ICD-10-CM/PCS MS-DRG v34.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v34.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 32 of 70 |
| A000 B399 C770 C84Z7 D49511 E113399 F1529 H00016 H26031 H5361 I6051 I82593 K266 L608 M06072 M2200 M4810 M71542 M84573P M90512 N904 O3103X3 O368229 O665 P399 R061 S01119A S04892D S1017XD S15009D S22048B S29022S S32129A S35411A S40241A S42301A S43393S S50829S S52224F S52356G S53025D S58922D S61101A S62163A S62512D S63228A S65590A S6990XA S72109N S72354D S7292XM S80821A S82141D S82422D S82863D S86011D S90931D S92209K S93134D S99102D T22042A T23752S T34532D T421X6S T472X1S T550X2D T654X2D T82591A Z048 Z91041 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S29022S | 09 | 604-605 | S31124D | 23 | 949-950 | S31801A | 09 | 604-605 | ||
| S29029A | 09 | 604-605 | S31124S | 09 | 604-605 | S31801A | 24 | 955-965 | ||
| S29029A | 24 | 955-965 | S31125A | 21 | 913-914 | S31801D | 23 | 949-950 | ||
| S29029D | 23 | 949-950 | S31125A | 24 | 955-965 | S31801S | 09 | 604-605 | ||
| S29029S | 09 | 604-605 | S31125D | 23 | 949-950 | S31802A | 09 | 604-605 | ||
| S29091A | 21 | 913-914 | S31125S | 09 | 604-605 | S31802A | 24 | 955-965 | ||
| S29091A | 24 | 955-965 | S31129A | 21 | 913-914 | S31802D | 23 | 949-950 | ||
| S29091D | 23 | 949-950 | S31129A | 24 | 955-965 | S31802S | 09 | 604-605 | ||
| S29091S | 21 | 913-914 | S31129D | 23 | 949-950 | S31803A | 09 | 604-605 | ||
| S29092A | 21 | 913-914 | S31129S | 09 | 604-605 | S31803A | 24 | 955-965 | ||
| S29092A | 24 | 955-965 | S31130A | 09 | 604-605 | S31803D | 23 | 949-950 | ||
| S29092D | 23 | 949-950 | S31130A | 24 | 955-965 | S31803S | 09 | 604-605 | ||
| S29092S | 21 | 913-914 | S31130D | 23 | 949-950 | S31804A | 09 | 604-605 | ||
| S29099A | 21 | 913-914 | S31130S | 09 | 604-605 | S31804A | 24 | 955-965 | ||
| S29099A | 24 | 955-965 | S31131A | 09 | 604-605 | S31804D | 23 | 949-950 | ||
| S29099D | 23 | 949-950 | S31131A | 24 | 955-965 | S31804S | 09 | 604-605 | ||
| S29099S | 21 | 913-914 | S31131D | 23 | 949-950 | S31805A | 09 | 604-605 | ||
| S298XXA | 21 | 913-914 | S31131S | 09 | 604-605 | S31805A | 24 | 955-965 | ||
| S298XXA | 24 | 955-965 | S31132A | 09 | 604-605 | S31805D | 23 | 949-950 | ||
| S298XXD | 23 | 949-950 | S31132A | 24 | 955-965 | S31805S | 09 | 604-605 | ||
| S298XXS | 21 | 913-914 | S31132D | 23 | 949-950 | S31809A | 09 | 604-605 | ||
| S299XXA | 21 | 913-914 | S31132S | 09 | 604-605 | S31809A | 24 | 955-965 | ||
| S299XXA | 24 | 955-965 | S31133A | 09 | 604-605 | S31809D | 23 | 949-950 | ||
| S299XXD | 23 | 949-950 | S31133A | 24 | 955-965 | S31809S | 09 | 604-605 | ||
| S299XXS | 21 | 913-914 | S31133D | 23 | 949-950 | S31811A | 09 | 604-605 | ||
| S300XXA | 09 | 604-605 | S31133S | 09 | 604-605 | S31811A | 24 | 955-965 | ||
| S300XXA | 24 | 955-965 | S31134A | 09 | 604-605 | S31811D | 23 | 949-950 | ||
| S300XXD | 23 | 949-950 | S31134A | 24 | 955-965 | S31811S | 09 | 604-605 | ||
| S300XXS | 09 | 604-605 | S31134D | 23 | 949-950 | S31812A | 09 | 604-605 | ||
| S301XXA | 09 | 604-605 | S31134S | 09 | 604-605 | S31812A | 24 | 955-965 | ||
| S301XXA | 24 | 955-965 | S31135A | 09 | 604-605 | S31812D | 23 | 949-950 | ||
| S301XXD | 23 | 949-950 | S31135A | 24 | 955-965 | S31812S | 09 | 604-605 | ||
| S301XXS | 09 | 604-605 | S31135D | 23 | 949-950 | S31813A | 09 | 604-605 | ||
| S30201A | 12 | 729-730 | S31135S | 09 | 604-605 | S31813A | 24 | 955-965 | ||
| S30201A | 24 | 955-965 | S31139A | 09 | 604-605 | S31813D | 23 | 949-950 | ||
| S30201D | 23 | 949-950 | S31139A | 24 | 955-965 | S31813S | 09 | 604-605 | ||
| S30201S | 09 | 604-605 | S31139D | 23 | 949-950 | S31814A | 09 | 604-605 | ||
| S30202A | 13 | 742-743 | S31139S | 09 | 604-605 | S31814A | 24 | 955-965 | ||
| S30202A | 13 | 760-761 | S31140A | 21 | 913-914 | S31814D | 23 | 949-950 | ||
| S30202A | 24 | 955-965 | S31140A | 24 | 955-965 | S31814S | 09 | 604-605 | ||
| S30202D | 23 | 949-950 | S31140D | 23 | 949-950 | S31815A | 09 | 604-605 | ||
| S30202S | 09 | 604-605 | S31140S | 09 | 604-605 | S31815A | 24 | 955-965 | ||
