| 0001A | <1% | 38 | $1K | |
| 90710 | <1% | 1,307 | $1K | |
| 96127 | <1% | 704 | $1K | |
| 90734 | <1% | 274 | $891.76 | |
| 0002A | <1% | 22 | $715.00 | |
| 90698 | <1% | 270 | $623.00 | |
| 90656 | <1% | 463 | $573.00 | |
| 97802 | <1% | 30 | $490.20 | |
| 90686 | <1% | 1,755 | $432.10 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $416.85 |
| 90633 | <1% | 1,845 | $351.62 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,504 | $318.78 |
| 90651 | <1% | 1,111 | $300.06 | |
| 98967 | <1% | 22 | $291.84 | |
| 36416 | <1% | 1,087 | $249.64 | |
| 81002 | <1% | 97 | $218.22 | |
| 90715 | <1% | 116 | $99.63 | |
| 90473 | <1% | 325 | $82.26 | |
| 82962 | <1% | 31 | $56.71 | |
| 82044 | <1% | 17 | $43.68 | |
| 3078F | <1% | 5,118 | $13.71 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 59 | $13.40 |
| 90461 | <1% | 991 | $11.88 | |
| 94760 | <1% | 81 | $10.65 | |
| 90680 | 0% | 1,738 | $0.00 | |
| 3074F | 0% | 5,416 | $0.00 | |
| 1111F | 0% | 176 | $0.00 | |
| 90647 | 0% | 83 | $0.00 | |
| 90723 | 0% | 393 | $0.00 | |
| 90744 | 0% | 25 | $0.00 | |
| 3008F | 0% | 782 | $0.00 | |
| 99000 | 0% | 188 | $0.00 | |
| 3079F | 0% | 49 | $0.00 | |
| 96150 | 0% | 82 | $0.00 | |
| 90620 | 0% | 36 | $0.00 | |
| 90696 | 0% | 121 | $0.00 | |
| 99174 | 0% | 91 | $0.00 | |
| 90700 | 0% | 138 | $0.00 | |
| 3077F | 0% | 39 | $0.00 | |
| 90648 | 0% | 819 | $0.00 | |
| 90681 | 0% | 182 | $0.00 | |
| 90685 | 0% | 138 | $0.00 | |
| 99499 | 0% | 15 | $0.00 | |
| 90621 | 0% | 30 | $0.00 | |
| 99188 | 0% | 23 | $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 officialANDERSON, SHARMILA (BUSINESS SERVICE ADMINISTRATOR)
Parent organizationGASTON FAMILY HEALTH SERVICES, INC
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.