*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J069 - Acute upper respiratory infection, unspecified - as a primary diagnosis code | J069 - Acute upper respiratory infection, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.59 | |
| Readmission Rate (%) | 19.3 | |
| Unplanned Readmission Rate (%) | 11.71 | |
| 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 153: OTITIS MEDIA AND URI WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 152: OTITIS MEDIA AND URI WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 988: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 987: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 34,349 | ||||
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 9,869 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 69.52 | ||||
| Avg LOS at DRG | 2.84 | ||||
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 2.56 | ||||
| Readmission Rate at DRG | 12.37 | ||||
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 13.96 | ||||
| Unplanned Readmission Rate at DRG | 8.55 | ||||
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 10.17 | ||||
| Total Medicare payments at DRG | $148,412,791 | ||||
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $44,145,900 | ||||
| Total Medicare payment per Day at DRG | $1,521 | ||||
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $1,750 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,321 | ||||
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $4,473 | ||||
| Total Medicare Charges at DRG | $793,754,980 | ||||
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $230,103,966 | ||||
| Avg Charges at DRG | $23,109 | ||||
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $23,316 | ||||
| Mortality Rate at DRG | 0.16 | ||||
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | 0.14 | ||||
| SNF Discharge Rate at DRG | 10.8 | ||||
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 11.73 | ||||
| Home Discharge Rate at DRG | 68.54 | ||||
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 66.4 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 982: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 52,726 |
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 14 |
| DRG Share of Total Hospitalizations | 0.16 |
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 0.1 |
| Avg LOS at DRG | 6.68 |
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 7.29 |
| Readmission Rate at DRG | 24.76 |
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA |
| Unplanned Readmission Rate at DRG | 14.45 |
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA |
| Total Medicare payments at DRG | $902,862,104 |
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $225,424 |
| Total Medicare payment per Day at DRG | $2,565 |
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $2,210 |
| Total Medicare payment per Hospitalization at DRG | $17,124 |
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $16,102 |
| Total Medicare Charges at DRG | $4,216,562,728 |
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $1,386,329 |
| Avg Charges at DRG | $79,971 |
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $99,024 |
| Mortality Rate at DRG | 0.83 |
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA |
| SNF Discharge Rate at DRG | 22.41 |
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA |
| Home Discharge Rate at DRG | 43.51 |
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 93 |
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 92 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 81 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. T GEORGE STOEV | 526 HALLE PARK DRIVE | COLLIERVILLE | TN | 38017 | 15 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. HANNA G LUBBOS | 201 W ARKANSAS ST | LEESVILLE | LA | 71446 | 29 |
| Dr. T GEORGE STOEV | 526 HALLE PARK DRIVE | COLLIERVILLE | TN | 38017 | 17 |
| Dr. GEORGES S YACOUB | 3006 N. CO. RD 25A STE 102 | TROY | OH | 45373 | 12 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 153: OTITIS MEDIA AND URI WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 34,349 | ||||
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 10,166 | ||||
| DRG Share of Total Hospitalizations | 0.1 | ||||
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 6.52 | ||||
| Avg LOS at DRG | 2.84 | ||||
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 2.56 | ||||
| Readmission Rate at DRG | 12.37 | ||||
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 13.83 | ||||
| Unplanned Readmission Rate at DRG | 8.55 | ||||
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 10.06 | ||||
| Total Medicare payments at DRG | $148,412,791 | ||||
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $45,458,186 | ||||
| Total Medicare payment per Day at DRG | $1,521 | ||||
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $1,746 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,321 | ||||
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $4,472 | ||||
| Total Medicare Charges at DRG | $793,754,980 | ||||
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $237,393,046 | ||||
| Avg Charges at DRG | $23,109 | ||||
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $23,352 | ||||
| Mortality Rate at DRG | 0.16 | ||||
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | 0.14 | ||||
| SNF Discharge Rate at DRG | 10.8 | ||||
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 11.51 | ||||
| Home Discharge Rate at DRG | 68.54 | ||||
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 66.65 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 202: BRONCHITIS AND ASTHMA WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 152: OTITIS MEDIA AND URI 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 | 535,322 | ||||