| S3021XA | 12 | 729-730 | S31141A | 21 | 913-914 | S31815D | 23 | 949-950 | ||
| S3021XA | 24 | 955-965 | S31141A | 24 | 955-965 | S31815S | 09 | 604-605 | ||
| S3021XD | 23 | 949-950 | S31141D | 23 | 949-950 | S31819A | 09 | 604-605 | ||
| S3021XS | 09 | 604-605 | S31141S | 09 | 604-605 | S31819A | 24 | 955-965 | ||
| S3022XA | 12 | 729-730 | S31142A | 21 | 913-914 | S31819D | 23 | 949-950 | ||
| S3022XA | 24 | 955-965 | S31142A | 24 | 955-965 | S31819S | 09 | 604-605 | ||
| S3022XD | 23 | 949-950 | S31142D | 23 | 949-950 | S31821A | 09 | 604-605 | ||
| S3022XS | 09 | 604-605 | S31142S | 09 | 604-605 | S31821A | 24 | 955-965 | ||
| S3023XA | 13 | 742-743 | S31143A | 21 | 913-914 | S31821D | 23 | 949-950 | ||
| S3023XA | 13 | 760-761 | S31143A | 24 | 955-965 | S31821S | 09 | 604-605 | ||
| S3023XA | 24 | 955-965 | S31143D | 23 | 949-950 | S31822A | 09 | 604-605 | ||
| S3023XD | 23 | 949-950 | S31143S | 09 | 604-605 | S31822A | 24 | 955-965 | ||
| S3023XS | 09 | 604-605 | S31144A | 21 | 913-914 | S31822D | 23 | 949-950 | ||
| S303XXA | 09 | 604-605 | S31144A | 24 | 955-965 | S31822S | 09 | 604-605 | ||
| S303XXA | 24 | 955-965 | S31144D | 23 | 949-950 | S31823A | 09 | 604-605 | ||
| S303XXD | 23 | 949-950 | S31144S | 09 | 604-605 | S31823A | 24 | 955-965 | ||
| S303XXS | 09 | 604-605 | S31145A | 21 | 913-914 | S31823D | 23 | 949-950 | ||
| S30810A | 09 | 604-605 | S31145A | 24 | 955-965 | S31823S | 09 | 604-605 | ||
| S30810A | 24 | 955-965 | S31145D | 23 | 949-950 | S31824A | 09 | 604-605 | ||
| S30810D | 23 | 949-950 | S31145S | 09 | 604-605 | S31824A | 24 | 955-965 | ||
| S30810S | 09 | 604-605 | S31149A | 21 | 913-914 | S31824D | 23 | 949-950 | ||
| S30811A | 09 | 604-605 | S31149A | 24 | 955-965 | S31824S | 09 | 604-605 | ||
| S30811A | 24 | 955-965 | S31149D | 23 | 949-950 | S31825A | 09 | 604-605 | ||
| S30811D | 23 | 949-950 | S31149S | 09 | 604-605 | S31825A | 24 | 955-965 | ||
| S30811S | 09 | 604-605 | S31150A | 09 | 604-605 | S31825D | 23 | 949-950 | ||
| S30812A | 09 | 604-605 | S31150A | 24 | 955-965 | S31825S | 09 | 604-605 | ||
| S30812A | 24 | 955-965 | S31150D | 23 | 949-950 | S31829A | 09 | 604-605 | ||
| S30812D | 23 | 949-950 | S31150S | 09 | 604-605 | S31829A | 24 | 955-965 | ||
| S30812S | 09 | 604-605 | S31151A | 09 | 604-605 | S31829D | 23 | 949-950 | ||
| S30813A | 09 | 604-605 | S31151A | 24 | 955-965 | S31829S | 09 | 604-605 | ||
| S30813A | 24 | 955-965 | S31151D | 23 | 949-950 | S31831A | 09 | 604-605 | ||
| S30813D | 23 | 949-950 | S31151S | 09 | 604-605 | S31831A | 24 | 955-965 | ||
| S30813S | 09 | 604-605 | S31152A | 09 | 604-605 | S31831D | 23 | 949-950 | ||
| S30814A | 09 | 604-605 | S31152A | 24 | 955-965 | S31831S | 09 | 604-605 | ||
| S30814A | 24 | 955-965 | S31152D | 23 | 949-950 | S31832A | 21 | 913-914 | ||
| S30814D | 23 | 949-950 | S31152S | 09 | 604-605 | S31832A | 24 | 955-965 | ||
| S30814S | 09 | 604-605 | S31153A | 09 | 604-605 | S31832D | 23 | 949-950 | ||
| S30815A | 09 | 604-605 | S31153A | 24 | 955-965 | S31832S | 09 | 604-605 | ||
| S30815A | 24 | 955-965 | S31153D | 23 | 949-950 | S31833A | 09 | 604-605 | ||
| S30815D | 23 | 949-950 | S31153S | 09 | 604-605 | S31833A | 24 | 955-965 | ||
| S30815S | 09 | 604-605 | S31154A | 09 | 604-605 | S31833D | 23 | 949-950 | ||
| S30816A | 09 | 604-605 | S31154A | 24 | 955-965 | S31833S | 09 | 604-605 | ||
| S30816A | 24 | 955-965 | S31154D | 23 | 949-950 | S31834A | 21 | 913-914 | ||
| S30816D | 23 | 949-950 | S31154S | 09 | 604-605 | S31834A | 24 | 955-965 | ||
| S30816S | 09 | 604-605 | S31155A | 09 | 604-605 | S31834D | 23 | 949-950 | ||
| S30817A | 09 | 604-605 | S31155A | 24 | 955-965 | S31834S | 09 | 604-605 | ||
| S30817A | 24 | 955-965 | S31155D | 23 | 949-950 | S31835A | 09 | 604-605 | ||
| S30817D | 23 | 949-950 | S31155S | 09 | 604-605 | S31835A | 24 | 955-965 | ||
| S30817S | 09 | 604-605 | S31159A | 09 | 604-605 | S31835D | 23 | 949-950 | ||
| S30820A | 09 | 606-607 | S31159A | 24 | 955-965 | S31835S | 09 | 604-605 | ||
| S30820A | 24 | 955-965 | S31159D | 23 | 949-950 | S31839A | 09 | 604-605 | ||
| S30820D | 23 | 949-950 | S31159S | 09 | 604-605 | S31839A | 24 | 955-965 | ||
