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| Skip to content | ICD-10-CM/PCS MS-DRGv33 Definitions Manual | ![Previous Page [Alt-p]](bakpg.png){kind=small} |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 27 of 67 |
| A B C D E F G H I J K L M N O P Q R S T X Z |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S065X0D | 23 | 949-950 | S09399A | 24 | 955-965 | S12041K | 08 | 564-566 | ||
| S065X0S | 01 | 091-093 | S09399D | 23 | 949-950 | S12041S | 08 | 551-552 | ||
| S065X1A | 01 | 082-084 | S09399S | 21 | 913-914 | S12090A | 08 | 551-552 | ||
| S065X1A | 01 | 085-087 | S098XXA | Pre | 011-013 | S12090A | 24 | 955-965 | ||
| S065X1A | 24 | 955-965 | S098XXA | 21 | 913-914 | S12090B | 08 | 551-552 | ||
| S065X1D | 23 | 949-950 | S098XXA | 24 | 955-965 | S12090B | 24 | 955-965 | ||
| S065X1S | 01 | 091-093 | S098XXD | 23 | 949-950 | S12090D | 08 | 559-561 | ||
| S065X2A | 01 | 082-084 | S098XXS | 21 | 913-914 | S12090G | 08 | 559-561 | ||
| S065X2A | 01 | 085-087 | S0990XA | Pre | 011-013 | S12090K | 08 | 564-566 | ||
| S065X2A | 24 | 955-965 | S0990XA | 21 | 913-914 | S12090S | 08 | 551-552 | ||
| S065X2D | 23 | 949-950 | S0990XA | 24 | 955-965 | S12091A | 08 | 551-552 | ||
| S065X2S | 01 | 091-093 | S0990XD | 23 | 949-950 | S12091A | 24 | 955-965 | ||
| S065X3A | 01 | 082-084 | S0990XS | 21 | 913-914 | S12091B | 08 | 551-552 | ||
| S065X3A | 24 | 955-965 | S0991XA | 03 | 154-156 | S12091B | 24 | 955-965 | ||
| S065X3D | 23 | 949-950 | S0991XA | 24 | 955-965 | S12091D | 08 | 559-561 | ||
| S065X3S | 01 | 091-093 | S0991XD | 23 | 949-950 | S12091G | 08 | 559-561 | ||
| S065X4A | 01 | 082-084 | S0991XS | 21 | 913-914 | S12091K | 08 | 564-566 | ||
| S065X4A | 24 | 955-965 | S0992XA | Pre | 011-013 | S12091S | 08 | 551-552 | ||
| S065X4D | 23 | 949-950 | S0992XA | 21 | 913-914 | S12100A | 08 | 551-552 | ||
| S065X4S | 01 | 091-093 | S0992XA | 24 | 955-965 | S12100A | 24 | 955-965 | ||
| S065X5A | 01 | 082-084 | S0992XD | 23 | 949-950 | S12100B | 08 | 551-552 | ||
| S065X5A | 24 | 955-965 | S0992XS | 21 | 913-914 | S12100B | 24 | 955-965 | ||
| S065X5D | 23 | 949-950 | S0993XA | Pre | 011-013 | S12100D | 08 | 559-561 | ||
| S065X5S | 01 | 091-093 | S0993XA | 21 | 913-914 | S12100G | 08 | 559-561 | ||
| S065X6A | 01 | 082-084 | S0993XA | 24 | 955-965 | S12100K | 08 | 564-566 | ||
| S065X6A | 24 | 955-965 | S0993XD | 23 | 949-950 | S12100S | 08 | 551-552 | ||
| S065X6D | 23 | 949-950 | S0993XS | 21 | 913-914 | S12101A | 08 | 551-552 | ||
| S065X6S | 01 | 091-093 | S100XXA | 09 | 604-605 | S12101A | 24 | 955-965 | ||
| S065X7A | 01 | 082-084 | S100XXA | 24 | 955-965 | S12101B | 08 | 551-552 | ||
| S065X7A | 24 | 955-965 | S100XXD | 23 | 949-950 | S12101B | 24 | 955-965 | ||
| S065X7D | 23 | 949-950 | S100XXS | 09 | 604-605 | S12101D | 08 | 559-561 | ||
