Behavioral
Edgewater Systems for Balanced Living, INC.
Edgewater Systems for Balanced Living, INC. was paid $461K by Medicaid between Jan 2018 and Dec 2021, across 30 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 37% of everything it billed.
33Billing provider infoEDGEWATER SYSTEMS FOR BALANCED LIVING, INC.
MERRILLVILLE, IN 46410
MERRILLVILLE, IN 46410
33aNPI1699225698assigned 10/13/2016
33bProvider typeMental Health Counselor
28Total paid$461K
24GClaims29,594
24DCodes billed30
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other Mental Health Counselor providers in Indiana
Rank by total paid#45 of 131
Median peer was paid$165K
This provider vs. median2.8×
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 | 9,477 | $70K | |
| 2019 | 10,873 | $198K | |
| 2020 | 8,096 | $148K | |
| 2021 | 1,148 | $46K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 37% | 11,524 | 2,119 | $172K |
| 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 | 23% | 3,938 | 2,861 | $106K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 15% | 3,149 | 2,442 | $70K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 8.0% | 2,361 | 1,848 | $37K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 7.9% | 1,332 | 831 | $37K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 2.4% | 2,432 | 445 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.4% | 622 | 434 | $6K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 241 | 178 | $3K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 69 | 54 | $3K |
| 99305 | <1% | 72 | 56 | $3K | |
| 99223 | Prolong inpt eval add15 m | <1% | 63 | 58 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 353 | 248 | $2K |
18 more codes
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 108 | $2K |
| 94010 | <1% | 348 | $1K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,417 | $1K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 425 | $1K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 36 | $570.23 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 15 | $410.48 |
| 81002 | <1% | 411 | $336.22 | |
| 80061 | Lipid panel | <1% | 153 | $273.37 |
| 93000 | <1% | 68 | $255.94 | |
| 94060 | <1% | 19 | $237.42 | |
| 99000 | <1% | 143 | $158.57 | |
| 80305 | <1% | 33 | $94.20 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 24 | $87.70 |
| 90749 | <1% | 18 | $51.79 | |
| 82962 | <1% | 18 | $18.43 | |
| 99406 | <1% | 46 | $11.80 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 37 | $1.94 |
| T1015 | A visit at a community health center or clinic (one all-in rate) | 0% | 119 | $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 officialJOHNSON HUGHES, DANITA (PRESIDENT/CEO)
Parent organizationEDGEWATER SYSTEMS FOR BALANCED LIVING, INC.