| S30820S | 09 | 604-605 | S3120XA | 12 | 729-730 | S31839D | 23 | 949-950 | ||
| S30821A | 09 | 606-607 | S3120XA | 24 | 955-965 | S31839S | 09 | 604-605 | ||
| S30821A | 24 | 955-965 | S3120XD | 23 | 949-950 | S32000A | 08 | 551-552 | ||
| S30821D | 23 | 949-950 | S3120XS | 09 | 604-605 | S32000A | 24 | 955-965 | ||
| S30821S | 09 | 604-605 | S3121XA | 12 | 729-730 | S32000B | 08 | 551-552 | ||
| S30822A | 09 | 606-607 | S3121XA | 24 | 955-965 | S32000B | 24 | 955-965 | ||
| S30822A | 24 | 955-965 | S3121XD | 23 | 949-950 | S32000D | 08 | 559-561 | ||
| S30822D | 23 | 949-950 | S3121XS | 09 | 604-605 | S32000G | 08 | 559-561 | ||
| S30822S | 09 | 604-605 | S3122XA | 12 | 729-730 | S32000K | 08 | 564-566 | ||
| S30823A | 09 | 606-607 | S3122XA | 24 | 955-965 | S32000S | 08 | 551-552 | ||
| S30823A | 24 | 955-965 | S3122XD | 23 | 949-950 | S32001A | 08 | 551-552 | ||
| S30823D | 23 | 949-950 | S3122XS | 09 | 604-605 | S32001A | 24 | 955-965 | ||
| S30823S | 09 | 604-605 | S3123XA | 12 | 729-730 | S32001B | 08 | 551-552 | ||
| S30824A | 09 | 606-607 | S3123XA | 24 | 955-965 | S32001B | 24 | 955-965 | ||
| S30824A | 24 | 955-965 | S3123XD | 23 | 949-950 | S32001D | 08 | 559-561 | ||
| S30824D | 23 | 949-950 | S3123XS | 09 | 604-605 | S32001G | 08 | 559-561 | ||
| S30824S | 09 | 604-605 | S3124XA | 12 | 729-730 | S32001K | 08 | 564-566 | ||
| S30825A | 09 | 606-607 | S3124XA | 24 | 955-965 | S32001S | 08 | 551-552 | ||
| S30825A | 24 | 955-965 | S3124XD | 23 | 949-950 | S32002A | 08 | 551-552 | ||
| S30825D | 23 | 949-950 | S3124XS | 09 | 604-605 | S32002A | 24 | 955-965 | ||
| S30825S | 09 | 604-605 | S3125XA | 12 | 729-730 | S32002B | 08 | 551-552 | ||
| S30826A | 09 | 606-607 | S3125XA | 24 | 955-965 | S32002B | 24 | 955-965 | ||
| S30826A | 24 | 955-965 | S3125XD | 23 | 949-950 | S32002D | 08 | 559-561 | ||
| S30826D | 23 | 949-950 | S3125XS | 09 | 604-605 | S32002G | 08 | 559-561 | ||
| S30826S | 09 | 604-605 | S3130XA | 12 | 729-730 | S32002K | 08 | 564-566 | ||
| S30827A | 09 | 606-607 | S3130XA | 24 | 955-965 | S32002S | 08 | 551-552 | ||
| S30827A | 24 | 955-965 | S3130XD | 23 | 949-950 | S32008A | 08 | 551-552 | ||
| S30827D | 23 | 949-950 | S3130XS | 09 | 604-605 | S32008A | 24 | 955-965 | ||
| S30827S | 09 | 604-605 | S3131XA | 12 | 729-730 | S32008B | 08 | 551-552 | ||
| S30840A | 09 | 604-605 | S3131XA | 24 | 955-965 | S32008B | 24 | 955-965 | ||
| S30840A | 24 | 955-965 | S3131XD | 23 | 949-950 | S32008D | 08 | 559-561 | ||
| S30840D | 23 | 949-950 | S3131XS | 09 | 604-605 | S32008G | 08 | 559-561 | ||
| S30840S | 09 | 604-605 | S3132XA | 12 | 729-730 | S32008K | 08 | 564-566 | ||
| S30841A | 09 | 604-605 | S3132XA | 24 | 955-965 | S32008S | 08 | 551-552 | ||
| S30841A | 24 | 955-965 | S3132XD | 23 | 949-950 | S32009A | 08 | 551-552 | ||
| S30841D | 23 | 949-950 | S3132XS | 09 | 604-605 | S32009A | 24 | 955-965 | ||
| S30841S | 09 | 604-605 | S3133XA | 12 | 729-730 | S32009B | 08 | 551-552 | ||
| S30842A | 09 | 604-605 | S3133XA | 24 | 955-965 | S32009B | 24 | 955-965 | ||
| S30842A | 24 | 955-965 | S3133XD | 23 | 949-950 | S32009D | 08 | 559-561 | ||
| S30842D | 23 | 949-950 | S3133XS | 09 | 604-605 | S32009G | 08 | 559-561 | ||
| S30842S | 09 | 604-605 | S3134XA | 12 | 729-730 | S32009K | 08 | 564-566 | ||
| S30843A | 09 | 604-605 | S3134XA | 24 | 955-965 | S32009S | 08 | 551-552 | ||
| S30843A | 24 | 955-965 | S3134XD | 23 | 949-950 | S32010A | 08 | 551-552 | ||
| S30843D | 23 | 949-950 | S3134XS | 09 | 604-605 | S32010A | 24 | 955-965 | ||
| S30843S | 09 | 604-605 | S3135XA | 12 | 729-730 | S32010B | 08 | 551-552 | ||
| S30844A | 09 | 604-605 | S3135XA | 24 | 955-965 | S32010B | 24 | 955-965 | ||
| S30844A | 24 | 955-965 | S3135XD | 23 | 949-950 | S32010D | 08 | 559-561 | ||
| S30844D | 23 | 949-950 | S3135XS | 09 | 604-605 | S32010G | 08 | 559-561 | ||
| S30844S | 09 | 604-605 | S3140XA | 13 | 742-743 | S32010K | 08 | 564-566 | ||
| S30845A | 09 | 604-605 | S3140XA | 13 | 760-761 | S32010S | 08 | 551-552 | ||
| S30845A | 24 | 955-965 | S3140XA | 24 | 955-965 | S32011A | 08 | 551-552 | ||