| S065X7S | 01 | 091-093 | S1010XA | 09 | 604-605 | S12101G | 08 | 559-561 | ||
| S065X8A | 01 | 082-084 | S1010XA | 24 | 955-965 | S12101K | 08 | 564-566 | ||
| S065X8A | 24 | 955-965 | S1010XD | 23 | 949-950 | S12101S | 08 | 551-552 | ||
| S065X8D | 23 | 949-950 | S1010XS | 09 | 604-605 | S12110A | 08 | 551-552 | ||
| S065X8S | 01 | 091-093 | S1011XA | 09 | 604-605 | S12110A | 24 | 955-965 | ||
| S065X9A | 01 | 082-084 | S1011XA | 24 | 955-965 | S12110B | 08 | 551-552 | ||
| S065X9A | 24 | 955-965 | S1011XD | 23 | 949-950 | S12110B | 24 | 955-965 | ||
| S065X9D | 23 | 949-950 | S1011XS | 09 | 604-605 | S12110D | 08 | 559-561 | ||
| S065X9S | 01 | 091-093 | S1012XA | 09 | 606-607 | S12110G | 08 | 559-561 | ||
| S066X0A | 01 | 023-027 | S1012XA | 24 | 955-965 | S12110K | 08 | 564-566 | ||
| S066X0A | 01 | 082-084 | S1012XD | 23 | 949-950 | S12110S | 08 | 551-552 | ||
| S066X0A | 01 | 085-087 | S1012XS | 09 | 604-605 | S12111A | 08 | 551-552 | ||
| S066X0A | 24 | 955-965 | S1014XA | 09 | 604-605 | S12111A | 24 | 955-965 | ||
| S066X0D | 23 | 949-950 | S1014XA | 24 | 955-965 | S12111B | 08 | 551-552 | ||
| S066X0S | 01 | 091-093 | S1014XD | 23 | 949-950 | S12111B | 24 | 955-965 | ||
| S066X1A | 01 | 023-027 | S1014XS | 09 | 604-605 | S12111D | 08 | 559-561 | ||
| S066X1A | 01 | 082-084 | S1015XA | 09 | 604-605 | S12111G | 08 | 559-561 | ||
| S066X1A | 01 | 085-087 | S1015XA | 24 | 955-965 | S12111K | 08 | 564-566 | ||
| S066X1A | 24 | 955-965 | S1015XD | 23 | 949-950 | S12111S | 08 | 551-552 | ||
| S066X1D | 23 | 949-950 | S1015XS | 09 | 604-605 | S12112A | 08 | 551-552 | ||
| S066X1S | 01 | 091-093 | S1016XA | 09 | 606-607 | S12112A | 24 | 955-965 | ||
| S066X2A | 01 | 023-027 | S1016XA | 24 | 955-965 | S12112B | 08 | 551-552 | ||
| S066X2A | 01 | 082-084 | S1016XD | 23 | 949-950 | S12112B | 24 | 955-965 | ||
| S066X2A | 01 | 085-087 | S1016XS | 09 | 604-605 | S12112D | 08 | 559-561 | ||
| S066X2A | 24 | 955-965 | S1017XA | 09 | 604-605 | S12112G | 08 | 559-561 | ||
| S066X2D | 23 | 949-950 | S1017XA | 24 | 955-965 | S12112K | 08 | 564-566 | ||
| S066X2S | 01 | 091-093 | S1017XD | 23 | 949-950 | S12112S | 08 | 551-552 | ||
| S066X3A | 01 | 023-027 | S1017XS | 09 | 604-605 | S12120A | 08 | 551-552 | ||
| S066X3A | 01 | 082-084 | S1080XA | 09 | 604-605 | S12120A | 24 | 955-965 | ||
| S066X3A | 24 | 955-965 | S1080XA | 24 | 955-965 | S12120B | 08 | 551-552 | ||
| S066X3D | 23 | 949-950 | S1080XD | 23 | 949-950 | S12120B | 24 | 955-965 | ||
| S066X3S | 01 | 091-093 | S1080XS | 09 | 604-605 | S12120D | 08 | 559-561 | ||
| S066X4A | 01 | 023-027 | S1081XA | 09 | 604-605 | S12120G | 08 | 559-561 | ||
| S066X4A | 01 | 082-084 | S1081XA | 24 | 955-965 | S12120K | 08 | 564-566 | ||
| S066X4A | 24 | 955-965 | S1081XD | 23 | 949-950 | S12120S | 08 | 551-552 | ||
