*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema - as a primary diagnosis code | E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.48 | |
| Readmission Rate (%) | 29.1 | |
| Unplanned Readmission Rate (%) | 14.66 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 125: OTHER DISORDERS OF THE EYE WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 124: OTHER DISORDERS OF THE EYE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 11,033 | |
| Total Hospitalizations with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 70 | |
| DRG Share of Total Hospitalizations | 0.03 | |
| % of Total ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema in DRG | 56.91 | |
| Avg LOS at DRG | 3.12 | |
| Avg LOS with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 2.84 | |
| Readmission Rate at DRG | 14.43 | |
| Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | NA | |
| Unplanned Readmission Rate at DRG | 9.53 | |
| Unplanned Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | NA | |
| Total Medicare payments at DRG | $51,804,064 | |
| Total Medicare payments with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $323,473 | |
| Total Medicare payment per Day at DRG | $1,505 | |
| Total Medicare payment per Day with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $1,625 | |
| Total Medicare payment per Hospitalization at DRG | $4,695 | |
| Total Medicare payment per Hospitalization with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $4,621 | |
| Total Medicare Charges at DRG | $301,182,636 | |
| Total Medicare Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $2,019,792 | |
| Avg Charges at DRG | $27,298 | |
| Avg Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $28,854 | |
| Mortality Rate at DRG | 0.11 | |
| Mortality Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | NA | |
| SNF Discharge Rate at DRG | 17.96 | |
| SNF Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | NA | |
| Home Discharge Rate at DRG | 57.38 | |
| Home Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 67.14 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 638: DIABETES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 16,201 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema in DRG | 6.32 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 5.57 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 30.38 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 23.85 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $156,524,194 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $1,736 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $9,661 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $736,006,364 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $45,430 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 2.17 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 17.2 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 45.15 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 252: OTHER VASCULAR PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 231,812 | ||||
| Total Hospitalizations with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 4,927 | ||||
| DRG Share of Total Hospitalizations | 0.71 | ||||
| % of Total ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema in DRG | 1.92 | ||||
| Avg LOS at DRG | 4.41 | ||||
| Avg LOS with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 3.65 | ||||
| Readmission Rate at DRG | 29.12 | ||||
| Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 31.7 | ||||
| Unplanned Readmission Rate at DRG | 22.82 | ||||
| Unplanned Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 26.38 | ||||
| Total Medicare payments at DRG | $1,743,376,418 | ||||
| Total Medicare payments with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $36,977,165 | ||||
| Total Medicare payment per Day at DRG | $1,704 | ||||
| Total Medicare payment per Day with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $2,055 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,521 | ||||
| Total Medicare payment per Hospitalization with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $7,505 | ||||
| Total Medicare Charges at DRG | $8,543,867,896 | ||||
| Total Medicare Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $177,998,646 | ||||
| Avg Charges at DRG | $36,857 | ||||
| Avg Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $36,127 | ||||
| Mortality Rate at DRG | 2.89 | ||||
| Mortality Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 1.22 | ||||
| SNF Discharge Rate at DRG | 22.92 | ||||
| SNF Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 14.17 | ||||
| Home Discharge Rate at DRG | 43.02 | ||||
| Home Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 59.85 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 637: DIABETES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 422,757 | ||||
| Total Hospitalizations with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 3,816 | ||||
| DRG Share of Total Hospitalizations | 1.29 | ||||
| % of Total ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema in DRG | 1.49 | ||||
| Avg LOS at DRG | 4.14 | ||||
| Avg LOS with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 4.62 | ||||
| Readmission Rate at DRG | 24.43 | ||||
| Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 26.63 | ||||
| Unplanned Readmission Rate at DRG | 18.48 | ||||
| Unplanned Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 20.47 | ||||
| Total Medicare payments at DRG | $2,636,135,714 | ||||
| Total Medicare payments with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $25,109,248 | ||||
| Total Medicare payment per Day at DRG | $1,507 | ||||
| Total Medicare payment per Day with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $1,425 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,236 | ||||
| Total Medicare payment per Hospitalization with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $6,580 | ||||
| Total Medicare Charges at DRG | $11,980,955,733 | ||||
| Total Medicare Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $116,396,819 | ||||
| Avg Charges at DRG | $28,340 | ||||
| Avg Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $30,502 | ||||
| Mortality Rate at DRG | 1.01 | ||||
| Mortality Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 0.47 | ||||
| SNF Discharge Rate at DRG | 16.05 | ||||
| SNF Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 14.12 | ||||
| Home Discharge Rate at DRG | 47.18 | ||||
| Home Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 48.87 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 652: KIDNEY TRANSPLANT | DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 134,001 | ||||
| Total Hospitalizations with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 2,744 | ||||
| DRG Share of Total Hospitalizations | 0.41 | ||||
| % of Total ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema in DRG | 1.07 | ||||
| Avg LOS at DRG | 5.32 | ||||
| Avg LOS with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 6.19 | ||||
| Readmission Rate at DRG | 23.7 | ||||
| Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 30.33 | ||||
| Unplanned Readmission Rate at DRG | 16.43 | ||||
| Unplanned Readmission Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 22.51 | ||||
| Total Medicare payments at DRG | $2,854,117,533 | ||||
| Total Medicare payments with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $61,635,558 | ||||
| Total Medicare payment per Day at DRG | $4,006 | ||||
| Total Medicare payment per Day with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $3,626 | ||||
| Total Medicare payment per Hospitalization at DRG | $21,299 | ||||
| Total Medicare payment per Hospitalization with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $22,462 | ||||
| Total Medicare Charges at DRG | $16,607,700,460 | ||||
| Total Medicare Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $360,558,612 | ||||
| Avg Charges at DRG | $123,937 | ||||
| Avg Charges with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | $131,399 | ||||
| Mortality Rate at DRG | 3.88 | ||||
| Mortality Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 2.88 | ||||
| SNF Discharge Rate at DRG | 10.96 | ||||
| SNF Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 11.84 | ||||
| Home Discharge Rate at DRG | 62.82 | ||||
| Home Discharge Rate with ICD E11319 - Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | 60.39 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| FORT DUNCAN MEDICAL CENTER | 3333 N FOSTER MALDONADO BLVD | EAGLE PASS | TX | 78852 | 1,122 |
| UNIVERSITY OF MICHIGAN HEALTH SYSTEM | 1500 EAST MEDICAL CENTER DRIVE | ANN ARBOR | MI | 48109 | 1,071 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 994 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. LUIS GUTIERREZ-PERRY | 3406 BOB ROGERS DR. | EAGLE PASS | TX | 78852 | 184 |
| Dr. ALEJANDRO SOLANO BAYARDO | 622 W MAPLE ST STE H | FARMINGTON | NM | 87401 | 116 |
| Dr. SHATISHKUMAR Y PATEL | 8200 WEDNESBURY LN | HOUSTON | TX | 77074 | 111 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SERGIO ZAMORA | 2450 EL INDIO HWY | EAGLE PASS | TX | 78852 | 941 |
| Dr. CARLOS SAMUEL MARTINEZ | 4214 BEVERLY BLVD STE 212 | LOS ANGELES | CA | 90004 | 282 |
| Dr. SHATISHKUMAR Y PATEL | 8200 WEDNESBURY LN | HOUSTON | TX | 77074 | 256 |