| S30845D | 23 | 949-950 | S3140XD | 23 | 949-950 | S32011A | 24 | 955-965 | ||
| S30845S | 09 | 604-605 | S3140XS | 09 | 604-605 | S32011B | 08 | 551-552 | ||
| S30846A | 09 | 604-605 | S3141XA | 13 | 742-743 | S32011B | 24 | 955-965 | ||
| S30846A | 24 | 955-965 | S3141XA | 13 | 760-761 | S32011D | 08 | 559-561 | ||
| S30846D | 23 | 949-950 | S3141XA | 24 | 955-965 | S32011G | 08 | 559-561 | ||
| S30846S | 09 | 604-605 | S3141XD | 23 | 949-950 | S32011K | 08 | 564-566 | ||
| S30850A | 09 | 604-605 | S3141XS | 09 | 604-605 | S32011S | 08 | 551-552 | ||
| S30850A | 24 | 955-965 | S3142XA | 13 | 742-743 | S32012A | 08 | 551-552 | ||
| S30850D | 23 | 949-950 | S3142XA | 13 | 760-761 | S32012A | 24 | 955-965 | ||
| S30850S | 09 | 604-605 | S3142XA | 24 | 955-965 | S32012B | 08 | 551-552 | ||
| S30851A | 09 | 604-605 | S3142XD | 23 | 949-950 | S32012B | 24 | 955-965 | ||
| S30851A | 24 | 955-965 | S3142XS | 09 | 604-605 | S32012D | 08 | 559-561 | ||
| S30851D | 23 | 949-950 | S3143XA | 13 | 742-743 | S32012G | 08 | 559-561 | ||
| S30851S | 09 | 604-605 | S3143XA | 13 | 760-761 | S32012K | 08 | 564-566 | ||
| S30852A | 09 | 604-605 | S3143XA | 24 | 955-965 | S32012S | 08 | 551-552 | ||
| S30852A | 24 | 955-965 | S3143XD | 23 | 949-950 | S32018A | 08 | 551-552 | ||
| S30852D | 23 | 949-950 | S3143XS | 09 | 604-605 | S32018A | 24 | 955-965 | ||
| S30852S | 09 | 604-605 | S3144XA | 13 | 742-743 | S32018B | 08 | 551-552 | ||
| S30853A | 09 | 604-605 | S3144XA | 13 | 760-761 | S32018B | 24 | 955-965 | ||
| S30853A | 24 | 955-965 | S3144XA | 24 | 955-965 | S32018D | 08 | 559-561 | ||
| S30853D | 23 | 949-950 | S3144XD | 23 | 949-950 | S32018G | 08 | 559-561 | ||
| S30853S | 09 | 604-605 | S3144XS | 09 | 604-605 | S32018K | 08 | 564-566 | ||
| S30854A | 09 | 604-605 | S3145XA | 13 | 742-743 | S32018S | 08 | 551-552 | ||
| S30854A | 24 | 955-965 | S3145XA | 13 | 760-761 | S32019A | 08 | 551-552 | ||
| S30854D | 23 | 949-950 | S3145XA | 24 | 955-965 | S32019A | 24 | 955-965 | ||
| S30854S | 09 | 604-605 | S3145XD | 23 | 949-950 | S32019B | 08 | 551-552 | ||
| S30855A | 09 | 604-605 | S3145XS | 09 | 604-605 | S32019B | 24 | 955-965 | ||
| S30855A | 24 | 955-965 | S31501A | 12 | 729-730 | S32019D | 08 | 559-561 | ||
| S30855D | 23 | 949-950 | S31501A | 24 | 955-965 | S32019G | 08 | 559-561 | ||
| S30855S | 09 | 604-605 | S31501D | 23 | 949-950 | S32019K | 08 | 564-566 | ||
| S30856A | 09 | 604-605 | S31501S | 12 | 729-730 | S32019S | 08 | 551-552 | ||
| S30856A | 24 | 955-965 | S31502A | 13 | 742-743 | S32020A | 08 | 551-552 | ||
| S30856D | 23 | 949-950 | S31502A | 13 | 760-761 | S32020A | 24 | 955-965 | ||
| S30856S | 09 | 604-605 | S31502A | 24 | 955-965 | S32020B | 08 | 551-552 | ||
| S30857A | 09 | 604-605 | S31502D | 23 | 949-950 | S32020B | 24 | 955-965 | ||
| S30857A | 24 | 955-965 | S31502S | 13 | 742-743 | S32020D | 08 | 559-561 | ||
| S30857D | 23 | 949-950 | S31502S | 13 | 760-761 | S32020G | 08 | 559-561 | ||
| S30857S | 09 | 604-605 | S31511A | 12 | 729-730 | S32020K | 08 | 564-566 | ||
| S30860A | 09 | 606-607 | S31511A | 24 | 955-965 | S32020S | 08 | 551-552 | ||
| S30860A | 24 | 955-965 | S31511D | 23 | 949-950 | S32021A | 08 | 551-552 | ||
| S30860D | 23 | 949-950 | S31511S | 12 | 729-730 | S32021A | 24 | 955-965 | ||
| S30860S | 09 | 604-605 | S31512A | 13 | 742-743 | S32021B | 08 | 551-552 | ||
| S30861A | 09 | 606-607 | S31512A | 13 | 760-761 | S32021B | 24 | 955-965 | ||
| S30861A | 24 | 955-965 | S31512A | 24 | 955-965 | S32021D | 08 | 559-561 | ||
| S30861D | 23 | 949-950 | S31512D | 23 | 949-950 | S32021G | 08 | 559-561 | ||
| S30861S | 09 | 604-605 | S31512S | 13 | 742-743 | S32021K | 08 | 564-566 | ||
| S30862A | 09 | 606-607 | S31512S | 13 | 760-761 | S32021S | 08 | 551-552 | ||
| S30862A | 24 | 955-965 | S31521A | 12 | 729-730 | S32022A | 08 | 551-552 | ||
| S30862D | 23 | 949-950 | S31521A | 24 | 955-965 | S32022A | 24 | 955-965 | ||
| S30862S | 09 | 604-605 | S31521D | 23 | 949-950 | S32022B | 08 | 551-552 | ||
| S30863A | 09 | 606-607 | S31521S | 12 | 729-730 | S32022B | 24 | 955-965 | ||