| S066X4D | 23 | 949-950 | S1081XS | 09 | 604-605 | S12121A | 08 | 551-552 | ||
| S066X4S | 01 | 091-093 | S1082XA | 09 | 606-607 | S12121A | 24 | 955-965 | ||
| S066X5A | 01 | 023-027 | S1082XA | 24 | 955-965 | S12121B | 08 | 551-552 | ||
| S066X5A | 01 | 082-084 | S1082XD | 23 | 949-950 | S12121B | 24 | 955-965 | ||
| S066X5A | 24 | 955-965 | S1082XS | 09 | 604-605 | S12121D | 08 | 559-561 | ||
| S066X5D | 23 | 949-950 | S1083XA | 09 | 604-605 | S12121G | 08 | 559-561 | ||
| S066X5S | 01 | 091-093 | S1083XA | 24 | 955-965 | S12121K | 08 | 564-566 | ||
| S066X6A | 01 | 023-027 | S1083XD | 23 | 949-950 | S12121S | 08 | 551-552 | ||
| S066X6A | 01 | 082-084 | S1083XS | 09 | 604-605 | S12130A | 08 | 551-552 | ||
| S066X6A | 24 | 955-965 | S1084XA | 09 | 604-605 | S12130A | 24 | 955-965 | ||
| S066X6D | 23 | 949-950 | S1084XA | 24 | 955-965 | S12130B | 08 | 551-552 | ||
| S066X6S | 01 | 091-093 | S1084XD | 23 | 949-950 | S12130B | 24 | 955-965 | ||
| S066X7A | 01 | 023-027 | S1084XS | 09 | 604-605 | S12130D | 08 | 559-561 | ||
| S066X7A | 01 | 082-084 | S1085XA | 09 | 604-605 | S12130G | 08 | 559-561 | ||
| S066X7A | 24 | 955-965 | S1085XA | 24 | 955-965 | S12130K | 08 | 564-566 | ||
| S066X7D | 23 | 949-950 | S1085XD | 23 | 949-950 | S12130S | 08 | 551-552 | ||
| S066X7S | 01 | 091-093 | S1085XS | 09 | 604-605 | S12131A | 08 | 551-552 | ||
| S066X8A | 01 | 023-027 | S1086XA | 09 | 606-607 | S12131A | 24 | 955-965 | ||
| S066X8A | 01 | 082-084 | S1086XA | 24 | 955-965 | S12131B | 08 | 551-552 | ||
| S066X8A | 24 | 955-965 | S1086XD | 23 | 949-950 | S12131B | 24 | 955-965 | ||
| S066X8D | 23 | 949-950 | S1086XS | 09 | 604-605 | S12131D | 08 | 559-561 | ||
| S066X8S | 01 | 091-093 | S1087XA | 09 | 604-605 | S12131G | 08 | 559-561 | ||
| S066X9A | 01 | 023-027 | S1087XA | 24 | 955-965 | S12131K | 08 | 564-566 | ||
| S066X9A | 01 | 082-084 | S1087XD | 23 | 949-950 | S12131S | 08 | 551-552 | ||
| S066X9A | 24 | 955-965 | S1087XS | 09 | 604-605 | S1214XA | 08 | 551-552 | ||
| S066X9D | 23 | 949-950 | S1090XA | 09 | 604-605 | S1214XA | 24 | 955-965 | ||
| S066X9S | 01 | 091-093 | S1090XA | 24 | 955-965 | S1214XB | 08 | 551-552 | ||
| S06810A | 01 | 082-084 | S1090XD | 23 | 949-950 | S1214XB | 24 | 955-965 | ||
| S06810A | 01 | 085-087 | S1090XS | 09 | 604-605 | S1214XD | 08 | 559-561 | ||
| S06810A | 24 | 955-965 | S1091XA | 09 | 604-605 | S1214XG | 08 | 559-561 | ||
| S06810D | 23 | 949-950 | S1091XA | 24 | 955-965 | S1214XK | 08 | 564-566 | ||
| S06810S | 01 | 091-093 | S1091XD | 23 | 949-950 | S1214XS | 08 | 551-552 | ||
| S06811A | 01 | 082-084 | S1091XS | 09 | 604-605 | S12150A | 08 | 551-552 | ||
| S06811A | 01 | 085-087 | S1092XA | 09 | 606-607 | S12150A | 24 | 955-965 | ||
| S06811A | 24 | 955-965 | S1092XA | 24 | 955-965 | S12150B | 08 | 551-552 | ||
