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 57 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S90931D | 23 | 949-950 | S91249D | 23 | 949-950 | S92061B | 08 | 562-563 | ||
| S90931S | 09 | 604-605 | S91249S | 09 | 604-605 | S92061B | 24 | 955-965 | ||
| S90932A | 09 | 604-605 | S91251A | 09 | 604-605 | S92061D | 08 | 559-561 | ||
| S90932A | 24 | 955-965 | S91251A | 24 | 955-965 | S92061G | 08 | 559-561 | ||
| S90932D | 23 | 949-950 | S91251D | 23 | 949-950 | S92061K | 08 | 564-566 | ||
| S90932S | 09 | 604-605 | S91251S | 09 | 604-605 | S92061P | 08 | 564-566 | ||
| S90933A | 09 | 604-605 | S91252A | 09 | 604-605 | S92061S | 08 | 559-561 | ||
| S90933A | 24 | 955-965 | S91252A | 24 | 955-965 | S92062A | 08 | 562-563 | ||
| S90933D | 23 | 949-950 | S91252D | 23 | 949-950 | S92062A | 24 | 955-965 | ||
| S90933S | 09 | 604-605 | S91252S | 09 | 604-605 | S92062B | 08 | 562-563 | ||
| S90934A | 09 | 604-605 | S91253A | 09 | 604-605 | S92062B | 24 | 955-965 | ||
| S90934A | 24 | 955-965 | S91253A | 24 | 955-965 | S92062D | 08 | 559-561 | ||
| S90934D | 23 | 949-950 | S91253D | 23 | 949-950 | S92062G | 08 | 559-561 | ||
| S90934S | 09 | 604-605 | S91253S | 09 | 604-605 | S92062K | 08 | 564-566 | ||
| S90935A | 09 | 604-605 | S91254A | 09 | 604-605 | S92062P | 08 | 564-566 | ||
| S90935A | 24 | 955-965 | S91254A | 24 | 955-965 | S92062S | 08 | 559-561 | ||
| S90935D | 23 | 949-950 | S91254D | 23 | 949-950 | S92063A | 08 | 562-563 | ||
| S90935S | 09 | 604-605 | S91254S | 09 | 604-605 | S92063A | 24 | 955-965 | ||
| S90936A | 09 | 604-605 | S91255A | 09 | 604-605 | S92063B | 08 | 562-563 | ||
| S90936A | 24 | 955-965 | S91255A | 24 | 955-965 | S92063B | 24 | 955-965 | ||
| S90936D | 23 | 949-950 | S91255D | 23 | 949-950 | S92063D | 08 | 559-561 | ||
| S90936S | 09 | 604-605 | S91255S | 09 | 604-605 | S92063G | 08 | 559-561 | ||
| S91001A | 09 | 604-605 | S91256A | 09 | 604-605 | S92063K | 08 | 564-566 | ||
| S91001A | 24 | 955-965 | S91256A | 24 | 955-965 | S92063P | 08 | 564-566 | ||
| S91001D | 23 | 949-950 | S91256D | 23 | 949-950 | S92063S | 08 | 559-561 | ||
| S91001S | 09 | 604-605 | S91256S | 09 | 604-605 | S92064A | 08 | 562-563 | ||
| S91002A | 09 | 604-605 | S91259A | 09 | 604-605 | S92064A | 24 | 955-965 | ||
| S91002A | 24 | 955-965 | S91259A | 24 | 955-965 | S92064B | 08 | 562-563 | ||
| S91002D | 23 | 949-950 | S91259D | 23 | 949-950 | S92064B | 24 | 955-965 | ||
| S91002S | 09 | 604-605 | S91259S | 09 | 604-605 | S92064D | 08 | 559-561 | ||
| S91009A | 09 | 604-605 | S91301A | 09 | 604-605 | S92064G | 08 | 559-561 | ||
| S91009A | 24 | 955-965 | S91301A | 24 | 955-965 | S92064K | 08 | 564-566 | ||
| S91009D | 23 | 949-950 | S91301D | 23 | 949-950 | S92064P | 08 | 564-566 | ||
| S91009S | 09 | 604-605 | S91301S | 09 | 604-605 | S92064S | 08 | 559-561 | ||
| S91011A | 09 | 604-605 | S91302A | 09 | 604-605 | S92065A | 08 | 562-563 | ||
| S91011A | 24 | 955-965 | S91302A | 24 | 955-965 | S92065A | 24 | 955-965 | ||
| S91011D | 23 | 949-950 | S91302D | 23 | 949-950 | S92065B | 08 | 562-563 | ||
| S91011S | 09 | 604-605 | S91302S | 09 | 604-605 | S92065B | 24 | 955-965 | ||
| S91012A | 09 | 604-605 | S91309A | 09 | 604-605 | S92065D | 08 | 559-561 | ||
| S91012A | 24 | 955-965 | S91309A | 24 | 955-965 | S92065G | 08 | 559-561 | ||
| S91012D | 23 | 949-950 | S91309D | 23 | 949-950 | S92065K | 08 | 564-566 | ||
| S91012S | 09 | 604-605 | S91309S | 09 | 604-605 | S92065P | 08 | 564-566 | ||
| S91019A | 09 | 604-605 | S91311A | 09 | 604-605 | S92065S | 08 | 559-561 | ||
| S91019A | 24 | 955-965 | S91311A | 24 | 955-965 | S92066A | 08 | 562-563 | ||
| S91019D | 23 | 949-950 | S91311D | 23 | 949-950 | S92066A | 24 | 955-965 | ||
| S91019S | 09 | 604-605 | S91311S | 09 | 604-605 | S92066B | 08 | 562-563 | ||
| S91021A | 21 | 913-914 | S91312A | 09 | 604-605 | S92066B | 24 | 955-965 | ||
| S91021A | 24 | 955-965 | S91312A | 24 | 955-965 | S92066D | 08 | 559-561 | ||
| S91021D | 23 | 949-950 | S91312D | 23 | 949-950 | S92066G | 08 | 559-561 | ||
