DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) - MARKET SIZE, PREVALENCE, INCIDENCE, QUALITY OUTCOMES, TOP HOSPITALS & PHYSICIANS


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CHARGE CAPTURE ANALYSIS FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) GROUP BASED ON MEDICARE

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DRG Code DRG Description Category Sub Category DRG Group Surgical Category Case Mix Level Total National Projected Hospitalizations - Annualized Total Medicare Hospitalizations - Jan 2017 to Dec 2017 Total Medicare Hospitalizations - Jan 2013 to Dec 2017 Total Medicare Hospitalizations After Exclusion Avg. LOS GMLOS All Cause Readmission Rate (%) Unplanned Readmission Rate (%) Total Medicare Payments Payment per Day Payment per Discharge Total Medicare Charges Avg. Charges Mortality Rate (%) SNF Discharge Rate (%) Home Discharge Rate (%)
194 SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy Non Surgical 43.60 NA 124,396 800,676 771,083
193 SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy Non Surgical 39.08 NA 123,605 717,724 664,932
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy Non Surgical 17.33 NA 46,671 318,219 307,566

DEMOGRAPHIC DETAILS OF DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC)

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Race Total Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
White 685,713 85.64
Black 68,646 8.57
Hispanic 15,909 1.99
Age Group ( Years ) Total Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
Greater than 84 236,491 29.54
80 to 84 128,139 16.0
75 to 79 117,938 14.73

TOP ICD DIAGNOSIS CODES FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC)

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ICD Code ICD Description Total ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
486 Pneumonia, organism unspecified 433,088 54.09
4019 Unspecified essential hypertension 242,172 30.25
J189 Pneumonia, unspecified organism 237,122 29.62

TOP ICD PROCEDURE CODES FOR DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC)

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ICD Code ICD Description Total Procedure ICD & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
9904 Transfusion Of Packed Cells 21,454 2.68
3491 Thoracentesis 11,394 1.42
9921 Injection Of Antibiotic 10,944 1.37

TOP HOSPITALS ASSOCIATED WITH DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC)

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Hospital Name Address City State Zip Code Total Hospital & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
Florida Hospital Orlando 601 E ROLLINS ST Orlando FL 32803 1,950 0.24
Christiana Hospital 501 W 14TH ST Wilmington DE 19801 1,834 0.23
University of Texas MD Anderson Cancer Center 1515 HOLCOMBE BLVD Houston TX 77030 1,388 0.17

TOP ATTENDING PHYSICIAN ASSOCIATED WITH DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC)

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Physician Name Address City State Zip Code Total Physician & DRG Hospitalization Volume - Jan 2013 to Dec 2017 % of DRG Volume
DR. VENKATAPURAM RAMESH REDDY 42320 HIGHWAY 195 HALEYVILLE AL 35565 779 0.1
DR. HOUSAM I HADDAD 187 WOLFORD AVE LIBERTY KY 42539 234 0.03
DR. STANLEY K MORROW 34867 HWY 43 HACKLEBURG AL 35564 229 0.03

DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) SUMMARY TABLE

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Category Sub Category DRG Group ICD Codes ICD Description National Projected Hospitalizations (Present on Admission - All) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - All) Jan 2013 to Dec 2017 National Projected Hospitalizations(Present on Admission - Yes) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - Yes) Jan 2013 to Dec 2017 National Projected Hospitalizations (Present on Admission - Not Y) Jan 2016 to Dec 2016 Medicare Hospitalizations (Present on Admission - Not Y) Jan 2013 to Dec 2017 Total Discharges After Exclusion Avg. LOS GMLOS All Cause Readmission Rate (%) Unplanned Readmission Rate (%) Total Medicare Payments Payment per Day Payment per Discharge Total Medicare Charges Avg. Charges Mortality Rate (%) SNF Discharge Rate (%) Home Discharge Rate (%)
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 486 Pneumonia, organism unspecified NA 433,088
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 4019 Unspecified essential hypertension NA 242,172
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy J189 Pneumonia, unspecified organism 229,954 237,122
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 2724 Other and unspecified hyperlipidemia NA 173,208
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy I10 Essential (primary) hypertension 129,914 147,825
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 4280 Congestive heart failure, unspecified NA 119,176
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 53081 Esophageal reflux NA 117,410
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 42731 Atrial fibrillation NA 117,269
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy 25000 Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled NA 116,728
Pulmonology Simple Pneumonia And Pleurisy Simple Pneumonia And Pleurisy E785 Hyperlipidemia, unspecified 85,561 113,546