Agency
Edgewater Systems for Balanced Living, INC.
Edgewater Systems for Balanced Living, INC. was paid $2.82M by Medicaid between Jan 2018 and Oct 2024, across 30 billing codes. Its largest line is 90837, psychotherapy session, about an hour — 42% of everything it billed.
33Billing provider infoEDGEWATER SYSTEMS FOR BALANCED LIVING, INC.
GARY, IN 46402
GARY, IN 46402
33aNPI1588705784assigned 02/09/2007
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$2.82M
24GClaims69,588
24DCodes billed30
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Indiana
Rank by total paid#18 of 82
Median peer was paid$713K
This provider vs. median4.0×
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.
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 | 23,244 | $388K | |
| 2019 | 20,215 | $897K | |
| 2020 | 15,108 | $882K | |
| 2021 | 9,428 | $596K | |
| 2022 | 852 | $36K | |
| 2023 | 566 | $16K | |
| 2024incomplete | 175 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 42% | 21,341 | 12,005 | $1.17M |
| 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 | 14% | 9,724 | 7,230 | $402K |
| H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | 9.6% | 1,786 | 194 | $270K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 8.0% | 3,226 | 2,824 | $227K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 3.7% | 1,969 | 1,086 | $105K |
| 90838 | 3.4% | 2,117 | 1,691 | $96K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.3% | 3,233 | 819 | $94K |
| H0038 | Self-help/peer services, per 15 minutes | 2.9% | 1,927 | 1,070 | $82K |
| 99205 | Prolong outpt/office vis | 2.4% | 1,208 | 953 | $68K |
| T1016 | Case management, each 15 minutes | 2.2% | 1,012 | 606 | $61K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.7% | 4,499 | 3,996 | $48K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 1.3% | 8,670 | 2,559 | $38K |
18 more codes
| 90834 | Psychotherapy session, about 45 minutes | 1.2% | 794 | $34K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 961 | $28K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 727 | $22K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 764 | $19K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 2,542 | $13K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 210 | $7K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 146 | $5K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 105 | $5K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 417 | $4K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 132 | $4K |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | <1% | 1,375 | $4K |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 41 | $2K |
| H2014 | Skills training and development, per 15 minutes | <1% | 77 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 19 | $2K |
| 90846 | Family psychotherapy without the patient present, 50 minutes | <1% | 17 | $1K |
| 90785 | <1% | 363 | $298.88 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 170 | $180.60 |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 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 officialLOTT, LUNETTE (DIRECTOR ACCTS. RECEIVABLES)