| S91021S | 09 | 604-605 | S91312S | 09 | 604-605 | S92066K | 08 | 564-566 | ||
| S91022A | 21 | 913-914 | S91319A | 09 | 604-605 | S92066P | 08 | 564-566 | ||
| S91022A | 24 | 955-965 | S91319A | 24 | 955-965 | S92066S | 08 | 559-561 | ||
| S91022D | 23 | 949-950 | S91319D | 23 | 949-950 | S92101A | 08 | 562-563 | ||
| S91022S | 09 | 604-605 | S91319S | 09 | 604-605 | S92101A | 24 | 955-965 | ||
| S91029A | 21 | 913-914 | S91321A | 21 | 913-914 | S92101B | 08 | 562-563 | ||
| S91029A | 24 | 955-965 | S91321A | 24 | 955-965 | S92101B | 24 | 955-965 | ||
| S91029D | 23 | 949-950 | S91321D | 23 | 949-950 | S92101D | 08 | 559-561 | ||
| S91029S | 09 | 604-605 | S91321S | 09 | 604-605 | S92101G | 08 | 559-561 | ||
| S91031A | 09 | 604-605 | S91322A | 21 | 913-914 | S92101K | 08 | 564-566 | ||
| S91031A | 24 | 955-965 | S91322A | 24 | 955-965 | S92101P | 08 | 564-566 | ||
| S91031D | 23 | 949-950 | S91322D | 23 | 949-950 | S92101S | 08 | 559-561 | ||
| S91031S | 09 | 604-605 | S91322S | 09 | 604-605 | S92102A | 08 | 562-563 | ||
| S91032A | 09 | 604-605 | S91329A | 21 | 913-914 | S92102A | 24 | 955-965 | ||
| S91032A | 24 | 955-965 | S91329A | 24 | 955-965 | S92102B | 08 | 562-563 | ||
| S91032D | 23 | 949-950 | S91329D | 23 | 949-950 | S92102B | 24 | 955-965 | ||
| S91032S | 09 | 604-605 | S91329S | 09 | 604-605 | S92102D | 08 | 559-561 | ||
| S91039A | 09 | 604-605 | S91331A | 09 | 604-605 | S92102G | 08 | 559-561 | ||
| S91039A | 24 | 955-965 | S91331A | 24 | 955-965 | S92102K | 08 | 564-566 | ||
| S91039D | 23 | 949-950 | S91331D | 23 | 949-950 | S92102P | 08 | 564-566 | ||
| S91039S | 09 | 604-605 | S91331S | 09 | 604-605 | S92102S | 08 | 559-561 | ||
| S91041A | 21 | 913-914 | S91332A | 09 | 604-605 | S92109A | 08 | 562-563 | ||
| S91041A | 24 | 955-965 | S91332A | 24 | 955-965 | S92109A | 24 | 955-965 | ||
| S91041D | 23 | 949-950 | S91332D | 23 | 949-950 | S92109B | 08 | 562-563 | ||
| S91041S | 09 | 604-605 | S91332S | 09 | 604-605 | S92109B | 24 | 955-965 | ||
| S91042A | 21 | 913-914 | S91339A | 09 | 604-605 | S92109D | 08 | 559-561 | ||
| S91042A | 24 | 955-965 | S91339A | 24 | 955-965 | S92109G | 08 | 559-561 | ||
| S91042D | 23 | 949-950 | S91339D | 23 | 949-950 | S92109K | 08 | 564-566 | ||
| S91042S | 09 | 604-605 | S91339S | 09 | 604-605 | S92109P | 08 | 564-566 | ||
| S91049A | 21 | 913-914 | S91341A | 21 | 913-914 | S92109S | 08 | 559-561 | ||
| S91049A | 24 | 955-965 | S91341A | 24 | 955-965 | S92111A | 08 | 562-563 | ||
| S91049D | 23 | 949-950 | S91341D | 23 | 949-950 | S92111A | 24 | 955-965 | ||
| S91049S | 09 | 604-605 | S91341S | 09 | 604-605 | S92111B | 08 | 562-563 | ||
| S91051A | 09 | 604-605 | S91342A | 21 | 913-914 | S92111B | 24 | 955-965 | ||
| S91051A | 24 | 955-965 | S91342A | 24 | 955-965 | S92111D | 08 | 559-561 | ||
| S91051D | 23 | 949-950 | S91342D | 23 | 949-950 | S92111G | 08 | 559-561 | ||
| S91051S | 09 | 604-605 | S91342S | 09 | 604-605 | S92111K | 08 | 564-566 | ||
| S91052A | 09 | 604-605 | S91349A | 21 | 913-914 | S92111P | 08 | 564-566 | ||
| S91052A | 24 | 955-965 | S91349A | 24 | 955-965 | S92111S | 08 | 559-561 | ||
| S91052D | 23 | 949-950 | S91349D | 23 | 949-950 | S92112A | 08 | 562-563 | ||
| S91052S | 09 | 604-605 | S91349S | 09 | 604-605 | S92112A | 24 | 955-965 | ||
| S91059A | 09 | 604-605 | S91351A | 09 | 604-605 | S92112B | 08 | 562-563 | ||
| S91059A | 24 | 955-965 | S91351A | 24 | 955-965 | S92112B | 24 | 955-965 | ||
| S91059D | 23 | 949-950 | S91351D | 23 | 949-950 | S92112D | 08 | 559-561 | ||
| S91059S | 09 | 604-605 | S91351S | 09 | 604-605 | S92112G | 08 | 559-561 | ||
| S91101A | 09 | 604-605 | S91352A | 09 | 604-605 | S92112K | 08 | 564-566 | ||
| S91101A | 24 | 955-965 | S91352A | 24 | 955-965 | S92112P | 08 | 564-566 | ||
| S91101D | 23 | 949-950 | S91352D | 23 | 949-950 | S92112S | 08 | 559-561 | ||
| S91101S | 09 | 604-605 | S91352S | 09 | 604-605 | S92113A | 08 | 562-563 | ||
| S91102A | 09 | 604-605 | S91359A | 09 | 604-605 | S92113A | 24 | 955-965 | ||