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 6,548 | ||||
| DRG Share of Total Hospitalizations | 1.63 | ||||
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 4.2 | ||||
| Avg LOS at DRG | 4.68 | ||||
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 4.56 | ||||
| Readmission Rate at DRG | 23.65 | ||||
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 19.92 | ||||
| Unplanned Readmission Rate at DRG | 18.66 | ||||
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 16.26 | ||||
| Total Medicare payments at DRG | $3,844,806,408 | ||||
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $49,173,006 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $1,646 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,182 | ||||
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $7,510 | ||||
| Total Medicare Charges at DRG | $19,258,468,078 | ||||
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $246,598,675 | ||||
| Avg Charges at DRG | $35,975 | ||||
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $37,660 | ||||
| Mortality Rate at DRG | 1.27 | ||||
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | 0.84 | ||||
| SNF Discharge Rate at DRG | 14.61 | ||||
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 11.96 | ||||
| Home Discharge Rate at DRG | 52.12 | ||||
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 57.8 |
*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 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 422,757 | ||||
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 3,198 | ||||
| DRG Share of Total Hospitalizations | 1.29 | ||||
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 2.05 | ||||
| Avg LOS at DRG | 4.14 | ||||
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 4.04 | ||||
| Readmission Rate at DRG | 24.43 | ||||
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 19.14 | ||||
| Unplanned Readmission Rate at DRG | 18.48 | ||||
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 14.98 | ||||
| Total Medicare payments at DRG | $2,636,135,714 | ||||
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $20,181,171 | ||||
| Total Medicare payment per Day at DRG | $1,507 | ||||
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $1,561 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,236 | ||||
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $6,311 | ||||
| Total Medicare Charges at DRG | $11,980,955,733 | ||||
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $94,882,918 | ||||
| Avg Charges at DRG | $28,340 | ||||
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $29,669 | ||||
| Mortality Rate at DRG | 1.01 | ||||
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | 0.5 | ||||
| SNF Discharge Rate at DRG | 16.05 | ||||
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 13.04 | ||||
| Home Discharge Rate at DRG | 47.18 | ||||
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 55.13 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 203: BRONCHITIS AND ASTHMA WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 292,335 | ||||
| Total Hospitalizations with ICD J069 - Acute upper respiratory infection, unspecified | 2,311 | ||||
| DRG Share of Total Hospitalizations | 0.89 | ||||
| % of Total ICD J069 - Acute upper respiratory infection, unspecified in DRG | 1.48 | ||||
| Avg LOS at DRG | 2.96 | ||||
| Avg LOS with ICD J069 - Acute upper respiratory infection, unspecified | 2.98 | ||||
| Readmission Rate at DRG | 19.18 | ||||
| Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 17.35 | ||||
| Unplanned Readmission Rate at DRG | 13.96 | ||||
| Unplanned Readmission Rate with ICD J069 - Acute upper respiratory infection, unspecified | 13.04 | ||||
| Total Medicare payments at DRG | $1,347,436,356 | ||||
| Total Medicare payments with ICD J069 - Acute upper respiratory infection, unspecified | $10,356,625 | ||||
| Total Medicare payment per Day at DRG | $1,557 | ||||
| Total Medicare payment per Day with ICD J069 - Acute upper respiratory infection, unspecified | $1,503 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,609 | ||||
| Total Medicare payment per Hospitalization with ICD J069 - Acute upper respiratory infection, unspecified | $4,481 | ||||
| Total Medicare Charges at DRG | $7,385,462,160 | ||||
| Total Medicare Charges with ICD J069 - Acute upper respiratory infection, unspecified | $60,964,959 | ||||
| Avg Charges at DRG | $25,264 | ||||
| Avg Charges with ICD J069 - Acute upper respiratory infection, unspecified | $26,380 | ||||
| Mortality Rate at DRG | 0.57 | ||||
| Mortality Rate with ICD J069 - Acute upper respiratory infection, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 11.55 | ||||
| SNF Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 8.48 | ||||
| Home Discharge Rate at DRG | 63.79 | ||||
| Home Discharge Rate with ICD J069 - Acute upper respiratory infection, unspecified | 70.4 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 752 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 612 |
| ADVENTHEALTH ORLANDO | 601 E ROLLINS ST | ORLANDO | FL | 32803 | 595 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. THEODORE V PARRAN | 2351 E 22ND ST | CLEVELAND | OH | 44115 | 210 |
| Dr. GREGORY DALE SMITH | 2412 RING RD | ELIZABETHTOWN | KY | 42701 | 86 |
| Dr. JAWED M MOVANIA | 700 W LINCOLN TRAIL BLVD | RADCLIFF | KY | 40160 | 57 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. THEODORE V PARRAN | 2351 E 22ND ST | CLEVELAND | OH | 44115 | 183 |
| Dr. GEORGES S YACOUB | 3006 N. CO. RD 25A STE 102 | TROY | OH | 45373 | 146 |
| Dr. NORMA HENRIQUEZ | 9941 SAINT MORITZ DR | MIROMAR LAKES | FL | 33913 | 98 |