| S30863A | 24 | 955-965 | S31522A | 13 | 742-743 | S32022D | 08 | 559-561 | ||
| S30863D | 23 | 949-950 | S31522A | 13 | 760-761 | S32022G | 08 | 559-561 | ||
| S30863S | 09 | 604-605 | S31522A | 24 | 955-965 | S32022K | 08 | 564-566 | ||
| S30864A | 09 | 606-607 | S31522D | 23 | 949-950 | S32022S | 08 | 551-552 | ||
| S30864A | 24 | 955-965 | S31522S | 13 | 742-743 | S32028A | 08 | 551-552 | ||
| S30864D | 23 | 949-950 | S31522S | 13 | 760-761 | S32028A | 24 | 955-965 | ||
| S30864S | 09 | 604-605 | S31531A | 12 | 729-730 | S32028B | 08 | 551-552 | ||
| S30865A | 09 | 606-607 | S31531A | 24 | 955-965 | S32028B | 24 | 955-965 | ||
| S30865A | 24 | 955-965 | S31531D | 23 | 949-950 | S32028D | 08 | 559-561 | ||
| S30865D | 23 | 949-950 | S31531S | 12 | 729-730 | S32028G | 08 | 559-561 | ||
| S30865S | 09 | 604-605 | S31532A | 13 | 742-743 | S32028K | 08 | 564-566 | ||
| S30866A | 09 | 606-607 | S31532A | 13 | 760-761 | S32028S | 08 | 551-552 | ||
| S30866A | 24 | 955-965 | S31532A | 24 | 955-965 | S32029A | 08 | 551-552 | ||
| S30866D | 23 | 949-950 | S31532D | 23 | 949-950 | S32029A | 24 | 955-965 | ||
| S30866S | 09 | 604-605 | S31532S | 13 | 742-743 | S32029B | 08 | 551-552 | ||
| S30867A | 09 | 606-607 | S31532S | 13 | 760-761 | S32029B | 24 | 955-965 | ||
| S30867A | 24 | 955-965 | S31541A | 12 | 729-730 | S32029D | 08 | 559-561 | ||
| S30867D | 23 | 949-950 | S31541A | 24 | 955-965 | S32029G | 08 | 559-561 | ||
| S30867S | 09 | 604-605 | S31541D | 23 | 949-950 | S32029K | 08 | 564-566 | ||
| S30870A | 09 | 604-605 | S31541S | 12 | 729-730 | S32029S | 08 | 551-552 | ||
| S30870A | 24 | 955-965 | S31542A | 13 | 742-743 | S32030A | 08 | 551-552 | ||
| S30870D | 23 | 949-950 | S31542A | 13 | 760-761 | S32030A | 24 | 955-965 | ||
| S30870S | 09 | 604-605 | S31542A | 24 | 955-965 | S32030B | 08 | 551-552 | ||
| S30871A | 09 | 604-605 | S31542D | 23 | 949-950 | S32030B | 24 | 955-965 | ||
| S30871A | 24 | 955-965 | S31542S | 13 | 742-743 | S32030D | 08 | 559-561 | ||
| S30871D | 23 | 949-950 | S31542S | 13 | 760-761 | S32030G | 08 | 559-561 | ||
| S30871S | 09 | 604-605 | S31551A | 12 | 729-730 | S32030K | 08 | 564-566 | ||
| S30872A | 09 | 604-605 | S31551A | 24 | 955-965 | S32030S | 08 | 551-552 | ||
| S30872A | 24 | 955-965 | S31551D | 23 | 949-950 | S32031A | 08 | 551-552 | ||
| S30872D | 23 | 949-950 | S31551S | 12 | 729-730 | S32031A | 24 | 955-965 | ||
| S30872S | 09 | 604-605 | S31552A | 13 | 742-743 | S32031B | 08 | 551-552 | ||
| S30873A | 09 | 604-605 | S31552A | 13 | 760-761 | S32031B | 24 | 955-965 | ||
| S30873A | 24 | 955-965 | S31552A | 24 | 955-965 | S32031D | 08 | 559-561 | ||
| S30873D | 23 | 949-950 | S31552D | 23 | 949-950 | S32031G | 08 | 559-561 | ||
| S30873S | 09 | 604-605 | S31552S | 13 | 742-743 | S32031K | 08 | 564-566 | ||
| S30874A | 09 | 604-605 | S31552S | 13 | 760-761 | S32031S | 08 | 551-552 | ||
| S30874A | 24 | 955-965 | S31600A | 06 | 393-395 | S32032A | 08 | 551-552 | ||
| S30874D | 23 | 949-950 | S31600A | 24 | 955-965 | S32032A | 24 | 955-965 | ||
| S30874S | 09 | 604-605 | S31600D | 23 | 949-950 | S32032B | 08 | 551-552 | ||
| S30875A | 09 | 604-605 | S31600S | 09 | 604-605 | S32032B | 24 | 955-965 | ||
| S30875A | 24 | 955-965 | S31601A | 06 | 393-395 | S32032D | 08 | 559-561 | ||
| S30875D | 23 | 949-950 | S31601A | 24 | 955-965 | S32032G | 08 | 559-561 | ||
| S30875S | 09 | 604-605 | S31601D | 23 | 949-950 | S32032K | 08 | 564-566 | ||
| S30876A | 09 | 604-605 | S31601S | 09 | 604-605 | S32032S | 08 | 551-552 | ||
| S30876A | 24 | 955-965 | S31602A | 06 | 393-395 | S32038A | 08 | 551-552 | ||
| S30876D | 23 | 949-950 | S31602A | 24 | 955-965 | S32038A | 24 | 955-965 | ||
| S30876S | 09 | 604-605 | S31602D | 23 | 949-950 | S32038B | 08 | 551-552 | ||
| S30877A | 09 | 604-605 | S31602S | 09 | 604-605 | S32038B | 24 | 955-965 | ||
| S30877A | 24 | 955-965 | S31603A | 06 | 393-395 | S32038D | 08 | 559-561 | ||
| S30877D | 23 | 949-950 | S31603A | 24 | 955-965 | S32038G | 08 | 559-561 | ||
| S30877S | 09 | 604-605 | S31603D | 23 | 949-950 | S32038K | 08 | 564-566 | ||
| S3091XA | 09 | 604-605 | S31603S | 09 | 604-605 | S32038S | 08 | 551-552 | ||