| S91102A | 24 | 955-965 | S91359A | 24 | 955-965 | S92113B | 08 | 562-563 | ||
| S91102D | 23 | 949-950 | S91359D | 23 | 949-950 | S92113B | 24 | 955-965 | ||
| S91102S | 09 | 604-605 | S91359S | 09 | 604-605 | S92113D | 08 | 559-561 | ||
| S91103A | 09 | 604-605 | S92001A | 08 | 562-563 | S92113G | 08 | 559-561 | ||
| S91103A | 24 | 955-965 | S92001A | 24 | 955-965 | S92113K | 08 | 564-566 | ||
| S91103D | 23 | 949-950 | S92001B | 08 | 562-563 | S92113P | 08 | 564-566 | ||
| S91103S | 09 | 604-605 | S92001B | 24 | 955-965 | S92113S | 08 | 559-561 | ||
| S91104A | 09 | 604-605 | S92001D | 08 | 559-561 | S92114A | 08 | 562-563 | ||
| S91104A | 24 | 955-965 | S92001G | 08 | 559-561 | S92114A | 24 | 955-965 | ||
| S91104D | 23 | 949-950 | S92001K | 08 | 564-566 | S92114B | 08 | 562-563 | ||
| S91104S | 09 | 604-605 | S92001P | 08 | 564-566 | S92114B | 24 | 955-965 | ||
| S91105A | 09 | 604-605 | S92001S | 08 | 559-561 | S92114D | 08 | 559-561 | ||
| S91105A | 24 | 955-965 | S92002A | 08 | 562-563 | S92114G | 08 | 559-561 | ||
| S91105D | 23 | 949-950 | S92002A | 24 | 955-965 | S92114K | 08 | 564-566 | ||
| S91105S | 09 | 604-605 | S92002B | 08 | 562-563 | S92114P | 08 | 564-566 | ||
| S91106A | 09 | 604-605 | S92002B | 24 | 955-965 | S92114S | 08 | 559-561 | ||
| S91106A | 24 | 955-965 | S92002D | 08 | 559-561 | S92115A | 08 | 562-563 | ||
| S91106D | 23 | 949-950 | S92002G | 08 | 559-561 | S92115A | 24 | 955-965 | ||
| S91106S | 09 | 604-605 | S92002K | 08 | 564-566 | S92115B | 08 | 562-563 | ||
| S91109A | 09 | 604-605 | S92002P | 08 | 564-566 | S92115B | 24 | 955-965 | ||
| S91109A | 24 | 955-965 | S92002S | 08 | 559-561 | S92115D | 08 | 559-561 | ||
| S91109D | 23 | 949-950 | S92009A | 08 | 562-563 | S92115G | 08 | 559-561 | ||
| S91109S | 09 | 604-605 | S92009A | 24 | 955-965 | S92115K | 08 | 564-566 | ||
| S91111A | 09 | 604-605 | S92009B | 08 | 562-563 | S92115P | 08 | 564-566 | ||
| S91111A | 24 | 955-965 | S92009B | 24 | 955-965 | S92115S | 08 | 559-561 | ||
| S91111D | 23 | 949-950 | S92009D | 08 | 559-561 | S92116A | 08 | 562-563 | ||
| S91111S | 09 | 604-605 | S92009G | 08 | 559-561 | S92116A | 24 | 955-965 | ||
| S91112A | 09 | 604-605 | S92009K | 08 | 564-566 | S92116B | 08 | 562-563 | ||
| S91112A | 24 | 955-965 | S92009P | 08 | 564-566 | S92116B | 24 | 955-965 | ||
| S91112D | 23 | 949-950 | S92009S | 08 | 559-561 | S92116D | 08 | 559-561 | ||
| S91112S | 09 | 604-605 | S92011A | 08 | 562-563 | S92116G | 08 | 559-561 | ||
| S91113A | 09 | 604-605 | S92011A | 24 | 955-965 | S92116K | 08 | 564-566 | ||
| S91113A | 24 | 955-965 | S92011B | 08 | 562-563 | S92116P | 08 | 564-566 | ||
| S91113D | 23 | 949-950 | S92011B | 24 | 955-965 | S92116S | 08 | 559-561 | ||
| S91113S | 09 | 604-605 | S92011D | 08 | 559-561 | S92121A | 08 | 562-563 | ||
| S91114A | 09 | 604-605 | S92011G | 08 | 559-561 | S92121A | 24 | 955-965 | ||
| S91114A | 24 | 955-965 | S92011K | 08 | 564-566 | S92121B | 08 | 562-563 | ||
| S91114D | 23 | 949-950 | S92011P | 08 | 564-566 | S92121B | 24 | 955-965 | ||
| S91114S | 09 | 604-605 | S92011S | 08 | 559-561 | S92121D | 08 | 559-561 | ||
| S91115A | 09 | 604-605 | S92012A | 08 | 562-563 | S92121G | 08 | 559-561 | ||
| S91115A | 24 | 955-965 | S92012A | 24 | 955-965 | S92121K | 08 | 564-566 | ||
| S91115D | 23 | 949-950 | S92012B | 08 | 562-563 | S92121P | 08 | 564-566 | ||
| S91115S | 09 | 604-605 | S92012B | 24 | 955-965 | S92121S | 08 | 559-561 | ||
| S91116A | 09 | 604-605 | S92012D | 08 | 559-561 | S92122A | 08 | 562-563 | ||
| S91116A | 24 | 955-965 | S92012G | 08 | 559-561 | S92122A | 24 | 955-965 | ||
| S91116D | 23 | 949-950 | S92012K | 08 | 564-566 | S92122B | 08 | 562-563 | ||
| S91116S | 09 | 604-605 | S92012P | 08 | 564-566 | S92122B | 24 | 955-965 | ||
| S91119A | 09 | 604-605 | S92012S | 08 | 559-561 | S92122D | 08 | 559-561 | ||
| S91119A | 24 | 955-965 | S92013A | 08 | 562-563 | S92122G | 08 | 559-561 | ||
| S91119D | 23 | 949-950 | S92013A | 24 | 955-965 | S92122K | 08 | 564-566 | ||
