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NPI 1891819017 · Christiansted, VI · Family Medicine Physician
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Gemaine Owen is a family medicine physician provider located in Christiansted, U.S. Virgin Islands. This profile covers 5 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Gemaine Owen |
| Address | 4500 Sunny Isle |
| City | Christiansted |
| State | VI |
| ZIP | 00820 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | March 16, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $23.2K |
| Medicare | $22.1K |
Provider-level payer mix is roughly balanced: reported lifetime Medicare revenue is $22.1K while lifetime Medicaid revenue is $23.2K, so this clinician is not effectively single-payer and derives comparable scale from both programs. The near parity suggests operational exposure to reimbursement and utilization patterns in both Medicare and Medicaid populations rather than dependence on a single program.
Revenue concentration on Medicare is high and narrowly focused: the top three Medicare codes (99232, 99233, 99223) account for 81.0% of this provider's total Medicare revenue, with 99232 alone representing 36.5% of Medicare revenue. All three are hospital inpatient/observation E/M codes, which indicates the provider’s Medicare activity is concentrated in inpatient evaluation-and-management services rather than in office-based primary care.
Medicaid revenue is even more concentrated: the top three Medicaid codes account for 100.0% of Medicaid revenue, with 99232 producing 89.8% and 99239 producing 10.2% of this provider's Medicaid revenue. This split points to a Medicaid practice profile dominated by subsequent inpatient/observation care (99232) and discharge-day management (99239), implying most Medicaid encounters are hospital-based E/M events.
Competitive standing nationally for the provider's Medicare activity is modest: 99232 ranks #63790 of 177383 providers (64th percentile) and both 99233 and 99223 rank in the 45th percentile nationally, labels the data frames as "typical, unremarkable volume for this code." These percentiles indicate the provider is an ordinary-volume participant for these inpatient E/M services at the national level rather than a high-volume or dominant national player.
State-level competitive position in Medicaid is stronger for inpatient follow-up: 99232 ranks #2 of 5 in-state (75th percentile) and 99239 ranks #2 of 3 in-state (50th percentile), with the dataset describing these as "typical, unremarkable volume for this code." Being second-ranked among a small in-state peer set for 99232 suggests a relatively important local role for that specific Medicaid service even if the absolute number of peers is small.
Tenure is long and supports interpretation of established practice patterns: the NPI was enumerated 2007-03-16 (~19 years ago), indicating nearly two decades of potential billing history that is consistent with the concentrated, repeatable E/M service mix observed across both payers. This longevity makes short-term anomalies less likely and supports treating the reported pattern as a stable operating profile.
Claim-level detail for Medicare reinforces the inpatient focus: for Medicare 99232 shows 137 claims at $59 avg paid/claim for $8.1K revenue (36.5% of Medicare revenue), 99233 shows 70 claims at $81 avg paid/claim for $5.7K revenue (25.6%), and 99223 shows 35 claims at $119 avg paid/claim for $4.2K revenue (18.8%). These per-code claim and payment figures align with hospital-based E/M services where fewer high-acuity initial or subsequent visits (higher avg paid per claim for 99223) and more frequent subsequent visits (higher claim counts for 99232) coexist.
Business exposure is concentrated in a narrow service line: given that the top three Medicare codes account for 81.0% of Medicare revenue and the top three Medicaid codes account for 100.0% of Medicaid revenue, the provider’s revenue depends heavily on a small set of inpatient/observation E/M codes. That concentration creates operational sensitivity to utilization shifts, coding practice changes, or payer policy changes affecting those specific hospital E/M services, and should be a focus for payer/provider analysts monitoring utilization or contract negotiations.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 140 | $60 | $8.1K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 70 | $80 | $5.7K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 40 | $120 | $4.2K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 40 | $80 | $3K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 20 | $70 | $1.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 460 | $50 | $20.7K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 40 | $60 | $2.3K |
How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. U.S. Virgin Islands median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 2 | 10 | 430 | $50 | $41.4K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 2 | 10 | 40 | $60 | $16.2K |
Other providers in the same ZIP code as Gemaine Owen, ranked by combined Medicare and Medicaid revenue.
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