Clinic
Gaston Family Health Services, INC.
Gaston Family Health Services, INC. was paid $2.38M by Medicaid between Jan 2018 and Dec 2024, across 24 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 infoGASTON FAMILY HEALTH SERVICES, INC.
LEXINGTON, NC 27292
LEXINGTON, NC 27292
33aNPI1407188071assigned 02/08/2010
33bProvider typeCommunity Health Clinic/Center
28Total paid$2.38M
24GClaims102,697
24DCodes billed24
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Community Health Clinic/Center providers in North Carolina
Rank by total paid#9 of 22
Median peer was paid$795K
This provider vs. median3.0×
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 | 1,903 | $139K | |
| 2019 | 2,070 | $155K | |
| 2020 | 1,473 | $154K | |
| 2021 | 4,535 | $268K | |
| 2022 | 10,322 | $282K | |
| 2023 | 27,403 | $394K | |
| 2024incomplete | 54,991 | $988K |
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% | 16,506 | 13,221 | $1.79M |
| 99199 | Unlisted special service, procedure or report | 23% | 84,277 | 48,035 | $558K |
| 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% | 171 | 94 | $6K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 497 | 470 | $5K |
| 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% | 100 | 80 | $5K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 210 | 149 | $4K |
| 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% | 35 | 26 | $3K |
| 0011A | <1% | 53 | 49 | $2K | |
| 0012A | <1% | 36 | 36 | $2K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 20 | 12 | $918.90 |
| 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% | 39 | 37 | $896.00 |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 80 | 43 | $677.38 |
12 more codes
| 36415 | Collection of venous blood by venipuncture | <1% | 283 | $490.84 |
| 94010 | <1% | 12 | $271.59 | |
| 99441 | <1% | 16 | $206.40 | |
| 82044 | <1% | 28 | $98.28 | |
| 81002 | <1% | 15 | $39.00 | |
| 3078F | <1% | 14 | $32.87 | |
| 3008F | 0% | 93 | $0.00 | |
| 3074F | 0% | 50 | $0.00 | |
| 3079F | 0% | 12 | $0.00 | |
| 91301 | 0% | 96 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 12 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 42 | $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.