Clinic
Edgewater Systems for Balanced Living, INC
Edgewater Systems for Balanced Living, INC was paid $2.40M by Medicaid between Jun 2019 and Nov 2024, across 27 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 30% of everything it billed.
33Billing provider infoEDGEWATER SYSTEMS FOR BALANCED LIVING, INC
GARY, IN 46402
GARY, IN 46402
33aNPI1598316978assigned 09/26/2019
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$2.40M
24GClaims44,188
24DCodes billed27
24AFirst – last monthJun 2019 – Nov 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Indiana
Rank by total paid#40 of 156
Median peer was paid$568K
This provider vs. median4.2×
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 | |
|---|---|---|---|
| 2019 | 1,290 | $174K | |
| 2020 | 5,237 | $343K | |
| 2021 | 11,228 | $550K | |
| 2022 | 12,695 | $631K | |
| 2023 | 8,133 | $412K | |
| 2024incomplete | 5,605 | $292K |
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 | 30% | 12,428 | 9,140 | $725K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 22% | 8,397 | 5,222 | $534K |
| 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 | 19% | 7,853 | 6,477 | $451K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 8.7% | 2,160 | 1,914 | $209K |
| 90838 | 5.3% | 1,406 | 1,202 | $128K | |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 3.3% | 2,879 | 2,231 | $79K |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit | 2.2% | 2,043 | 1,221 | $52K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.9% | 1,319 | 1,137 | $46K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.7% | 1,285 | 858 | $41K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.4% | 640 | 546 | $33K |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 622 | 360 | $23K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,414 | 1,273 | $19K |
15 more codes
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 271 | $16K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 718 | $16K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 113 | $13K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 186 | $6K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 44 | $3K |
| 99205 | Prolong outpt/office vis | <1% | 17 | $2K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 16 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 111 | $1K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 22 | $1K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 17 | $936.88 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 70 | $825.00 |
| 36415 | Collection of venous blood by venipuncture | <1% | 12 | $34.28 |
| 99308 | Subsequent nursing facility care, per day, straightforward | 0% | 114 | $0.00 |
| 99442 | 0% | 15 | $0.00 | |
| 90710 | 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 officialHUGHES, DANITA (PRESIDENT & CEO)
| Provider | Location | Paid |
|---|---|---|
| Edgewater Systems for Balanced Living, INC | Gary, IN | $3.62M |
| Edgewater Systems for Balanced Living, INC | Merrillville, IN | $295K |
| Edgewater Systems for Balanced Living, INC | Gary, IN | $182K |
| Edgewater Systems for Balanced Living, INC | Griffith, IN | $1K |
| Edgewater Systems for Balanced Living, INC | Gary, IN | $714.78 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.