*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| T402X5A - Adverse effect of other opioids, initial encounter - as a primary diagnosis code | T402X5A - Adverse effect of other opioids, initial encounter - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.01 | |
| Readmission Rate (%) | 24.81 | |
| Unplanned Readmission Rate (%) | 15.25 | |
| 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 917: POISONING AND TOXIC EFFECTS OF DRUGS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 918: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|
| Total Hospitalizations at DRG | 101,548 | |
| Total Hospitalizations with ICD T402X5A - Adverse effect of other opioids, initial encounter | 260 | |
| DRG Share of Total Hospitalizations | 0.31 | |
| % of Total ICD T402X5A - Adverse effect of other opioids, initial encounter in DRG | 61.47 | |
| Avg LOS at DRG | 4.68 | |
| Avg LOS with ICD T402X5A - Adverse effect of other opioids, initial encounter | 3.92 | |
| Readmission Rate at DRG | 32.74 | |
| Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 24.51 | |
| Unplanned Readmission Rate at DRG | 13.79 | |
| Unplanned Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 16.21 | |
| Total Medicare payments at DRG | $922,969,291 | |
| Total Medicare payments with ICD T402X5A - Adverse effect of other opioids, initial encounter | $2,179,846 | |
| Total Medicare payment per Day at DRG | $1,941 | |
| Total Medicare payment per Day with ICD T402X5A - Adverse effect of other opioids, initial encounter | $2,139 | |
| Total Medicare payment per Hospitalization at DRG | $9,089 | |
| Total Medicare payment per Hospitalization with ICD T402X5A - Adverse effect of other opioids, initial encounter | $8,384 | |
| Total Medicare Charges at DRG | $4,727,523,206 | |
| Total Medicare Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $8,208,610 | |
| Avg Charges at DRG | $46,555 | |
| Avg Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $31,572 | |
| Mortality Rate at DRG | 2.95 | |
| Mortality Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | NA | |
| SNF Discharge Rate at DRG | 13.87 | |
| SNF Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 25.77 | |
| Home Discharge Rate at DRG | 43.04 | |
| Home Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 38.85 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH COMPLICATION OR COMORBIDITY (CC) | DRG 948: SIGNS AND SYMPTOMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,522,684 | ||||
| Total Hospitalizations with ICD T402X5A - Adverse effect of other opioids, initial encounter | 9,244 | ||||
| DRG Share of Total Hospitalizations | 4.63 | ||||
| % of Total ICD T402X5A - Adverse effect of other opioids, initial encounter in DRG | 6.26 | ||||
| Avg LOS at DRG | 2.52 | ||||
| Avg LOS with ICD T402X5A - Adverse effect of other opioids, initial encounter | 3.34 | ||||
| Readmission Rate at DRG | 9.03 | ||||
| Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 11.2 | ||||
| Unplanned Readmission Rate at DRG | 3.35 | ||||
| Unplanned Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 4.32 | ||||
| Total Medicare payments at DRG | $17,672,828,347 | ||||
| Total Medicare payments with ICD T402X5A - Adverse effect of other opioids, initial encounter | $115,530,014 | ||||
| Total Medicare payment per Day at DRG | $4,606 | ||||
| Total Medicare payment per Day with ICD T402X5A - Adverse effect of other opioids, initial encounter | $3,741 | ||||
| Total Medicare payment per Hospitalization at DRG | $11,606 | ||||
| Total Medicare payment per Hospitalization with ICD T402X5A - Adverse effect of other opioids, initial encounter | $12,498 | ||||
| Total Medicare Charges at DRG | $91,836,200,128 | ||||
| Total Medicare Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $567,046,940 | ||||
| Avg Charges at DRG | $60,312 | ||||
| Avg Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $61,342 | ||||
| Mortality Rate at DRG | 0.05 | ||||
| Mortality Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 23.53 | ||||
| SNF Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 35.57 | ||||
| Home Discharge Rate at DRG | 30.67 | ||||
| Home Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 22.53 |
*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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 552: MEDICAL BACK PROBLEMS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 469: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 101,617 | ||||
| Total Hospitalizations with ICD T402X5A - Adverse effect of other opioids, initial encounter | 2,884 | ||||
| DRG Share of Total Hospitalizations | 0.31 | ||||
| % of Total ICD T402X5A - Adverse effect of other opioids, initial encounter in DRG | 1.95 | ||||
| Avg LOS at DRG | 9.5 | ||||
| Avg LOS with ICD T402X5A - Adverse effect of other opioids, initial encounter | 4.91 | ||||
| Readmission Rate at DRG | 26.88 | ||||
| Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 25.78 | ||||
| Unplanned Readmission Rate at DRG | 19.26 | ||||
| Unplanned Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 19.11 | ||||
| Total Medicare payments at DRG | $1,599,186,807 | ||||
| Total Medicare payments with ICD T402X5A - Adverse effect of other opioids, initial encounter | $28,006,804 | ||||
| Total Medicare payment per Day at DRG | $1,656 | ||||
| Total Medicare payment per Day with ICD T402X5A - Adverse effect of other opioids, initial encounter | $1,977 | ||||
