Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Puerto Rico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Puerto Rico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Puerto Rico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Farmacia Doral, Inc. (NPI 1003989831)

Field	Value
Entity Type	Organization
Organization	Farmacia Doral, Inc.
Address	1001 Calle San Roberto, Ste 101
City	San Juan
State	PR
ZIP	00926
Taxonomy	Specialty Pharmacy
NPI Enumerated	November 17, 2006

Payer Source	Total Paid
Medicaid	$115.6M
Medicare	$0

Key Findings

FARMACIA DORAL, INC. reports $115.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer (Medicaid) operation in the available data. This concentration on Medicaid billing shapes its competitive and financial profile and means payer-specific reimbursement policy changes at the state level could materially affect its business.

Revenue is highly concentrated in a small set of high-cost biologic/injectable drugs: the precomputed top three Medicaid codes account for 65.5% of the provider's Medicaid revenue. Those top three are J9271 ($38.9M; 33.7% of total), J9035 ($21.3M; 18.5% of total), and J9299 ($15.2M; 13.2% of total), indicating that a minority of codes drive the majority of cash flow.

The code mix and dollar values point to a specialty oncology/injectable biologics operation rather than a general retail pharmacy: J9271 (pembrolizumab), J9035 (bevacizumab), J9299 (nivolumab) and nearby high-revenue items such as J9355 (trastuzumab) and J9306 (pertuzumab) are systemic oncology biologics typically administered or dispensed through specialty infusion or specialty pharmacy channels. Average paid/claim amounts reinforce this profile — for example, J9271 averages $9015 paid/claim, J9299 averages $7519 paid/claim, and J9035 averages $4133 paid/claim — consistent with handling high-cost oncology therapies.

State-level competitive standing is mixed but strong in several key products: FARMACIA DORAL ranks #1 in the state for J9035 (rank #1 of 23; 100th percentile; labeled an "extreme outlier"), J9299 (rank #1 of 4; 100th percentile; typical), and J9355 (rank #1 of 6; 100th percentile; notably above typical). It ranks #2 for J9271 (rank #2 of 6; 80th percentile; typical), indicating the provider is a leading statewide supplier for multiple high-revenue oncology agents and an outlier for bevacizumab volume.

The provider’s heavy reliance on a few very costly oncology codes implies revenue and operational exposure to utilization and reimbursement shifts for those drugs: with $115.6M in Medicaid revenue and no Medicare receipts, any changes in state Medicaid coverage, pricing, or prior-authorization policies for J9271, J9035, or J9299 could disproportionately affect overall revenue. The combination of single-payer concentration and a top-three share of 65.5% suggests limited diversification across payers and product lines.

FARMACIA DORAL has an NPI enumeration date of 2006-11-17 (~20 years ago), indicating an established presence in the market and likely sustained relationships with state Medicaid programs and prescribing providers. Despite this tenure, the business remains concentrated in specialty oncology injectables rather than a broad mix of pharmacy services, as evidenced by the top codes and their high average paid/claim amounts.

Beyond the top three, the Medicaid claims list shows repeated high-state rankings for oncology and supportive-care injectables (for example, J9312, J9310, J2506, and J9190 appear with notable rank or high per-claim payments), reinforcing that the operation centers on infusion-administered and high-cost injectable therapies rather than routine outpatient pharmacy volumes. This pattern underscores a service-line focus on specialty dispensing and/or infusion management within the oncology therapeutic area.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	4,310	$9,020	$38.9M
J9035	Injection, bevacizumab, 10 mg	5,160	$4,130	$21.3M
J9299	Injection, nivolumab, 1 mg	2,030	$7,520	$15.2M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	2,770	$4,450	$12.3M
J9306	Injection, pertuzumab, 1 mg	1,770	$5,230	$9.2M
J9312	Injection, rituximab, 10 mg	1,160	$4,760	$5.5M
J0897	Injection, denosumab, 1 mg	1,650	$2,260	$3.7M
J9395	Injection, fulvestrant, 25 mg	1,190	$1,660	$2M
J9055	Injection, cetuximab, 10 mg	170	$6,490	$1.1M
J9022	Injection, atezolizumab, 10 mg	160	$6,280	$991.6K

Showing 1–10 of 42

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

Claims Volume vs. Puerto Rico Distribution

Farmacia Doral, Inc. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	2	10	220	$9,780	$16.9M
J9299	Injection, nivolumab, 1 mg	1	10	1,120	$7,470	$8M
J9306	Injection, pertuzumab, 1 mg	2	10	420	$5,490	$5M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	1	10	490	$4,520	$4.4M
J9358	Injection, fam-trastuzumab deruxtecan-nxki, 1 mg	2	10	380	$10,180	$3.8M
J9312	Injection, rituximab, 10 mg	1	10	720	$4,970	$3.3M
J0897	Injection, denosumab, 1 mg	2	10	940	$2,500	$3.2M
J9022	Injection, atezolizumab, 10 mg	2	10	350	$9,090	$3.2M
J9055	Injection, cetuximab, 10 mg	2	10	310	$7,470	$2.3M
J9035	Injection, bevacizumab, 10 mg	1	20	370	$2,820	$2.3M

Showing 1–10 of 42

Nearby Providers

Other providers in the same ZIP code as Farmacia Doral, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grupo Neonatal C.s.p.	PR	Neonatal-Perinatal Medicine Physician	$0	$6M
Aps Clinics Of Puerto Rico, Inc.	PR	Adult Mental Health Clinic/Center	$0	$5.7M
Alejandro Marmolejo	PR	General Practice Physician	$2.5K	$2.1M
Bvr Ambulance Best Care Inc	PR	Land Ambulance	$10.2K	$1.6M
Jan Rodriguez Ferrer	PR	Internal Medicine Physician	$60.6K	$1.4M
Nuvasive Pr, Inc.	PR	Durable Medical Equipment & Medical Supplies	$0	$1.2M
Rebeca Cuebas	PR	Pediatrics Physician	$0	$1M
Cck Medical Csp	PR	Cardiovascular Disease Physician	$0	$983K
Renato Rivera	PR	Family Medicine Physician	$0	$886.7K
Carlos Maldonado	PR	General Practice Dentistry	$0	$859K

Farmacia Doral, Inc. — Billing Profile & Reimbursement Data

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Farmacia Doral, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References