| S91119S | 09 | 604-605 | S92013B | 08 | 562-563 | S92122P | 08 | 564-566 | ||
| S91121A | 21 | 913-914 | S92013B | 24 | 955-965 | S92122S | 08 | 559-561 | ||
| S91121A | 24 | 955-965 | S92013D | 08 | 559-561 | S92123A | 08 | 562-563 | ||
| S91121D | 23 | 949-950 | S92013G | 08 | 559-561 | S92123A | 24 | 955-965 | ||
| S91121S | 09 | 604-605 | S92013K | 08 | 564-566 | S92123B | 08 | 562-563 | ||
| S91122A | 21 | 913-914 | S92013P | 08 | 564-566 | S92123B | 24 | 955-965 | ||
| S91122A | 24 | 955-965 | S92013S | 08 | 559-561 | S92123D | 08 | 559-561 | ||
| S91122D | 23 | 949-950 | S92014A | 08 | 562-563 | S92123G | 08 | 559-561 | ||
| S91122S | 09 | 604-605 | S92014A | 24 | 955-965 | S92123K | 08 | 564-566 | ||
| S91123A | 21 | 913-914 | S92014B | 08 | 562-563 | S92123P | 08 | 564-566 | ||
| S91123A | 24 | 955-965 | S92014B | 24 | 955-965 | S92123S | 08 | 559-561 | ||
| S91123D | 23 | 949-950 | S92014D | 08 | 559-561 | S92124A | 08 | 562-563 | ||
| S91123S | 09 | 604-605 | S92014G | 08 | 559-561 | S92124A | 24 | 955-965 | ||
| S91124A | 21 | 913-914 | S92014K | 08 | 564-566 | S92124B | 08 | 562-563 | ||
| S91124A | 24 | 955-965 | S92014P | 08 | 564-566 | S92124B | 24 | 955-965 | ||
| S91124D | 23 | 949-950 | S92014S | 08 | 559-561 | S92124D | 08 | 559-561 | ||
| S91124S | 09 | 604-605 | S92015A | 08 | 562-563 | S92124G | 08 | 559-561 | ||
| S91125A | 21 | 913-914 | S92015A | 24 | 955-965 | S92124K | 08 | 564-566 | ||
| S91125A | 24 | 955-965 | S92015B | 08 | 562-563 | S92124P | 08 | 564-566 | ||
| S91125D | 23 | 949-950 | S92015B | 24 | 955-965 | S92124S | 08 | 559-561 | ||
| S91125S | 09 | 604-605 | S92015D | 08 | 559-561 | S92125A | 08 | 562-563 | ||
| S91126A | 21 | 913-914 | S92015G | 08 | 559-561 | S92125A | 24 | 955-965 | ||
| S91126A | 24 | 955-965 | S92015K | 08 | 564-566 | S92125B | 08 | 562-563 | ||
| S91126D | 23 | 949-950 | S92015P | 08 | 564-566 | S92125B | 24 | 955-965 | ||
| S91126S | 09 | 604-605 | S92015S | 08 | 559-561 | S92125D | 08 | 559-561 | ||
| S91129A | 21 | 913-914 | S92016A | 08 | 562-563 | S92125G | 08 | 559-561 | ||
| S91129A | 24 | 955-965 | S92016A | 24 | 955-965 | S92125K | 08 | 564-566 | ||
| S91129D | 23 | 949-950 | S92016B | 08 | 562-563 | S92125P | 08 | 564-566 | ||
| S91129S | 09 | 604-605 | S92016B | 24 | 955-965 | S92125S | 08 | 559-561 | ||
| S91131A | 09 | 604-605 | S92016D | 08 | 559-561 | S92126A | 08 | 562-563 | ||
| S91131A | 24 | 955-965 | S92016G | 08 | 559-561 | S92126A | 24 | 955-965 | ||
| S91131D | 23 | 949-950 | S92016K | 08 | 564-566 | S92126B | 08 | 562-563 | ||
| S91131S | 09 | 604-605 | S92016P | 08 | 564-566 | S92126B | 24 | 955-965 | ||
| S91132A | 09 | 604-605 | S92016S | 08 | 559-561 | S92126D | 08 | 559-561 | ||
| S91132A | 24 | 955-965 | S92021A | 08 | 562-563 | S92126G | 08 | 559-561 | ||
| S91132D | 23 | 949-950 | S92021A | 24 | 955-965 | S92126K | 08 | 564-566 | ||
| S91132S | 09 | 604-605 | S92021B | 08 | 562-563 | S92126P | 08 | 564-566 | ||
| S91133A | 09 | 604-605 | S92021B | 24 | 955-965 | S92126S | 08 | 559-561 | ||
| S91133A | 24 | 955-965 | S92021D | 08 | 559-561 | S92131A | 08 | 562-563 | ||
| S91133D | 23 | 949-950 | S92021G | 08 | 559-561 | S92131A | 24 | 955-965 | ||
| S91133S | 09 | 604-605 | S92021K | 08 | 564-566 | S92131B | 08 | 562-563 | ||
| S91134A | 09 | 604-605 | S92021P | 08 | 564-566 | S92131B | 24 | 955-965 | ||
| S91134A | 24 | 955-965 | S92021S | 08 | 559-561 | S92131D | 08 | 559-561 | ||
| S91134D | 23 | 949-950 | S92022A | 08 | 562-563 | S92131G | 08 | 559-561 | ||
| S91134S | 09 | 604-605 | S92022A | 24 | 955-965 | S92131K | 08 | 564-566 | ||
| S91135A | 09 | 604-605 | S92022B | 08 | 562-563 | S92131P | 08 | 564-566 | ||
| S91135A | 24 | 955-965 | S92022B | 24 | 955-965 | S92131S | 08 | 559-561 | ||
| S91135D | 23 | 949-950 | S92022D | 08 | 559-561 | S92132A | 08 | 562-563 | ||
| S91135S | 09 | 604-605 | S92022G | 08 | 559-561 | S92132A | 24 | 955-965 | ||
| S91136A | 09 | 604-605 | S92022K | 08 | 564-566 | S92132B | 08 | 562-563 | ||
| S91136A | 24 | 955-965 | S92022P | 08 | 564-566 | S92132B | 24 | 955-965 | ||