| S3091XA | 24 | 955-965 | S31604A | 06 | 393-395 | S32039A | 08 | 551-552 | ||
| S3091XD | 23 | 949-950 | S31604A | 24 | 955-965 | S32039A | 24 | 955-965 | ||
| S3091XS | 09 | 604-605 | S31604D | 23 | 949-950 | S32039B | 08 | 551-552 | ||
| S3092XA | 09 | 604-605 | S31604S | 09 | 604-605 | S32039B | 24 | 955-965 | ||
| S3092XA | 24 | 955-965 | S31605A | 06 | 393-395 | S32039D | 08 | 559-561 | ||
| S3092XD | 23 | 949-950 | S31605A | 24 | 955-965 | S32039G | 08 | 559-561 | ||
| S3092XS | 09 | 604-605 | S31605D | 23 | 949-950 | S32039K | 08 | 564-566 | ||
| S3093XA | 09 | 604-605 | S31605S | 09 | 604-605 | S32039S | 08 | 551-552 | ||
| S3093XA | 24 | 955-965 | S31609A | 06 | 393-395 | S32040A | 08 | 551-552 | ||
| S3093XD | 23 | 949-950 | S31609A | 24 | 955-965 | S32040A | 24 | 955-965 | ||
| S3093XS | 09 | 604-605 | S31609D | 23 | 949-950 | S32040B | 08 | 551-552 | ||
| S3094XA | 09 | 604-605 | S31609S | 09 | 604-605 | S32040B | 24 | 955-965 | ||
| S3094XA | 24 | 955-965 | S31610A | 06 | 393-395 | S32040D | 08 | 559-561 | ||
| S3094XD | 23 | 949-950 | S31610A | 24 | 955-965 | S32040G | 08 | 559-561 | ||
| S3094XS | 09 | 604-605 | S31610D | 23 | 949-950 | S32040K | 08 | 564-566 | ||
| S3095XA | 09 | 604-605 | S31610S | 09 | 604-605 | S32040S | 08 | 551-552 | ||
| S3095XA | 24 | 955-965 | S31611A | 06 | 393-395 | S32041A | 08 | 551-552 | ||
| S3095XD | 23 | 949-950 | S31611A | 24 | 955-965 | S32041A | 24 | 955-965 | ||
| S3095XS | 09 | 604-605 | S31611D | 23 | 949-950 | S32041B | 08 | 551-552 | ||
| S3096XA | 09 | 604-605 | S31611S | 09 | 604-605 | S32041B | 24 | 955-965 | ||
| S3096XA | 24 | 955-965 | S31612A | 06 | 393-395 | S32041D | 08 | 559-561 | ||
| S3096XD | 23 | 949-950 | S31612A | 24 | 955-965 | S32041G | 08 | 559-561 | ||
| S3096XS | 09 | 604-605 | S31612D | 23 | 949-950 | S32041K | 08 | 564-566 | ||
| S3097XA | 09 | 604-605 | S31612S | 09 | 604-605 | S32041S | 08 | 551-552 | ||
| S3097XA | 24 | 955-965 | S31613A | 06 | 393-395 | S32042A | 08 | 551-552 | ||
| S3097XD | 23 | 949-950 | S31613A | 24 | 955-965 | S32042A | 24 | 955-965 | ||
| S3097XS | 09 | 604-605 | S31613D | 23 | 949-950 | S32042B | 08 | 551-552 | ||
| S3098XA | 09 | 604-605 | S31613S | 09 | 604-605 | S32042B | 24 | 955-965 | ||
| S3098XA | 24 | 955-965 | S31614A | 06 | 393-395 | S32042D | 08 | 559-561 | ||
| S3098XD | 23 | 949-950 | S31614A | 24 | 955-965 | S32042G | 08 | 559-561 | ||
| S3098XS | 09 | 604-605 | S31614D | 23 | 949-950 | S32042K | 08 | 564-566 | ||
| S31000A | 09 | 604-605 | S31614S | 09 | 604-605 | S32042S | 08 | 551-552 | ||
| S31000A | 24 | 955-965 | S31615A | 06 | 393-395 | S32048A | 08 | 551-552 | ||
| S31000D | 23 | 949-950 | S31615A | 24 | 955-965 | S32048A | 24 | 955-965 | ||
| S31000S | 09 | 604-605 | S31615D | 23 | 949-950 | S32048B | 08 | 551-552 | ||
| S31001A | 11 | 698-700 | S31615S | 09 | 604-605 | S32048B | 24 | 955-965 | ||
| S31001A | 24 | 955-965 | S31619A | 06 | 393-395 | S32048D | 08 | 559-561 | ||
| S31001D | 23 | 949-950 | S31619A | 24 | 955-965 | S32048G | 08 | 559-561 | ||
| S31001S | 09 | 604-605 | S31619D | 23 | 949-950 | S32048K | 08 | 564-566 | ||
| S31010A | 09 | 604-605 | S31619S | 09 | 604-605 | S32048S | 08 | 551-552 | ||
| S31010A | 24 | 955-965 | S31620A | 06 | 393-395 | S32049A | 08 | 551-552 | ||
| S31010D | 23 | 949-950 | S31620A | 24 | 955-965 | S32049A | 24 | 955-965 | ||
| S31010S | 09 | 604-605 | S31620D | 23 | 949-950 | S32049B | 08 | 551-552 | ||
| S31011A | 11 | 698-700 | S31620S | 09 | 604-605 | S32049B | 24 | 955-965 | ||
| S31011A | 24 | 955-965 | S31621A | 06 | 393-395 | S32049D | 08 | 559-561 | ||
| S31011D | 23 | 949-950 | S31621A | 24 | 955-965 | S32049G | 08 | 559-561 | ||
| S31011S | 09 | 604-605 | S31621D | 23 | 949-950 | S32049K | 08 | 564-566 | ||
| S31020A | 09 | 604-605 | S31621S | 09 | 604-605 | S32049S | 08 | 551-552 | ||
| S31020A | 24 | 955-965 | S31622A | 06 | 393-395 | S32050A | 08 | 551-552 | ||
| S31020D | 23 | 949-950 | S31622A | 24 | 955-965 | S32050A | 24 | 955-965 | ||
| S31020S | 09 | 604-605 | S31622D | 23 | 949-950 | S32050B | 08 | 551-552 | ||
