*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code | I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code | |
---|---|---|
OUTCOMES | ||
Avg. LOS | 7.48 | |
Readmission Rate (%) | 28.55 | |
Unplanned Readmission Rate (%) | 15.65 | |
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 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
---|---|---|---|---|---|
Total Hospitalizations at DRG | 422,757 | ||||
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 641 | ||||
DRG Share of Total Hospitalizations | 1.29 | ||||
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 45.4 | ||||
Avg LOS at DRG | 4.14 | ||||
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 5.09 | ||||
Readmission Rate at DRG | 24.43 | ||||
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 23.74 | ||||
Unplanned Readmission Rate at DRG | 18.48 | ||||
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 15.6 | ||||
Total Medicare payments at DRG | $2,636,135,714 | ||||
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $5,157,372 | ||||
Total Medicare payment per Day at DRG | $1,507 | ||||
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $1,582 | ||||
Total Medicare payment per Hospitalization at DRG | $6,236 | ||||
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $8,046 | ||||
Total Medicare Charges at DRG | $11,980,955,733 | ||||
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $16,002,354 | ||||
Avg Charges at DRG | $28,340 | ||||
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $24,965 | ||||
Mortality Rate at DRG | 1.01 | ||||
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 2.81 | ||||
SNF Discharge Rate at DRG | 16.05 | ||||
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 12.79 | ||||
Home Discharge Rate at DRG | 47.18 | ||||
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 41.03 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) | |
---|---|---|
Total Hospitalizations at DRG | 114,725 | |
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 16 | |
DRG Share of Total Hospitalizations | 0.35 | |
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.13 | |
Avg LOS at DRG | 6.91 | |
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 5.25 | |
Readmission Rate at DRG | 28.23 | |
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA | |
Unplanned Readmission Rate at DRG | 17.16 | |
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA | |
Total Medicare payments at DRG | $1,698,418,701 | |
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $222,284 | |
Total Medicare payment per Day at DRG | $2,144 | |
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $2,646 | |
Total Medicare payment per Hospitalization at DRG | $14,804 | |
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $13,893 | |
Total Medicare Charges at DRG | $9,142,710,160 | |
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $947,090 | |
Avg Charges at DRG | $79,692 | |
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $59,193 | |
Mortality Rate at DRG | 3.27 | |
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA | |
SNF Discharge Rate at DRG | 10.66 | |
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA | |
Home Discharge Rate at DRG | 53.35 | |
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA |
Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
---|---|---|---|---|---|
CUMBERLAND MEMORIAL HOSPITAL | 1110 7TH AVE | CUMBERLAND | WI | 54829 | 41 |
BAPTIST MEMORIAL REHABILITATION HOSPITAL | 1240 SOUTH GERMANTOWN ROAD | GERMANTOWN | TN | 38138 | 16 |
BARSTOW COMMUNITY HOSPITAL | 820 E MOUNTAIN VIEW ST | BARSTOW | CA | 92311 | 15 |
Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
---|---|---|---|---|---|
Dr. DALE P CUNNINGHAM | 3265 W SARAZENS CIR | MEMPHIS | TN | 38125 | 16 |
Dr. GREGORY J LEITHEISER | 1475 WEBB ST | CUMBERLAND | WI | 54829 | 16 |
Dr. BARBARA M ANKARLO | 1475 WEBB ST | CUMBERLAND | WI | 54829 | 11 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | |
---|---|---|---|---|---|
Total Hospitalizations at DRG | 1,808,415 | ||||
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 2,621 | ||||
DRG Share of Total Hospitalizations | 5.5 | ||||
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 7.47 | ||||
Avg LOS at DRG | 6.34 | ||||
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 7.37 | ||||
Readmission Rate at DRG | 24.2 | ||||
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 30.7 | ||||
Unplanned Readmission Rate at DRG | 16.78 | ||||
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 20.01 | ||||
Total Medicare payments at DRG | $21,288,214,047 | ||||
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $33,497,544 | ||||
Total Medicare payment per Day at DRG | $1,857 | ||||
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $1,734 | ||||
Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $12,780 | ||||
Total Medicare Charges at DRG | $107,155,481,388 | ||||
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $194,388,928 | ||||
Avg Charges at DRG | $59,254 | ||||
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $74,166 | ||||
Mortality Rate at DRG | 12.11 | ||||
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 17.09 | ||||
SNF Discharge Rate at DRG | 27.18 | ||||
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 28.31 | ||||
Home Discharge Rate at DRG | 25.81 | ||||
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 19.42 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
---|---|---|---|---|---|
Total Hospitalizations at DRG | 434,264 | ||||
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 737 | ||||