| S06811D | 23 | 949-950 | S1092XD | 23 | 949-950 | S12150B | 24 | 955-965 | ||
| S06811S | 01 | 091-093 | S1092XS | 09 | 604-605 | S12150D | 08 | 559-561 | ||
| S06812A | 01 | 082-084 | S1093XA | 09 | 604-605 | S12150G | 08 | 559-561 | ||
| S06812A | 01 | 085-087 | S1093XA | 24 | 955-965 | S12150K | 08 | 564-566 | ||
| S06812A | 24 | 955-965 | S1093XD | 23 | 949-950 | S12150S | 08 | 551-552 | ||
| S06812D | 23 | 949-950 | S1093XS | 09 | 604-605 | S12151A | 08 | 551-552 | ||
| S06812S | 01 | 091-093 | S1094XA | 09 | 604-605 | S12151A | 24 | 955-965 | ||
| S06813A | 01 | 082-084 | S1094XA | 24 | 955-965 | S12151B | 08 | 551-552 | ||
| S06813A | 24 | 955-965 | S1094XD | 23 | 949-950 | S12151B | 24 | 955-965 | ||
| S06813D | 23 | 949-950 | S1094XS | 09 | 604-605 | S12151D | 08 | 559-561 | ||
| S06813S | 01 | 091-093 | S1095XA | 09 | 604-605 | S12151G | 08 | 559-561 | ||
| S06814A | 01 | 082-084 | S1095XA | 24 | 955-965 | S12151K | 08 | 564-566 | ||
| S06814A | 24 | 955-965 | S1095XD | 23 | 949-950 | S12151S | 08 | 551-552 | ||
| S06814D | 23 | 949-950 | S1095XS | 09 | 604-605 | S12190A | 08 | 551-552 | ||
| S06814S | 01 | 091-093 | S1096XA | 09 | 606-607 | S12190A | 24 | 955-965 | ||
| S06815A | 01 | 082-084 | S1096XA | 24 | 955-965 | S12190B | 08 | 551-552 | ||
| S06815A | 24 | 955-965 | S1096XD | 23 | 949-950 | S12190B | 24 | 955-965 | ||
| S06815D | 23 | 949-950 | S1096XS | 09 | 604-605 | S12190D | 08 | 559-561 | ||
| S06815S | 01 | 091-093 | S1097XA | 09 | 604-605 | S12190G | 08 | 559-561 | ||
| S06816A | 01 | 082-084 | S1097XA | 24 | 955-965 | S12190K | 08 | 564-566 | ||
| S06816A | 24 | 955-965 | S1097XD | 23 | 949-950 | S12190S | 08 | 551-552 | ||
| S06816D | 23 | 949-950 | S1097XS | 09 | 604-605 | S12191A | 08 | 551-552 | ||
| S06816S | 01 | 091-093 | S11011A | Pre | 011-013 | S12191A | 24 | 955-965 | ||
| S06817A | 01 | 082-084 | S11011A | 03 | 154-156 | S12191B | 08 | 551-552 | ||
| S06817A | 24 | 955-965 | S11011A | 24 | 955-965 | S12191B | 24 | 955-965 | ||
| S06817D | 23 | 949-950 | S11011D | 23 | 949-950 | S12191D | 08 | 559-561 | ||
| S06817S | 01 | 091-093 | S11011S | 09 | 604-605 | S12191G | 08 | 559-561 | ||
| S06818A | 01 | 082-084 | S11012A | Pre | 011-013 | S12191K | 08 | 564-566 | ||
| S06818A | 24 | 955-965 | S11012A | 03 | 154-156 | S12191S | 08 | 551-552 | ||
| S06818D | 23 | 949-950 | S11012A | 24 | 955-965 | S12200A | 08 | 551-552 | ||
| S06818S | 01 | 091-093 | S11012D | 23 | 949-950 | S12200A | 24 | 955-965 | ||
| S06819A | 01 | 082-084 | S11012S | 09 | 604-605 | S12200B | 08 | 551-552 | ||
| S06819A | 24 | 955-965 | S11013A | Pre | 011-013 | S12200B | 24 | 955-965 | ||
| S06819D | 23 | 949-950 | S11013A | 03 | 154-156 | S12200D | 08 | 559-561 | ||
| S06819S | 01 | 091-093 | S11013A | 24 | 955-965 | S12200G | 08 | 559-561 | ||