| S31021A | 11 | 698-700 | S31622S | 09 | 604-605 | S32050B | 24 | 955-965 | ||
| S31021A | 24 | 955-965 | S31623A | 06 | 393-395 | S32050D | 08 | 559-561 | ||
| S31021D | 23 | 949-950 | S31623A | 24 | 955-965 | S32050G | 08 | 559-561 | ||
| S31021S | 09 | 604-605 | S31623D | 23 | 949-950 | S32050K | 08 | 564-566 | ||
| S31030A | 09 | 604-605 | S31623S | 09 | 604-605 | S32050S | 08 | 551-552 | ||
| S31030A | 24 | 955-965 | S31624A | 06 | 393-395 | S32051A | 08 | 551-552 | ||
| S31030D | 23 | 949-950 | S31624A | 24 | 955-965 | S32051A | 24 | 955-965 | ||
| S31030S | 09 | 604-605 | S31624D | 23 | 949-950 | S32051B | 08 | 551-552 | ||
| S31031A | 11 | 698-700 | S31624S | 09 | 604-605 | S32051B | 24 | 955-965 | ||
| S31031A | 24 | 955-965 | S31625A | 06 | 393-395 | S32051D | 08 | 559-561 | ||
| S31031D | 23 | 949-950 | S31625A | 24 | 955-965 | S32051G | 08 | 559-561 | ||
| S31031S | 09 | 604-605 | S31625D | 23 | 949-950 | S32051K | 08 | 564-566 | ||
| S31040A | 09 | 604-605 | S31625S | 09 | 604-605 | S32051S | 08 | 551-552 | ||
| S31040A | 24 | 955-965 | S31629A | 06 | 393-395 | S32052A | 08 | 551-552 | ||
| S31040D | 23 | 949-950 | S31629A | 24 | 955-965 | S32052A | 24 | 955-965 | ||
| S31040S | 09 | 604-605 | S31629D | 23 | 949-950 | S32052B | 08 | 551-552 | ||
| S31041A | 11 | 698-700 | S31629S | 09 | 604-605 | S32052B | 24 | 955-965 | ||
| S31041A | 24 | 955-965 | S31630A | 06 | 393-395 | S32052D | 08 | 559-561 | ||
| S31041D | 23 | 949-950 | S31630A | 24 | 955-965 | S32052G | 08 | 559-561 | ||
| S31041S | 09 | 604-605 | S31630D | 23 | 949-950 | S32052K | 08 | 564-566 | ||
| S31050A | 09 | 604-605 | S31630S | 09 | 604-605 | S32052S | 08 | 551-552 | ||
| S31050A | 24 | 955-965 | S31631A | 06 | 393-395 | S32058A | 08 | 551-552 | ||
| S31050D | 23 | 949-950 | S31631A | 24 | 955-965 | S32058A | 24 | 955-965 | ||
| S31050S | 09 | 604-605 | S31631D | 23 | 949-950 | S32058B | 08 | 551-552 | ||
| S31051A | 11 | 698-700 | S31631S | 09 | 604-605 | S32058B | 24 | 955-965 | ||
| S31051A | 24 | 955-965 | S31632A | 06 | 393-395 | S32058D | 08 | 559-561 | ||
| S31051D | 23 | 949-950 | S31632A | 24 | 955-965 | S32058G | 08 | 559-561 | ||
| S31051S | 09 | 604-605 | S31632D | 23 | 949-950 | S32058K | 08 | 564-566 | ||
| S31100A | 09 | 604-605 | S31632S | 09 | 604-605 | S32058S | 08 | 551-552 | ||
| S31100A | 24 | 955-965 | S31633A | 06 | 393-395 | S32059A | 08 | 551-552 | ||
| S31100D | 23 | 949-950 | S31633A | 24 | 955-965 | S32059A | 24 | 955-965 | ||
| S31100S | 09 | 604-605 | S31633D | 23 | 949-950 | S32059B | 08 | 551-552 | ||
| S31101A | 09 | 604-605 | S31633S | 09 | 604-605 | S32059B | 24 | 955-965 | ||
| S31101A | 24 | 955-965 | S31634A | 06 | 393-395 | S32059D | 08 | 559-561 | ||
| S31101D | 23 | 949-950 | S31634A | 24 | 955-965 | S32059G | 08 | 559-561 | ||
| S31101S | 09 | 604-605 | S31634D | 23 | 949-950 | S32059K | 08 | 564-566 | ||
| S31102A | 09 | 604-605 | S31634S | 09 | 604-605 | S32059S | 08 | 551-552 | ||
| S31102A | 24 | 955-965 | S31635A | 06 | 393-395 | S3210XA | 08 | 551-552 | ||
| S31102D | 23 | 949-950 | S31635A | 24 | 955-965 | S3210XA | 24 | 955-965 | ||
| S31102S | 09 | 604-605 | S31635D | 23 | 949-950 | S3210XB | 08 | 551-552 | ||
| S31103A | 09 | 604-605 | S31635S | 09 | 604-605 | S3210XB | 24 | 955-965 | ||
| S31103A | 24 | 955-965 | S31639A | 06 | 393-395 | S3210XD | 08 | 559-561 | ||
| S31103D | 23 | 949-950 | S31639A | 24 | 955-965 | S3210XG | 08 | 559-561 | ||
| S31103S | 09 | 604-605 | S31639D | 23 | 949-950 | S3210XK | 08 | 564-566 | ||
| S31104A | 09 | 604-605 | S31639S | 09 | 604-605 | S3210XS | 08 | 551-552 | ||
| S31104A | 24 | 955-965 | S31640A | 06 | 393-395 | S32110A | 08 | 551-552 | ||
| S31104D | 23 | 949-950 | S31640A | 24 | 955-965 | S32110A | 24 | 955-965 | ||
| S31104S | 09 | 604-605 | S31640D | 23 | 949-950 | S32110B | 08 | 551-552 | ||
| S31105A | 09 | 604-605 | S31640S | 09 | 604-605 | S32110B | 24 | 955-965 | ||
| S31105A | 24 | 955-965 | S31641A | 06 | 393-395 | S32110D | 08 | 559-561 | ||
| S31105D | 23 | 949-950 | S31641A | 24 | 955-965 | S32110G | 08 | 559-561 | ||
| S31105S | 09 | 604-605 | S31641D | 23 | 949-950 | S32110K | 08 | 564-566 | ||