| Total Medicare payment per Hospitalization at DRG | $15,737 | ||||
| Total Medicare payment per Hospitalization with ICD T402X5A - Adverse effect of other opioids, initial encounter | $9,711 | ||||
| Total Medicare Charges at DRG | $4,836,538,333 | ||||
| Total Medicare Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $115,903,721 | ||||
| Avg Charges at DRG | $47,596 | ||||
| Avg Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $40,189 | ||||
| Mortality Rate at DRG | 2.8 | ||||
| Mortality Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 1.84 | ||||
| SNF Discharge Rate at DRG | 20.21 | ||||
| SNF Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 34.33 | ||||
| Home Discharge Rate at DRG | 20.17 | ||||
| Home Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 27.81 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 389: G.I. OBSTRUCTION WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 365,119 | ||||
| Total Hospitalizations with ICD T402X5A - Adverse effect of other opioids, initial encounter | 2,198 | ||||
| DRG Share of Total Hospitalizations | 1.11 | ||||
| % of Total ICD T402X5A - Adverse effect of other opioids, initial encounter in DRG | 1.49 | ||||
| Avg LOS at DRG | 5.91 | ||||
| Avg LOS with ICD T402X5A - Adverse effect of other opioids, initial encounter | 5.28 | ||||
| Readmission Rate at DRG | 27.73 | ||||
| Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 25.55 | ||||
| Unplanned Readmission Rate at DRG | 20.3 | ||||
| Unplanned Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 17.62 | ||||
| Total Medicare payments at DRG | $3,552,910,533 | ||||
| Total Medicare payments with ICD T402X5A - Adverse effect of other opioids, initial encounter | $20,504,163 | ||||
| Total Medicare payment per Day at DRG | $1,646 | ||||
| Total Medicare payment per Day with ICD T402X5A - Adverse effect of other opioids, initial encounter | $1,767 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,731 | ||||
| Total Medicare payment per Hospitalization with ICD T402X5A - Adverse effect of other opioids, initial encounter | $9,329 | ||||
| Total Medicare Charges at DRG | $16,860,985,198 | ||||
| Total Medicare Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $86,912,080 | ||||
| Avg Charges at DRG | $46,179 | ||||
| Avg Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $39,541 | ||||
| Mortality Rate at DRG | 5.06 | ||||
| Mortality Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 2.32 | ||||
| SNF Discharge Rate at DRG | 28.7 | ||||
| SNF Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 28.53 | ||||
| Home Discharge Rate at DRG | 32.16 | ||||
| Home Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 33.76 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 812: RED BLOOD CELL DISORDERS WITHOUT 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 947: SIGNS AND SYMPTOMS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 201,938 | ||||
| Total Hospitalizations with ICD T402X5A - Adverse effect of other opioids, initial encounter | 1,720 | ||||
| DRG Share of Total Hospitalizations | 0.61 | ||||
| % of Total ICD T402X5A - Adverse effect of other opioids, initial encounter in DRG | 1.16 | ||||
| Avg LOS at DRG | 3.4 | ||||
| Avg LOS with ICD T402X5A - Adverse effect of other opioids, initial encounter | 6.36 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 39.69 | ||||
| Unplanned Readmission Rate at DRG | 21.29 | ||||
| Unplanned Readmission Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 34.69 | ||||
| Total Medicare payments at DRG | $1,046,791,335 | ||||
| Total Medicare payments with ICD T402X5A - Adverse effect of other opioids, initial encounter | $10,716,193 | ||||
| Total Medicare payment per Day at DRG | $1,523 | ||||
| Total Medicare payment per Day with ICD T402X5A - Adverse effect of other opioids, initial encounter | $979 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,184 | ||||
| Total Medicare payment per Hospitalization with ICD T402X5A - Adverse effect of other opioids, initial encounter | $6,230 | ||||
| Total Medicare Charges at DRG | $5,572,284,000 | ||||
| Total Medicare Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $68,429,997 | ||||
| Avg Charges at DRG | $27,594 | ||||
| Avg Charges with ICD T402X5A - Adverse effect of other opioids, initial encounter | $39,785 | ||||
| Mortality Rate at DRG | 0.31 | ||||
| Mortality Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | NA | ||||
| SNF Discharge Rate at DRG | 12.45 | ||||
| SNF Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 4.94 | ||||
| Home Discharge Rate at DRG | 66.72 | ||||
| Home Discharge Rate with ICD T402X5A - Adverse effect of other opioids, initial encounter | 84.01 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| ARTHUR G JAMES CANCER HOSPITAL | 300 W 10TH AVE | COLUMBUS | OH | 43210 | 725 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 632 |
| PARK NICOLLET METHODIST HOSPITAL | 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 620 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. REBECCA MARIE BIERDEN | 4401 UNION ST | JOHNSTOWN | CO | 80534 | 67 |
| Dr. PAUL G JOHNSON | 300 LAKE DR E | CHANHASSEN | MN | 55317 | 61 |
| Dr. TODD MICHAEL REITER | 300 GATEWOOD AVE | HIGH POINT | NC | 27262 | 58 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 113 |
| Dr. REBECCA MARIE BIERDEN | 4401 UNION ST | JOHNSTOWN | CO | 80534 | 75 |
| Dr. TODD MICHAEL REITER | 300 GATEWOOD AVE | HIGH POINT | NC | 27262 | 66 |