| S91136D | 23 | 949-950 | S92022S | 08 | 559-561 | S92132D | 08 | 559-561 | ||
| S91136S | 09 | 604-605 | S92023A | 08 | 562-563 | S92132G | 08 | 559-561 | ||
| S91139A | 09 | 604-605 | S92023A | 24 | 955-965 | S92132K | 08 | 564-566 | ||
| S91139A | 24 | 955-965 | S92023B | 08 | 562-563 | S92132P | 08 | 564-566 | ||
| S91139D | 23 | 949-950 | S92023B | 24 | 955-965 | S92132S | 08 | 559-561 | ||
| S91139S | 09 | 604-605 | S92023D | 08 | 559-561 | S92133A | 08 | 562-563 | ||
| S91141A | 21 | 913-914 | S92023G | 08 | 559-561 | S92133A | 24 | 955-965 | ||
| S91141A | 24 | 955-965 | S92023K | 08 | 564-566 | S92133B | 08 | 562-563 | ||
| S91141D | 23 | 949-950 | S92023P | 08 | 564-566 | S92133B | 24 | 955-965 | ||
| S91141S | 09 | 604-605 | S92023S | 08 | 559-561 | S92133D | 08 | 559-561 | ||
| S91142A | 21 | 913-914 | S92024A | 08 | 562-563 | S92133G | 08 | 559-561 | ||
| S91142A | 24 | 955-965 | S92024A | 24 | 955-965 | S92133K | 08 | 564-566 | ||
| S91142D | 23 | 949-950 | S92024B | 08 | 562-563 | S92133P | 08 | 564-566 | ||
| S91142S | 09 | 604-605 | S92024B | 24 | 955-965 | S92133S | 08 | 559-561 | ||
| S91143A | 21 | 913-914 | S92024D | 08 | 559-561 | S92134A | 08 | 562-563 | ||
| S91143A | 24 | 955-965 | S92024G | 08 | 559-561 | S92134A | 24 | 955-965 | ||
| S91143D | 23 | 949-950 | S92024K | 08 | 564-566 | S92134B | 08 | 562-563 | ||
| S91143S | 09 | 604-605 | S92024P | 08 | 564-566 | S92134B | 24 | 955-965 | ||
| S91144A | 21 | 913-914 | S92024S | 08 | 559-561 | S92134D | 08 | 559-561 | ||
| S91144A | 24 | 955-965 | S92025A | 08 | 562-563 | S92134G | 08 | 559-561 | ||
| S91144D | 23 | 949-950 | S92025A | 24 | 955-965 | S92134K | 08 | 564-566 | ||
| S91144S | 09 | 604-605 | S92025B | 08 | 562-563 | S92134P | 08 | 564-566 | ||
| S91145A | 21 | 913-914 | S92025B | 24 | 955-965 | S92134S | 08 | 559-561 | ||
| S91145A | 24 | 955-965 | S92025D | 08 | 559-561 | S92135A | 08 | 562-563 | ||
| S91145D | 23 | 949-950 | S92025G | 08 | 559-561 | S92135A | 24 | 955-965 | ||
| S91145S | 09 | 604-605 | S92025K | 08 | 564-566 | S92135B | 08 | 562-563 | ||
| S91146A | 21 | 913-914 | S92025P | 08 | 564-566 | S92135B | 24 | 955-965 | ||
| S91146A | 24 | 955-965 | S92025S | 08 | 559-561 | S92135D | 08 | 559-561 | ||
| S91146D | 23 | 949-950 | S92026A | 08 | 562-563 | S92135G | 08 | 559-561 | ||
| S91146S | 09 | 604-605 | S92026A | 24 | 955-965 | S92135K | 08 | 564-566 | ||
| S91149A | 21 | 913-914 | S92026B | 08 | 562-563 | S92135P | 08 | 564-566 | ||
| S91149A | 24 | 955-965 | S92026B | 24 | 955-965 | S92135S | 08 | 559-561 | ||
| S91149D | 23 | 949-950 | S92026D | 08 | 559-561 | S92136A | 08 | 562-563 | ||
| S91149S | 09 | 604-605 | S92026G | 08 | 559-561 | S92136A | 24 | 955-965 | ||
| S91151A | 09 | 604-605 | S92026K | 08 | 564-566 | S92136B | 08 | 562-563 | ||
| S91151A | 24 | 955-965 | S92026P | 08 | 564-566 | S92136B | 24 | 955-965 | ||
| S91151D | 23 | 949-950 | S92026S | 08 | 559-561 | S92136D | 08 | 559-561 | ||
| S91151S | 09 | 604-605 | S92031A | 08 | 562-563 | S92136G | 08 | 559-561 | ||
| S91152A | 09 | 604-605 | S92031A | 24 | 955-965 | S92136K | 08 | 564-566 | ||
| S91152A | 24 | 955-965 | S92031B | 08 | 562-563 | S92136P | 08 | 564-566 | ||
| S91152D | 23 | 949-950 | S92031B | 24 | 955-965 | S92136S | 08 | 559-561 | ||
| S91152S | 09 | 604-605 | S92031D | 08 | 559-561 | S92141A | 08 | 562-563 | ||
| S91153A | 09 | 604-605 | S92031G | 08 | 559-561 | S92141A | 24 | 955-965 | ||
| S91153A | 24 | 955-965 | S92031K | 08 | 564-566 | S92141B | 08 | 562-563 | ||
| S91153D | 23 | 949-950 | S92031P | 08 | 564-566 | S92141B | 24 | 955-965 | ||
| S91153S | 09 | 604-605 | S92031S | 08 | 559-561 | S92141D | 08 | 559-561 | ||
| S91154A | 09 | 604-605 | S92032A | 08 | 562-563 | S92141G | 08 | 559-561 | ||
| S91154A | 24 | 955-965 | S92032A | 24 | 955-965 | S92141K | 08 | 564-566 | ||
| S91154D | 23 | 949-950 | S92032B | 08 | 562-563 | S92141P | 08 | 564-566 | ||
| S91154S | 09 | 604-605 | S92032B | 24 | 955-965 | S92141S | 08 | 559-561 | ||