| S06820A | 01 | 082-084 | S11013D | 23 | 949-950 | S12200K | 08 | 564-566 | ||
| S06820A | 01 | 085-087 | S11013S | 09 | 604-605 | S12200S | 08 | 551-552 | ||
| S06820A | 24 | 955-965 | S11014A | Pre | 011-013 | S12201A | 08 | 551-552 | ||
| S06820D | 23 | 949-950 | S11014A | 03 | 154-156 | S12201A | 24 | 955-965 | ||
| S06820S | 01 | 091-093 | S11014A | 24 | 955-965 | S12201B | 08 | 551-552 | ||
| S06821A | 01 | 082-084 | S11014D | 23 | 949-950 | S12201B | 24 | 955-965 | ||
| S06821A | 01 | 085-087 | S11014S | 09 | 604-605 | S12201D | 08 | 559-561 | ||
| S06821A | 24 | 955-965 | S11015A | Pre | 011-013 | S12201G | 08 | 559-561 | ||
| S06821D | 23 | 949-950 | S11015A | 03 | 154-156 | S12201K | 08 | 564-566 | ||
| S06821S | 01 | 091-093 | S11015A | 24 | 955-965 | S12201S | 08 | 551-552 | ||
| S06822A | 01 | 082-084 | S11015D | 23 | 949-950 | S12230A | 08 | 551-552 | ||
| S06822A | 01 | 085-087 | S11015S | 09 | 604-605 | S12230A | 24 | 955-965 | ||
| S06822A | 24 | 955-965 | S11019A | Pre | 011-013 | S12230B | 08 | 551-552 | ||
| S06822D | 23 | 949-950 | S11019A | 03 | 154-156 | S12230B | 24 | 955-965 | ||
| S06822S | 01 | 091-093 | S11019A | 24 | 955-965 | S12230D | 08 | 559-561 | ||
| S06823A | 01 | 082-084 | S11019D | 23 | 949-950 | S12230G | 08 | 559-561 | ||
| S06823A | 24 | 955-965 | S11019S | 09 | 604-605 | S12230K | 08 | 564-566 | ||
| S06823D | 23 | 949-950 | S11021A | Pre | 011-013 | S12230S | 08 | 551-552 | ||
| S06823S | 01 | 091-093 | S11021A | 04 | 183-185 | S12231A | 08 | 551-552 | ||
| S06824A | 01 | 082-084 | S11021A | 24 | 955-965 | S12231A | 24 | 955-965 | ||
| S06824A | 24 | 955-965 | S11021D | 23 | 949-950 | S12231B | 08 | 551-552 | ||
| S06824D | 23 | 949-950 | S11021S | 09 | 604-605 | S12231B | 24 | 955-965 | ||
| S06824S | 01 | 091-093 | S11022A | Pre | 011-013 | S12231D | 08 | 559-561 | ||
| S06825A | 01 | 082-084 | S11022A | 04 | 183-185 | S12231G | 08 | 559-561 | ||
| S06825A | 24 | 955-965 | S11022A | 24 | 955-965 | S12231K | 08 | 564-566 | ||
| S06825D | 23 | 949-950 | S11022D | 23 | 949-950 | S12231S | 08 | 551-552 | ||
| S06825S | 01 | 091-093 | S11022S | 09 | 604-605 | S1224XA | 08 | 551-552 | ||
| S06826A | 01 | 082-084 | S11023A | Pre | 011-013 | S1224XA | 24 | 955-965 | ||
| S06826A | 24 | 955-965 | S11023A | 04 | 183-185 | S1224XB | 08 | 551-552 | ||
| S06826D | 23 | 949-950 | S11023A | 24 | 955-965 | S1224XB | 24 | 955-965 | ||
| S06826S | 01 | 091-093 | S11023D | 23 | 949-950 | S1224XD | 08 | 559-561 | ||
| S06827A | 01 | 082-084 | S11023S | 09 | 604-605 | S1224XG | 08 | 559-561 | ||
| S06827A | 24 | 955-965 | S11024A | Pre | 011-013 | S1224XK | 08 | 564-566 | ||
| S06827D | 23 | 949-950 | S11024A | 04 | 183-185 | S1224XS | 08 | 551-552 | ||
| S06827S | 01 | 091-093 | S11024A | 24 | 955-965 | S12250A | 08 | 551-552 | ||
