*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| J129 - Viral pneumonia, unspecified - as a primary diagnosis code | J129 - Viral pneumonia, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.97 | |
| Readmission Rate (%) | 18.78 | |
| Unplanned Readmission Rate (%) | 10.6 | |
| 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 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 443,386 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 2,797 | ||||
| DRG Share of Total Hospitalizations | 1.35 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 44.24 | ||||
| Avg LOS at DRG | 5.27 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 5.26 | ||||
| Readmission Rate at DRG | 21.6 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 17.98 | ||||
| Unplanned Readmission Rate at DRG | 15.91 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 12.89 | ||||
| Total Medicare payments at DRG | $3,812,834,208 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $24,621,504 | ||||
| Total Medicare payment per Day at DRG | $1,632 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $1,673 | ||||
| Total Medicare payment per Hospitalization at DRG | $8,599 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $8,803 | ||||
| Total Medicare Charges at DRG | $18,110,468,211 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $121,013,061 | ||||
| Avg Charges at DRG | $40,846 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $43,265 | ||||
| Mortality Rate at DRG | 3.59 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | 1.89 | ||||
| SNF Discharge Rate at DRG | 22.57 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 18.81 | ||||
| Home Discharge Rate at DRG | 40.95 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 50.91 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 975: HIV WITH MAJOR RELATED CONDITION WITH COMPLICATION OR COMORBIDITY (CC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 974: HIV WITH MAJOR RELATED CONDITION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 99,136 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 38 | ||||
| DRG Share of Total Hospitalizations | 0.3 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 0.6 | ||||
| Avg LOS at DRG | 22.0 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 17.03 | ||||
| Readmission Rate at DRG | 40.67 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | NA | ||||
| Unplanned Readmission Rate at DRG | 20.54 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | NA | ||||
| Total Medicare payments at DRG | $4,616,563,352 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $1,630,794 | ||||
| Total Medicare payment per Day at DRG | $2,116 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $2,521 | ||||
| Total Medicare payment per Hospitalization at DRG | $46,568 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $42,916 | ||||
| Total Medicare Charges at DRG | $21,375,486,291 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $10,147,381 | ||||
| Avg Charges at DRG | $215,618 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $267,036 | ||||
| Mortality Rate at DRG | 28.16 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | 42.11 | ||||
| SNF Discharge Rate at DRG | 30.65 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | NA | ||||
| Home Discharge Rate at DRG | 5.17 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| NCH BAKER HOSPITAL DOWNTOWN | 350 7TH ST N | NAPLES | FL | 34102 | 33 |
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 33 |
| NORTHSHORE UNIVERSITY HEALTHSYSTEM EVANSTON HOSPITAL | 2650 RIDGE AVE | EVANSTON | IL | 60201 | 26 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. VENKATAPURAM RAMESH REDDY | 42320 HIGHWAY 195 | HALEYVILLE | AL | 35565 | 15 |
| Dr. TAM K NGUYEN | 19087 CHANDON LN | HUNTINGTON BEACH | CA | 92648 | 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 4,170 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 19.59 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 5.67 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 18.22 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 13.2 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $49,221,093 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $2,080 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $11,804 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $227,361,638 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $54,523 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | 5.83 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 20.38 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 43.55 |
*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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 1,121 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 5.27 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 5.77 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 22.5 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 17.54 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $10,772,935 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $1,665 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $9,610 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $57,196,570 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $51,023 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | 2.68 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 24.44 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 38.18 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 99,217 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 229 | ||||
| DRG Share of Total Hospitalizations | 0.3 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 1.08 | ||||
| Avg LOS at DRG | 14.88 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 16.28 | ||||
| Readmission Rate at DRG | 41.65 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 37.31 | ||||
| Unplanned Readmission Rate at DRG | 18.54 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 11.94 | ||||
| Total Medicare payments at DRG | $4,073,197,631 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $10,375,285 | ||||
| Total Medicare payment per Day at DRG | $2,758 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $2,782 | ||||
| Total Medicare payment per Hospitalization at DRG | $41,053 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $45,307 | ||||
| Total Medicare Charges at DRG | $20,258,140,795 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $51,898,641 | ||||
| Avg Charges at DRG | $204,180 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $226,632 | ||||
| Mortality Rate at DRG | 35.07 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | 36.24 | ||||
| SNF Discharge Rate at DRG | 25.76 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 19.65 | ||||
| Home Discharge Rate at DRG | 4.34 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 10.48 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 202: BRONCHITIS AND ASTHMA WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | DRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 120,026 | ||||
| Total Hospitalizations with ICD J129 - Viral pneumonia, unspecified | 191 | ||||
| DRG Share of Total Hospitalizations | 0.37 | ||||
| % of Total ICD J129 - Viral pneumonia, unspecified in DRG | 0.9 | ||||
| Avg LOS at DRG | 3.68 | ||||
| Avg LOS with ICD J129 - Viral pneumonia, unspecified | 4.13 | ||||
| Readmission Rate at DRG | 16.52 | ||||
| Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 14.52 | ||||
| Unplanned Readmission Rate at DRG | 13.07 | ||||
| Unplanned Readmission Rate with ICD J129 - Viral pneumonia, unspecified | 9.68 | ||||
| Total Medicare payments at DRG | $659,875,657 | ||||
| Total Medicare payments with ICD J129 - Viral pneumonia, unspecified | $1,087,032 | ||||
| Total Medicare payment per Day at DRG | $1,493 | ||||
| Total Medicare payment per Day with ICD J129 - Viral pneumonia, unspecified | $1,379 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,498 | ||||
| Total Medicare payment per Hospitalization with ICD J129 - Viral pneumonia, unspecified | $5,691 | ||||
| Total Medicare Charges at DRG | $3,598,009,636 | ||||
| Total Medicare Charges with ICD J129 - Viral pneumonia, unspecified | $6,169,279 | ||||
| Avg Charges at DRG | $29,977 | ||||
| Avg Charges with ICD J129 - Viral pneumonia, unspecified | $32,300 | ||||
| Mortality Rate at DRG | 0.22 | ||||
| Mortality Rate with ICD J129 - Viral pneumonia, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 10.98 | ||||
| SNF Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 10.47 | ||||
| Home Discharge Rate at DRG | 64.98 | ||||
| Home Discharge Rate with ICD J129 - Viral pneumonia, unspecified | 65.97 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 2401 S 31ST ST | TEMPLE | TX | 76508 | 110 |
| YALE NEW HAVEN HOSPITAL | 20 YORK ST | NEW HAVEN | CT | 06504 | 90 |
| ADVOCATE LUTHERAN GENERAL HOSPITAL | 1775 DEMPSTER STREET | PARK RIDGE | IL | 60068 | 86 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RAJAT PRAKASH | 3050 COMMERCE DR | FORT GRATIOT | MI | 48059 | 28 |
| Dr. TAM K NGUYEN | 19087 CHANDON LN | HUNTINGTON BEACH | CA | 92648 | 22 |
| Dr. SELLAS PECOS COBLE | 600 BLUES LAKE PKWY | ROLLA | MO | 65401 | 20 |