| S91155A | 09 | 604-605 | S92032D | 08 | 559-561 | S92142A | 08 | 562-563 | ||
| S91155A | 24 | 955-965 | S92032G | 08 | 559-561 | S92142A | 24 | 955-965 | ||
| S91155D | 23 | 949-950 | S92032K | 08 | 564-566 | S92142B | 08 | 562-563 | ||
| S91155S | 09 | 604-605 | S92032P | 08 | 564-566 | S92142B | 24 | 955-965 | ||
| S91156A | 09 | 604-605 | S92032S | 08 | 559-561 | S92142D | 08 | 559-561 | ||
| S91156A | 24 | 955-965 | S92033A | 08 | 562-563 | S92142G | 08 | 559-561 | ||
| S91156D | 23 | 949-950 | S92033A | 24 | 955-965 | S92142K | 08 | 564-566 | ||
| S91156S | 09 | 604-605 | S92033B | 08 | 562-563 | S92142P | 08 | 564-566 | ||
| S91159A | 09 | 604-605 | S92033B | 24 | 955-965 | S92142S | 08 | 559-561 | ||
| S91159A | 24 | 955-965 | S92033D | 08 | 559-561 | S92143A | 08 | 562-563 | ||
| S91159D | 23 | 949-950 | S92033G | 08 | 559-561 | S92143A | 24 | 955-965 | ||
| S91159S | 09 | 604-605 | S92033K | 08 | 564-566 | S92143B | 08 | 562-563 | ||
| S91201A | 09 | 604-605 | S92033P | 08 | 564-566 | S92143B | 24 | 955-965 | ||
| S91201A | 24 | 955-965 | S92033S | 08 | 559-561 | S92143D | 08 | 559-561 | ||
| S91201D | 23 | 949-950 | S92034A | 08 | 562-563 | S92143G | 08 | 559-561 | ||
| S91201S | 09 | 604-605 | S92034A | 24 | 955-965 | S92143K | 08 | 564-566 | ||
| S91202A | 09 | 604-605 | S92034B | 08 | 562-563 | S92143P | 08 | 564-566 | ||
| S91202A | 24 | 955-965 | S92034B | 24 | 955-965 | S92143S | 08 | 559-561 | ||
| S91202D | 23 | 949-950 | S92034D | 08 | 559-561 | S92144A | 08 | 562-563 | ||
| S91202S | 09 | 604-605 | S92034G | 08 | 559-561 | S92144A | 24 | 955-965 | ||
| S91203A | 09 | 604-605 | S92034K | 08 | 564-566 | S92144B | 08 | 562-563 | ||
| S91203A | 24 | 955-965 | S92034P | 08 | 564-566 | S92144B | 24 | 955-965 | ||
| S91203D | 23 | 949-950 | S92034S | 08 | 559-561 | S92144D | 08 | 559-561 | ||
| S91203S | 09 | 604-605 | S92035A | 08 | 562-563 | S92144G | 08 | 559-561 | ||
| S91204A | 09 | 604-605 | S92035A | 24 | 955-965 | S92144K | 08 | 564-566 | ||
| S91204A | 24 | 955-965 | S92035B | 08 | 562-563 | S92144P | 08 | 564-566 | ||
| S91204D | 23 | 949-950 | S92035B | 24 | 955-965 | S92144S | 08 | 559-561 | ||
| S91204S | 09 | 604-605 | S92035D | 08 | 559-561 | S92145A | 08 | 562-563 | ||
| S91205A | 09 | 604-605 | S92035G | 08 | 559-561 | S92145A | 24 | 955-965 | ||
| S91205A | 24 | 955-965 | S92035K | 08 | 564-566 | S92145B | 08 | 562-563 | ||
| S91205D | 23 | 949-950 | S92035P | 08 | 564-566 | S92145B | 24 | 955-965 | ||
| S91205S | 09 | 604-605 | S92035S | 08 | 559-561 | S92145D | 08 | 559-561 | ||
| S91206A | 09 | 604-605 | S92036A | 08 | 562-563 | S92145G | 08 | 559-561 | ||
| S91206A | 24 | 955-965 | S92036A | 24 | 955-965 | S92145K | 08 | 564-566 | ||
| S91206D | 23 | 949-950 | S92036B | 08 | 562-563 | S92145P | 08 | 564-566 | ||
| S91206S | 09 | 604-605 | S92036B | 24 | 955-965 | S92145S | 08 | 559-561 | ||
| S91209A | 09 | 604-605 | S92036D | 08 | 559-561 | S92146A | 08 | 562-563 | ||
| S91209A | 24 | 955-965 | S92036G | 08 | 559-561 | S92146A | 24 | 955-965 | ||
| S91209D | 23 | 949-950 | S92036K | 08 | 564-566 | S92146B | 08 | 562-563 | ||
| S91209S | 09 | 604-605 | S92036P | 08 | 564-566 | S92146B | 24 | 955-965 | ||
| S91211A | 09 | 604-605 | S92036S | 08 | 559-561 | S92146D | 08 | 559-561 | ||
| S91211A | 24 | 955-965 | S92041A | 08 | 562-563 | S92146G | 08 | 559-561 | ||
| S91211D | 23 | 949-950 | S92041A | 24 | 955-965 | S92146K | 08 | 564-566 | ||
| S91211S | 09 | 604-605 | S92041B | 08 | 562-563 | S92146P | 08 | 564-566 | ||
| S91212A | 09 | 604-605 | S92041B | 24 | 955-965 | S92146S | 08 | 559-561 | ||
| S91212A | 24 | 955-965 | S92041D | 08 | 559-561 | S92151A | 08 | 562-563 | ||
| S91212D | 23 | 949-950 | S92041G | 08 | 559-561 | S92151A | 24 | 955-965 | ||
| S91212S | 09 | 604-605 | S92041K | 08 | 564-566 | S92151B | 08 | 562-563 | ||
| S91213A | 09 | 604-605 | S92041P | 08 | 564-566 | S92151B | 24 | 955-965 | ||
| S91213A | 24 | 955-965 | S92041S | 08 | 559-561 | S92151D | 08 | 559-561 | ||