| S31109A | 09 | 604-605 | S31641S | 09 | 604-605 | S32110S | 08 | 551-552 | ||
| S31109A | 24 | 955-965 | S31642A | 06 | 393-395 | S32111A | 08 | 551-552 | ||
| S31109D | 23 | 949-950 | S31642A | 24 | 955-965 | S32111A | 24 | 955-965 | ||
| S31109S | 09 | 604-605 | S31642D | 23 | 949-950 | S32111B | 08 | 551-552 | ||
| S31110A | 09 | 604-605 | S31642S | 09 | 604-605 | S32111B | 24 | 955-965 | ||
| S31110A | 24 | 955-965 | S31643A | 06 | 393-395 | S32111D | 08 | 559-561 | ||
| S31110D | 23 | 949-950 | S31643A | 24 | 955-965 | S32111G | 08 | 559-561 | ||
| S31110S | 09 | 604-605 | S31643D | 23 | 949-950 | S32111K | 08 | 564-566 | ||
| S31111A | 09 | 604-605 | S31643S | 09 | 604-605 | S32111S | 08 | 551-552 | ||
| S31111A | 24 | 955-965 | S31644A | 06 | 393-395 | S32112A | 08 | 551-552 | ||
| S31111D | 23 | 949-950 | S31644A | 24 | 955-965 | S32112A | 24 | 955-965 | ||
| S31111S | 09 | 604-605 | S31644D | 23 | 949-950 | S32112B | 08 | 551-552 | ||
| S31112A | 09 | 604-605 | S31644S | 09 | 604-605 | S32112B | 24 | 955-965 | ||
| S31112A | 24 | 955-965 | S31645A | 06 | 393-395 | S32112D | 08 | 559-561 | ||
| S31112D | 23 | 949-950 | S31645A | 24 | 955-965 | S32112G | 08 | 559-561 | ||
| S31112S | 09 | 604-605 | S31645D | 23 | 949-950 | S32112K | 08 | 564-566 | ||
| S31113A | 09 | 604-605 | S31645S | 09 | 604-605 | S32112S | 08 | 551-552 | ||
| S31113A | 24 | 955-965 | S31649A | 06 | 393-395 | S32119A | 08 | 551-552 | ||
| S31113D | 23 | 949-950 | S31649A | 24 | 955-965 | S32119A | 24 | 955-965 | ||
| S31113S | 09 | 604-605 | S31649D | 23 | 949-950 | S32119B | 08 | 551-552 | ||
| S31114A | 09 | 604-605 | S31649S | 09 | 604-605 | S32119B | 24 | 955-965 | ||
| S31114A | 24 | 955-965 | S31650A | 06 | 393-395 | S32119D | 08 | 559-561 | ||
| S31114D | 23 | 949-950 | S31650A | 24 | 955-965 | S32119G | 08 | 559-561 | ||
| S31114S | 09 | 604-605 | S31650D | 23 | 949-950 | S32119K | 08 | 564-566 | ||
| S31115A | 09 | 604-605 | S31650S | 09 | 604-605 | S32119S | 08 | 551-552 | ||
| S31115A | 24 | 955-965 | S31651A | 06 | 393-395 | S32120A | 08 | 551-552 | ||
| S31115D | 23 | 949-950 | S31651A | 24 | 955-965 | S32120A | 24 | 955-965 | ||
| S31115S | 09 | 604-605 | S31651D | 23 | 949-950 | S32120B | 08 | 551-552 | ||
| S31119A | 09 | 604-605 | S31651S | 09 | 604-605 | S32120B | 24 | 955-965 | ||
| S31119A | 24 | 955-965 | S31652A | 06 | 393-395 | S32120D | 08 | 559-561 | ||
| S31119D | 23 | 949-950 | S31652A | 24 | 955-965 | S32120G | 08 | 559-561 | ||
| S31119S | 09 | 604-605 | S31652D | 23 | 949-950 | S32120K | 08 | 564-566 | ||
| S31120A | 21 | 913-914 | S31652S | 09 | 604-605 | S32120S | 08 | 551-552 | ||
| S31120A | 24 | 955-965 | S31653A | 06 | 393-395 | S32121A | 08 | 551-552 | ||
| S31120D | 23 | 949-950 | S31653A | 24 | 955-965 | S32121A | 24 | 955-965 | ||
| S31120S | 09 | 604-605 | S31653D | 23 | 949-950 | S32121B | 08 | 551-552 | ||
| S31121A | 21 | 913-914 | S31653S | 09 | 604-605 | S32121B | 24 | 955-965 | ||
| S31121A | 24 | 955-965 | S31654A | 06 | 393-395 | S32121D | 08 | 559-561 | ||
| S31121D | 23 | 949-950 | S31654A | 24 | 955-965 | S32121G | 08 | 559-561 | ||
| S31121S | 09 | 604-605 | S31654D | 23 | 949-950 | S32121K | 08 | 564-566 | ||
| S31122A | 21 | 913-914 | S31654S | 09 | 604-605 | S32121S | 08 | 551-552 | ||
| S31122A | 24 | 955-965 | S31655A | 06 | 393-395 | S32122A | 08 | 551-552 | ||
| S31122D | 23 | 949-950 | S31655A | 24 | 955-965 | S32122A | 24 | 955-965 | ||
| S31122S | 09 | 604-605 | S31655D | 23 | 949-950 | S32122B | 08 | 551-552 | ||
| S31123A | 21 | 913-914 | S31655S | 09 | 604-605 | S32122B | 24 | 955-965 | ||
| S31123A | 24 | 955-965 | S31659A | 06 | 393-395 | S32122D | 08 | 559-561 | ||
| S31123D | 23 | 949-950 | S31659A | 24 | 955-965 | S32122G | 08 | 559-561 | ||
| S31123S | 09 | 604-605 | S31659D | 23 | 949-950 | S32122K | 08 | 564-566 | ||
| S31124A | 21 | 913-914 | S31659S | 09 | 604-605 | S32122S | 08 | 551-552 | ||
| S31124A | 24 | 955-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 02 Nov 2016 09:53:07 PROD, CMS, code-revision=31, description-revision=86 |