*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter - as a primary diagnosis code | T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 4.67 | |
| Readmission Rate (%) | 24.54 | |
| Unplanned Readmission Rate (%) | NA | |
| 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 949: AFTERCARE WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|
| Total Hospitalizations at DRG | 120,351 |
| Total Hospitalizations with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 45 |
| DRG Share of Total Hospitalizations | 0.37 |
| % of Total ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter in DRG | 86.54 |
| Avg LOS at DRG | 12.45 |
| Avg LOS with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 3.07 |
| Readmission Rate at DRG | 17.61 |
| Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA |
| Unplanned Readmission Rate at DRG | 12.6 |
| Unplanned Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA |
| Total Medicare payments at DRG | $2,245,410,425 |
| Total Medicare payments with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $326,461 |
| Total Medicare payment per Day at DRG | $1,499 |
| Total Medicare payment per Day with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $2,366 |
| Total Medicare payment per Hospitalization at DRG | $18,657 |
| Total Medicare payment per Hospitalization with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $7,255 |
| Total Medicare Charges at DRG | $5,810,478,166 |
| Total Medicare Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,012,253 |
| Avg Charges at DRG | $48,279 |
| Avg Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $22,495 |
| Mortality Rate at DRG | 0.55 |
| Mortality Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA |
| SNF Discharge Rate at DRG | 14.77 |
| SNF Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA |
| Home Discharge Rate at DRG | 22.27 |
| Home Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 68.89 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 638: DIABETES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 637: DIABETES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 639: DIABETES WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 919: COMPLICATIONS OF TREATMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 174,196 | ||||
| Total Hospitalizations with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 3,251 | ||||
| DRG Share of Total Hospitalizations | 0.53 | ||||
| % of Total ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter in DRG | 22.89 | ||||
| Avg LOS at DRG | 3.86 | ||||
| Avg LOS with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 3.18 | ||||
| Readmission Rate at DRG | 23.62 | ||||
| Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 24.55 | ||||
| Unplanned Readmission Rate at DRG | 17.61 | ||||
| Unplanned Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 18.32 | ||||
| Total Medicare payments at DRG | $959,872,570 | ||||
| Total Medicare payments with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $17,802,813 | ||||
| Total Medicare payment per Day at DRG | $1,426 | ||||
| Total Medicare payment per Day with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,723 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,510 | ||||
| Total Medicare payment per Hospitalization with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $5,476 | ||||
| Total Medicare Charges at DRG | $4,945,131,055 | ||||
| Total Medicare Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $75,253,645 | ||||
| Avg Charges at DRG | $28,388 | ||||
| Avg Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $23,148 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 14.83 | ||||
| SNF Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 9.6 | ||||
| Home Discharge Rate at DRG | 53.93 | ||||
| Home Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 63.0 |
*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 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH COMPLICATION OR COMORBIDITY (CC) OR TPA IN 24 HOURS | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,808,415 | ||||
| Total Hospitalizations with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 475 | ||||
| DRG Share of Total Hospitalizations | 5.5 | ||||
| % of Total ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter in DRG | 3.35 | ||||
| Avg LOS at DRG | 6.34 | ||||
| Avg LOS with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 6.24 | ||||
| Readmission Rate at DRG | 24.2 | ||||
| Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 26.08 | ||||
| Unplanned Readmission Rate at DRG | 16.78 | ||||
| Unplanned Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 16.27 | ||||
| Total Medicare payments at DRG | $21,288,214,047 | ||||
| Total Medicare payments with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $5,367,574 | ||||
| Total Medicare payment per Day at DRG | $1,857 | ||||
| Total Medicare payment per Day with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,810 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,772 | ||||
| Total Medicare payment per Hospitalization with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $11,300 | ||||