| S91213D | 23 | 949-950 | S92042A | 08 | 562-563 | S92151G | 08 | 559-561 | ||
| S91213S | 09 | 604-605 | S92042A | 24 | 955-965 | S92151K | 08 | 564-566 | ||
| S91214A | 09 | 604-605 | S92042B | 08 | 562-563 | S92151P | 08 | 564-566 | ||
| S91214A | 24 | 955-965 | S92042B | 24 | 955-965 | S92151S | 08 | 559-561 | ||
| S91214D | 23 | 949-950 | S92042D | 08 | 559-561 | S92152A | 08 | 562-563 | ||
| S91214S | 09 | 604-605 | S92042G | 08 | 559-561 | S92152A | 24 | 955-965 | ||
| S91215A | 09 | 604-605 | S92042K | 08 | 564-566 | S92152B | 08 | 562-563 | ||
| S91215A | 24 | 955-965 | S92042P | 08 | 564-566 | S92152B | 24 | 955-965 | ||
| S91215D | 23 | 949-950 | S92042S | 08 | 559-561 | S92152D | 08 | 559-561 | ||
| S91215S | 09 | 604-605 | S92043A | 08 | 562-563 | S92152G | 08 | 559-561 | ||
| S91216A | 09 | 604-605 | S92043A | 24 | 955-965 | S92152K | 08 | 564-566 | ||
| S91216A | 24 | 955-965 | S92043B | 08 | 562-563 | S92152P | 08 | 564-566 | ||
| S91216D | 23 | 949-950 | S92043B | 24 | 955-965 | S92152S | 08 | 559-561 | ||
| S91216S | 09 | 604-605 | S92043D | 08 | 559-561 | S92153A | 08 | 562-563 | ||
| S91219A | 09 | 604-605 | S92043G | 08 | 559-561 | S92153A | 24 | 955-965 | ||
| S91219A | 24 | 955-965 | S92043K | 08 | 564-566 | S92153B | 08 | 562-563 | ||
| S91219D | 23 | 949-950 | S92043P | 08 | 564-566 | S92153B | 24 | 955-965 | ||
| S91219S | 09 | 604-605 | S92043S | 08 | 559-561 | S92153D | 08 | 559-561 | ||
| S91221A | 21 | 913-914 | S92044A | 08 | 562-563 | S92153G | 08 | 559-561 | ||
| S91221A | 24 | 955-965 | S92044A | 24 | 955-965 | S92153K | 08 | 564-566 | ||
| S91221D | 23 | 949-950 | S92044B | 08 | 562-563 | S92153P | 08 | 564-566 | ||
| S91221S | 09 | 604-605 | S92044B | 24 | 955-965 | S92153S | 08 | 559-561 | ||
| S91222A | 21 | 913-914 | S92044D | 08 | 559-561 | S92154A | 08 | 562-563 | ||
| S91222A | 24 | 955-965 | S92044G | 08 | 559-561 | S92154A | 24 | 955-965 | ||
| S91222D | 23 | 949-950 | S92044K | 08 | 564-566 | S92154B | 08 | 562-563 | ||
| S91222S | 09 | 604-605 | S92044P | 08 | 564-566 | S92154B | 24 | 955-965 | ||
| S91223A | 21 | 913-914 | S92044S | 08 | 559-561 | S92154D | 08 | 559-561 | ||
| S91223A | 24 | 955-965 | S92045A | 08 | 562-563 | S92154G | 08 | 559-561 | ||
| S91223D | 23 | 949-950 | S92045A | 24 | 955-965 | S92154K | 08 | 564-566 | ||
| S91223S | 09 | 604-605 | S92045B | 08 | 562-563 | S92154P | 08 | 564-566 | ||
| S91224A | 21 | 913-914 | S92045B | 24 | 955-965 | S92154S | 08 | 559-561 | ||
| S91224A | 24 | 955-965 | S92045D | 08 | 559-561 | S92155A | 08 | 562-563 | ||
| S91224D | 23 | 949-950 | S92045G | 08 | 559-561 | S92155A | 24 | 955-965 | ||
| S91224S | 09 | 604-605 | S92045K | 08 | 564-566 | S92155B | 08 | 562-563 | ||
| S91225A | 21 | 913-914 | S92045P | 08 | 564-566 | S92155B | 24 | 955-965 | ||
| S91225A | 24 | 955-965 | S92045S | 08 | 559-561 | S92155D | 08 | 559-561 | ||
| S91225D | 23 | 949-950 | S92046A | 08 | 562-563 | S92155G | 08 | 559-561 | ||
| S91225S | 09 | 604-605 | S92046A | 24 | 955-965 | S92155K | 08 | 564-566 | ||
| S91226A | 21 | 913-914 | S92046B | 08 | 562-563 | S92155P | 08 | 564-566 | ||
| S91226A | 24 | 955-965 | S92046B | 24 | 955-965 | S92155S | 08 | 559-561 | ||
| S91226D | 23 | 949-950 | S92046D | 08 | 559-561 | S92156A | 08 | 562-563 | ||
| S91226S | 09 | 604-605 | S92046G | 08 | 559-561 | S92156A | 24 | 955-965 | ||
| S91229A | 21 | 913-914 | S92046K | 08 | 564-566 | S92156B | 08 | 562-563 | ||
| S91229A | 24 | 955-965 | S92046P | 08 | 564-566 | S92156B | 24 | 955-965 | ||
| S91229D | 23 | 949-950 | S92046S | 08 | 559-561 | S92156D | 08 | 559-561 | ||
| S91229S | 09 | 604-605 | S92051A | 08 | 562-563 | S92156G | 08 | 559-561 | ||
| S91231A | 09 | 604-605 | S92051A | 24 | 955-965 | S92156K | 08 | 564-566 | ||
| S91231A | 24 | 955-965 | S92051B | 08 | 562-563 | S92156P | 08 | 564-566 | ||
| S91231D | 23 | 949-950 | S92051B | 24 | 955-965 | S92156S | 08 | 559-561 | ||
| S91231S | 09 | 604-605 | S92051D | 08 | 559-561 | S92191A | 08 | 562-563 | ||
| S91232A | 09 | 604-605 | S92051G | 08 | 559-561 | S92191A | 24 | 955-965 | ||