DRG Share of Total Hospitalizations | 1.32 | ||||
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 2.1 | ||||
Avg LOS at DRG | 3.94 | ||||
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 4.14 | ||||
Readmission Rate at DRG | 22.76 | ||||
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 27.9 | ||||
Unplanned Readmission Rate at DRG | 16.46 | ||||
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 21.32 | ||||
Total Medicare payments at DRG | $2,472,138,198 | ||||
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $4,647,312 | ||||
Total Medicare payment per Day at DRG | $1,444 | ||||
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $1,522 | ||||
Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $6,306 | ||||
Total Medicare Charges at DRG | $12,478,361,060 | ||||
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $21,438,158 | ||||
Avg Charges at DRG | $28,735 | ||||
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $29,088 | ||||
Mortality Rate at DRG | 0.91 | ||||
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 1.63 | ||||
SNF Discharge Rate at DRG | 22.02 | ||||
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 23.74 | ||||
Home Discharge Rate at DRG | 46.68 | ||||
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 44.91 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | |
---|---|---|---|---|---|
Total Hospitalizations at DRG | 443,386 | ||||
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 578 | ||||
DRG Share of Total Hospitalizations | 1.35 | ||||
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.65 | ||||
Avg LOS at DRG | 5.27 | ||||
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 6.29 | ||||
Readmission Rate at DRG | 21.6 | ||||
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 25.58 | ||||
Unplanned Readmission Rate at DRG | 15.91 | ||||
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 16.92 | ||||
Total Medicare payments at DRG | $3,812,834,208 | ||||
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $5,489,674 | ||||
Total Medicare payment per Day at DRG | $1,632 | ||||
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $1,509 | ||||
Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $9,498 | ||||
Total Medicare Charges at DRG | $18,110,468,211 | ||||
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $28,112,844 | ||||
Avg Charges at DRG | $40,846 | ||||
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $48,638 | ||||
Mortality Rate at DRG | 3.59 | ||||
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 6.75 | ||||
SNF Discharge Rate at DRG | 22.57 | ||||
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 26.64 | ||||
Home Discharge Rate at DRG | 40.95 | ||||
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 33.22 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
DRG 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | |
---|---|---|---|---|---|
Total Hospitalizations at DRG | 101,617 | ||||
Total Hospitalizations with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 442 | ||||
DRG Share of Total Hospitalizations | 0.31 | ||||
% of Total ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.26 | ||||
Avg LOS at DRG | 9.5 | ||||
Avg LOS with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 12.02 | ||||
Readmission Rate at DRG | 26.88 | ||||
Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 34.57 | ||||
Unplanned Readmission Rate at DRG | 19.26 | ||||
Unplanned Readmission Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 29.71 | ||||
Total Medicare payments at DRG | $1,599,186,807 | ||||
Total Medicare payments with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $8,226,488 | ||||
Total Medicare payment per Day at DRG | $1,656 | ||||
Total Medicare payment per Day with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $1,548 | ||||
Total Medicare payment per Hospitalization at DRG | $15,737 | ||||
Total Medicare payment per Hospitalization with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $18,612 | ||||
Total Medicare Charges at DRG | $4,836,538,333 | ||||
Total Medicare Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $19,261,130 | ||||
Avg Charges at DRG | $47,596 | ||||
Avg Charges with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | $43,577 | ||||
Mortality Rate at DRG | 2.8 | ||||
Mortality Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
SNF Discharge Rate at DRG | 20.21 | ||||
SNF Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 15.84 | ||||
Home Discharge Rate at DRG | 20.17 | ||||
Home Discharge Rate with ICD I5040 - Unspecified combined systolic (congestive) and diastolic (congestive) heart failure | 16.97 |
Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
---|---|---|---|---|---|
METHODIST UNIVERSITY HOSPITAL | 1265 UNION AVE | MEMPHIS | TN | 38104 | 136 |
BAPTIST MEMORIAL REHABILITATION HOSPITAL | 1240 SOUTH GERMANTOWN ROAD | GERMANTOWN | TN | 38138 | 135 |
CUMBERLAND MEMORIAL HOSPITAL | 1110 7TH AVE | CUMBERLAND | WI | 54829 | 131 |
Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
---|---|---|---|---|---|
Dr. DAVID MARK GORDON | 28455 HAGGERTY RD | NOVI | MI | 48377 | 30 |
Dr. BALJIT K SHARMA | 602 N. 39TH AVE. | YAKIMA | WA | 98902 | 27 |
Dr. ARASH KIARASH | 25500 GODDARD RD. | TAYLOR | MI | 48180 | 15 |
Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
---|---|---|---|---|---|
Dr. DALE P CUNNINGHAM | 3265 W SARAZENS CIR | MEMPHIS | TN | 38125 | 112 |
Dr. GREGORY J LEITHEISER | 1475 WEBB ST | CUMBERLAND | WI | 54829 | 55 |
Dr. RAKESH R PATEL | 2005 VALLEY VIEW BLVD | ALTOONA | PA | 16602 | 47 |