| Total Medicare Charges at DRG | $107,155,481,388 | ||||
| Total Medicare Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $27,096,062 | ||||
| Avg Charges at DRG | $59,254 | ||||
| Avg Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $57,044 | ||||
| Mortality Rate at DRG | 12.11 | ||||
| Mortality Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 3.79 | ||||
| SNF Discharge Rate at DRG | 27.18 | ||||
| SNF Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 22.74 | ||||
| Home Discharge Rate at DRG | 25.81 | ||||
| Home Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 41.68 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 603: CELLULITIS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 617: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 499,133 | ||||
| Total Hospitalizations with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 178 | ||||
| DRG Share of Total Hospitalizations | 1.52 | ||||
| % of Total ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter in DRG | 1.25 | ||||
| Avg LOS at DRG | 4.34 | ||||
| Avg LOS with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 4.15 | ||||
| Readmission Rate at DRG | 17.57 | ||||
| Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 16.36 | ||||
| Unplanned Readmission Rate at DRG | 12.56 | ||||
| Unplanned Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 10.91 | ||||
| Total Medicare payments at DRG | $3,254,711,780 | ||||
| Total Medicare payments with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,287,723 | ||||
| Total Medicare payment per Day at DRG | $1,504 | ||||
| Total Medicare payment per Day with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,745 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,521 | ||||
| Total Medicare payment per Hospitalization with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $7,234 | ||||
| Total Medicare Charges at DRG | $16,863,396,143 | ||||
| Total Medicare Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $5,264,671 | ||||
| Avg Charges at DRG | $33,785 | ||||
| Avg Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $29,577 | ||||
| Mortality Rate at DRG | 1.33 | ||||
| Mortality Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 19.89 | ||||
| SNF Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 14.61 | ||||
| Home Discharge Rate at DRG | 49.27 | ||||
| Home Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 61.24 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 074: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 247: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 67,236 | ||||
| Total Hospitalizations with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 111 | ||||
| DRG Share of Total Hospitalizations | 0.2 | ||||
| % of Total ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter in DRG | 0.78 | ||||
| Avg LOS at DRG | 4.93 | ||||
| Avg LOS with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 3.45 | ||||
| Readmission Rate at DRG | 23.47 | ||||
| Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 32.04 | ||||
| Unplanned Readmission Rate at DRG | 16.32 | ||||
| Unplanned Readmission Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 27.18 | ||||
| Total Medicare payments at DRG | $519,464,020 | ||||
| Total Medicare payments with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $625,693 | ||||
| Total Medicare payment per Day at DRG | $1,566 | ||||
| Total Medicare payment per Day with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $1,634 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,726 | ||||
| Total Medicare payment per Hospitalization with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $5,637 | ||||
| Total Medicare Charges at DRG | $2,306,121,861 | ||||
| Total Medicare Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $3,175,465 | ||||
| Avg Charges at DRG | $34,299 | ||||
| Avg Charges with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | $28,608 | ||||
| Mortality Rate at DRG | 0.07 | ||||
| Mortality Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 14.97 | ||||
| SNF Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 9.91 | ||||
| Home Discharge Rate at DRG | 53.9 | ||||
| Home Discharge Rate with ICD T383X6A - Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter | 59.46 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| EASTERN NEW MEXICO MEDICAL CENTER | 405 W COUNTRY CLUB RD | ROSWELL | NM | 88201 | 195 |
| HENNEPIN COUNTY MEDICAL CENTER | 701 PARK AVE, P1-FINANCE | MINNEAPOLIS | MN | 55415 | 102 |
| RENOWN REGIONAL MEDICAL CENTER | 1155 MILL STREET | RENO | NV | 89502 | 91 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ASHLEY MACKENZIE RIVERS | 2890 N WILSHIRE BLVD | ROSWELL | NM | 88201 | 19 |
| Dr. GREGORY STEPHEN SUGALSKI | 30 BERGEN ST | NEWARK | NJ | 07107 | 12 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SUDHIR SHAH | 720 BROADWAY | BROOKLYN | NY | 11206 | 33 |
| Dr. KRISHNA KANTH GALI | 405 W COUNTRY CLUB RD | ROSWELL | NM | 88201 | 33 |
| Dr. SUCHITHA BHEEMREDDY | 4201 SAINT ANTOINE ST | DETROIT | MI | 48201 | 22 |