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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Bloodworks (NPI 1053799403)

Field	Value
Entity Type	Organization
Organization	Bloodworks
Address	921 Terry Ave
City	Seattle
State	WA
ZIP	98104
Taxonomy	Community/Retail Pharmacy
NPI Enumerated	May 18, 2015

Payer Source	Total Paid
Medicaid	$56.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file and the practice reports $56.8M in lifetime Medicaid revenue, indicating Medicaid is the dominant (and only reported) public payer relationship for this entity. The absence of Medicare activity suggests its business and billing operations are focused on Medicaid-covered services rather than dual Medicare/Medicaid contracting.

Revenue is highly concentrated in three Medicaid codes that together account for 100.0% of the provider's Medicaid income. Specifically, J7192 accounts for $25M revenue (43.9% of this provider's total Medicaid revenue), J7170 accounts for $20.5M revenue (36.2% of this provider's total Medicaid revenue), and S9430 accounts for $11.3M revenue (19.9% of this provider's total Medicaid revenue).

The provider’s Community/Retail Pharmacy taxonomy combined with the top codes indicates a specialty pharmacy operation focused on high-cost hemophilia therapies and pharmacy compounding/dispensing. J7192 (Factor viii, recombinant) and J7170 (emicizumab-kxwh) are specialty biologic/injectable products used in bleeding disorder management, while S9430 denotes pharmacy compounding and dispensing services, signaling integrated specialty dispensing and compounding workflows.

J7192 is the single largest Medicaid revenue driver at $25M and ranks #1 of 2 in-state (100th percentile), a position characterized as typical and unremarkable for volume; this indicates the provider is a leading in-state supplier of this product but operates in a market with very few competitors. J7170 generates $20.5M, ranks #2 of 2 in-state (0th percentile) and is also labeled typical and unremarkable, suggesting meaningful participation in emicizumab dispensing but without wide in-state dominance for that specific code.

S9430 (pharmacy compounding and dispensing services) shows 3.2K claims, a $3495 avg paid/claim and $11.3M in revenue, and ranks #6 of 21 in-state (75th percentile) with a typical, unremarkable volume designation. This placement indicates the provider is a relatively prominent compounding/dispensing provider within the state, supporting its specialty product distribution role but not the very top tier statewide for this service line.

The concentration of Medicaid revenue in two very high-cost biologic codes (J7192 at 43.9% and J7170 at 36.2%) plus a compounding/dispensing code (S9430 at 19.9%) creates business sensitivity to changes in formulary coverage, payer contracting, or utilization patterns for a small number of products. Such a concentrated revenue mix can accelerate revenue volatility if payer policies or clinical use of these agents shift, but it also highlights a focused expertise in high-value specialty therapies.

The provider’s NPI was enumerated on 2015-05-18 (~11 years ago), indicating an established operational history in its market. This tenure, combined with demonstrated volume in specialty biologics and compounding, suggests operational experience with high-cost injectable product handling and Medicaid reimbursement processes that may support continued participation in these niches.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J7192	Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified	1,560	$16,020	$25M
J7170	Injection, emicizumab-kxwh, 0.5 mg	880	$23,400	$20.5M
S9430	Pharmacy compounding and dispensing services	3,240	$3,500	$11.3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Bloodworks — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J7170	Injection, emicizumab-kxwh, 0.5 mg	2	10	1,970	$27,570	$54.3M
J7192	Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified	1	10	1,250	$13,430	$16.8M
S9430	Pharmacy compounding and dispensing services	6	20	1,170	$280	$2.2M

Related Providers

Other providers that share a Tax Identification Number (TIN) with Bloodworks, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington Institute For Coagulation	WA	Community/Retail Pharmacy	$656.3K	$117M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Harborview Medical Center	WA	General Acute Care Hospital	$0	$128.2M
Seattle-king County Dept Of Public Health	WA	Case Manager/Care Coordinator	$0	$74M
The Association Of University Physicians	WA	Anesthesiology Physician	$0	$66.3M
Seattle-king County Dept Of Public Health	WA	Dental Clinic/Center	$0	$62.9M
Swedish Health Services	WA	Internal Medicine Physician	$0	$21.1M
International Community Health Services	WA	Dentist	$0	$16M
Swedish Health Services	WA	Family Medicine Physician	$0	$11.1M
Northwest Kidney Centers	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.2M
King County Finance	WA	State or Local Public Health Clinic/Center	$0	$5.7M
Downtown Emergency Service Center	WA	Community/Behavioral Health Agency	$0	$3.3M

Bloodworks — Billing Profile & Reimbursement Data

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Bloodworks — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References