| S06828A | 01 | 082-084 | S11024D | 23 | 949-950 | S12250A | 24 | 955-965 | ||
| S06828A | 24 | 955-965 | S11024S | 09 | 604-605 | S12250B | 08 | 551-552 | ||
| S06828D | 23 | 949-950 | S11025A | Pre | 011-013 | S12250B | 24 | 955-965 | ||
| S06828S | 01 | 091-093 | S11025A | 04 | 183-185 | S12250D | 08 | 559-561 | ||
| S06829A | 01 | 082-084 | S11025A | 24 | 955-965 | S12250G | 08 | 559-561 | ||
| S06829A | 24 | 955-965 | S11025D | 23 | 949-950 | S12250K | 08 | 564-566 | ||
| S06829D | 23 | 949-950 | S11025S | 09 | 604-605 | S12250S | 08 | 551-552 | ||
| S06829S | 01 | 091-093 | S11029A | Pre | 011-013 | S12251A | 08 | 551-552 | ||
| S06890A | 01 | 082-084 | S11029A | 04 | 183-185 | S12251A | 24 | 955-965 | ||
| S06890A | 01 | 085-087 | S11029A | 24 | 955-965 | S12251B | 08 | 551-552 | ||
| S06890A | 24 | 955-965 | S11029D | 23 | 949-950 | S12251B | 24 | 955-965 | ||
| S06890D | 23 | 949-950 | S11029S | 09 | 604-605 | S12251D | 08 | 559-561 | ||
| S06890S | 01 | 091-093 | S11031A | Pre | 011-013 | S12251G | 08 | 559-561 | ||
| S06891A | 01 | 082-084 | S11031A | 03 | 154-156 | S12251K | 08 | 564-566 | ||
| S06891A | 01 | 085-087 | S11031A | 24 | 955-965 | S12251S | 08 | 551-552 | ||
| S06891A | 24 | 955-965 | S11031D | 23 | 949-950 | S12290A | 08 | 551-552 | ||
| S06891D | 23 | 949-950 | S11031S | 09 | 604-605 | S12290A | 24 | 955-965 | ||
| S06891S | 01 | 091-093 | S11032A | Pre | 011-013 | S12290B | 08 | 551-552 | ||
| S06892A | 01 | 082-084 | S11032A | 03 | 154-156 | S12290B | 24 | 955-965 | ||
| S06892A | 01 | 085-087 | S11032A | 24 | 955-965 | S12290D | 08 | 559-561 | ||
| S06892A | 24 | 955-965 | S11032D | 23 | 949-950 | S12290G | 08 | 559-561 | ||
| S06892D | 23 | 949-950 | S11032S | 09 | 604-605 | S12290K | 08 | 564-566 | ||
| S06892S | 01 | 091-093 | S11033A | Pre | 011-013 | S12290S | 08 | 551-552 | ||
| S06893A | 01 | 082-084 | S11033A | 03 | 154-156 | S12291A | 08 | 551-552 | ||
| S06893A | 24 | 955-965 | S11033A | 24 | 955-965 | S12291A | 24 | 955-965 | ||
| S06893D | 23 | 949-950 | S11033D | 23 | 949-950 | S12291B | 08 | 551-552 | ||
| S06893S | 01 | 091-093 | S11033S | 09 | 604-605 | S12291B | 24 | 955-965 | ||
| S06894A | 01 | 082-084 | S11034A | Pre | 011-013 | S12291D | 08 | 559-561 | ||
| S06894A | 24 | 955-965 | S11034A | 03 | 154-156 | S12291G | 08 | 559-561 | ||
| S06894D | 23 | 949-950 | S11034A | 24 | 955-965 | S12291K | 08 | 564-566 | ||
| S06894S | 01 | 091-093 | S11034D | 23 | 949-950 | S12291S | 08 | 551-552 | ||
| S06895A | 01 | 082-084 | S11034S | 09 | 604-605 | S12300A | 08 | 551-552 | ||
| S06895A | 24 | 955-965 | S11035A | Pre | 011-013 | S12300A | 24 | 955-965 | ||
| S06895D | 23 | 949-950 | S11035A | 03 | 154-156 | S12300B | 08 | 551-552 | ||
| S06895S | 01 | 091-093 | S11035A | 24 | 955-965 | S12300B | 24 | 955-965 | ||