| S91232A | 24 | 955-965 | S92051K | 08 | 564-566 | S92191B | 08 | 562-563 | ||
| S91232D | 23 | 949-950 | S92051P | 08 | 564-566 | S92191B | 24 | 955-965 | ||
| S91232S | 09 | 604-605 | S92051S | 08 | 559-561 | S92191D | 08 | 559-561 | ||
| S91233A | 09 | 604-605 | S92052A | 08 | 562-563 | S92191G | 08 | 559-561 | ||
| S91233A | 24 | 955-965 | S92052A | 24 | 955-965 | S92191K | 08 | 564-566 | ||
| S91233D | 23 | 949-950 | S92052B | 08 | 562-563 | S92191P | 08 | 564-566 | ||
| S91233S | 09 | 604-605 | S92052B | 24 | 955-965 | S92191S | 08 | 559-561 | ||
| S91234A | 09 | 604-605 | S92052D | 08 | 559-561 | S92192A | 08 | 562-563 | ||
| S91234A | 24 | 955-965 | S92052G | 08 | 559-561 | S92192A | 24 | 955-965 | ||
| S91234D | 23 | 949-950 | S92052K | 08 | 564-566 | S92192B | 08 | 562-563 | ||
| S91234S | 09 | 604-605 | S92052P | 08 | 564-566 | S92192B | 24 | 955-965 | ||
| S91235A | 09 | 604-605 | S92052S | 08 | 559-561 | S92192D | 08 | 559-561 | ||
| S91235A | 24 | 955-965 | S92053A | 08 | 562-563 | S92192G | 08 | 559-561 | ||
| S91235D | 23 | 949-950 | S92053A | 24 | 955-965 | S92192K | 08 | 564-566 | ||
| S91235S | 09 | 604-605 | S92053B | 08 | 562-563 | S92192P | 08 | 564-566 | ||
| S91236A | 09 | 604-605 | S92053B | 24 | 955-965 | S92192S | 08 | 559-561 | ||
| S91236A | 24 | 955-965 | S92053D | 08 | 559-561 | S92199A | 08 | 562-563 | ||
| S91236D | 23 | 949-950 | S92053G | 08 | 559-561 | S92199A | 24 | 955-965 | ||
| S91236S | 09 | 604-605 | S92053K | 08 | 564-566 | S92199B | 08 | 562-563 | ||
| S91239A | 09 | 604-605 | S92053P | 08 | 564-566 | S92199B | 24 | 955-965 | ||
| S91239A | 24 | 955-965 | S92053S | 08 | 559-561 | S92199D | 08 | 559-561 | ||
| S91239D | 23 | 949-950 | S92054A | 08 | 562-563 | S92199G | 08 | 559-561 | ||
| S91239S | 09 | 604-605 | S92054A | 24 | 955-965 | S92199K | 08 | 564-566 | ||
| S91241A | 21 | 913-914 | S92054B | 08 | 562-563 | S92199P | 08 | 564-566 | ||
| S91241A | 24 | 955-965 | S92054B | 24 | 955-965 | S92199S | 08 | 559-561 | ||
| S91241D | 23 | 949-950 | S92054D | 08 | 559-561 | S92201A | 08 | 562-563 | ||
| S91241S | 09 | 604-605 | S92054G | 08 | 559-561 | S92201A | 24 | 955-965 | ||
| S91242A | 21 | 913-914 | S92054K | 08 | 564-566 | S92201B | 08 | 562-563 | ||
| S91242A | 24 | 955-965 | S92054P | 08 | 564-566 | S92201B | 24 | 955-965 | ||
| S91242D | 23 | 949-950 | S92054S | 08 | 559-561 | S92201D | 08 | 559-561 | ||
| S91242S | 09 | 604-605 | S92055A | 08 | 562-563 | S92201G | 08 | 559-561 | ||
| S91243A | 21 | 913-914 | S92055A | 24 | 955-965 | S92201K | 08 | 564-566 | ||
| S91243A | 24 | 955-965 | S92055B | 08 | 562-563 | S92201P | 08 | 564-566 | ||
| S91243D | 23 | 949-950 | S92055B | 24 | 955-965 | S92201S | 08 | 559-561 | ||
| S91243S | 09 | 604-605 | S92055D | 08 | 559-561 | S92202A | 08 | 562-563 | ||
| S91244A | 21 | 913-914 | S92055G | 08 | 559-561 | S92202A | 24 | 955-965 | ||
| S91244A | 24 | 955-965 | S92055K | 08 | 564-566 | S92202B | 08 | 562-563 | ||
| S91244D | 23 | 949-950 | S92055P | 08 | 564-566 | S92202B | 24 | 955-965 | ||
| S91244S | 09 | 604-605 | S92055S | 08 | 559-561 | S92202D | 08 | 559-561 | ||
| S91245A | 21 | 913-914 | S92056A | 08 | 562-563 | S92202G | 08 | 559-561 | ||
| S91245A | 24 | 955-965 | S92056A | 24 | 955-965 | S92202K | 08 | 564-566 | ||
| S91245D | 23 | 949-950 | S92056B | 08 | 562-563 | S92202P | 08 | 564-566 | ||
| S91245S | 09 | 604-605 | S92056B | 24 | 955-965 | S92202S | 08 | 559-561 | ||
| S91246A | 21 | 913-914 | S92056D | 08 | 559-561 | S92209A | 08 | 562-563 | ||
| S91246A | 24 | 955-965 | S92056G | 08 | 559-561 | S92209A | 24 | 955-965 | ||
| S91246D | 23 | 949-950 | S92056K | 08 | 564-566 | S92209B | 08 | 562-563 | ||
| S91246S | 09 | 604-605 | S92056P | 08 | 564-566 | S92209B | 24 | 955-965 | ||
| S91249A | 21 | 913-914 | S92056S | 08 | 559-561 | S92209D | 08 | 559-561 | ||
| S91249A | 24 | 955-965 | S92061A | 08 | 562-563 | S92209G | 08 | 559-561 | ||
| S92061A | 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 |