| S06896A | 01 | 082-084 | S11035D | 23 | 949-950 | S12300D | 08 | 559-561 | ||
| S06896A | 24 | 955-965 | S11035S | 09 | 604-605 | S12300G | 08 | 559-561 | ||
| S06896D | 23 | 949-950 | S11039A | Pre | 011-013 | S12300K | 08 | 564-566 | ||
| S06896S | 01 | 091-093 | S11039A | 03 | 154-156 | S12300S | 08 | 551-552 | ||
| S06897A | 01 | 082-084 | S11039A | 24 | 955-965 | S12301A | 08 | 551-552 | ||
| S06897A | 24 | 955-965 | S11039D | 23 | 949-950 | S12301A | 24 | 955-965 | ||
| S06897D | 23 | 949-950 | S11039S | 09 | 604-605 | S12301B | 08 | 551-552 | ||
| S06897S | 01 | 091-093 | S1110XA | Pre | 011-013 | S12301B | 24 | 955-965 | ||
| S06898A | 01 | 082-084 | S1110XA | 10 | 643-645 | S12301D | 08 | 559-561 | ||
| S06898A | 24 | 955-965 | S1110XA | 24 | 955-965 | S12301G | 08 | 559-561 | ||
| S06898D | 23 | 949-950 | S1110XD | 23 | 949-950 | S12301K | 08 | 564-566 | ||
| S06898S | 01 | 091-093 | S1110XS | 09 | 604-605 | S12301S | 08 | 551-552 | ||
| S06899A | 01 | 082-084 | S1111XA | Pre | 011-013 | S12330A | 08 | 551-552 | ||
| S06899A | 24 | 955-965 | S1111XA | 10 | 643-645 | S12330A | 24 | 955-965 | ||
| S06899D | 23 | 949-950 | S1111XA | 24 | 955-965 | S12330B | 08 | 551-552 | ||
| S06899S | 01 | 091-093 | S1111XD | 23 | 949-950 | S12330B | 24 | 955-965 | ||
| S069X0A | 01 | 082-084 | S1111XS | 09 | 604-605 | S12330D | 08 | 559-561 | ||
| S069X0A | 01 | 085-087 | S1112XA | Pre | 011-013 | S12330G | 08 | 559-561 | ||
| S069X0A | 24 | 955-965 | S1112XA | 10 | 643-645 | S12330K | 08 | 564-566 | ||
| S069X0D | 23 | 949-950 | S1112XA | 24 | 955-965 | S12330S | 08 | 551-552 | ||
| S069X0S | 01 | 091-093 | S1112XD | 23 | 949-950 | S12331A | 08 | 551-552 | ||
| S069X1A | 01 | 082-084 | S1112XS | 09 | 604-605 | S12331A | 24 | 955-965 | ||
| S069X1A | 01 | 085-087 | S1113XA | Pre | 011-013 | S12331B | 08 | 551-552 | ||
| S069X1A | 24 | 955-965 | S1113XA | 10 | 643-645 | S12331B | 24 | 955-965 | ||
| S069X1D | 23 | 949-950 | S1113XA | 24 | 955-965 | S12331D | 08 | 559-561 | ||
| S069X1S | 01 | 091-093 | S1113XD | 23 | 949-950 | S12331G | 08 | 559-561 | ||
| S069X2A | 01 | 082-084 | S1113XS | 09 | 604-605 | S12331K | 08 | 564-566 | ||
| S069X2A | 01 | 085-087 | S1114XA | Pre | 011-013 | S12331S | 08 | 551-552 | ||
| S069X2A | 24 | 955-965 | S1114XA | 10 | 643-645 | S1234XA | 08 | 551-552 | ||
| S069X2D | 23 | 949-950 | S1114XA | 24 | 955-965 | S1234XA | 24 | 955-965 | ||
| S069X2S | 01 | 091-093 | S1114XD | 23 | 949-950 | S1234XB | 08 | 551-552 | ||
| S069X3A | 01 | 082-084 | S1114XS | 09 | 604-605 | S1234XB | 24 | 955-965 | ||
| S069X3A | 24 | 955-965 | S1115XA | Pre | 011-013 | S1234XD | 08 | 559-561 | ||
| S069X3D | 23 | 949-950 | S1115XA | 10 | 643-645 | S1234XG | 08 | 559-561 | ||
| S069X3S | 01 | 091-093 | S1115XA | 24 | 955-965 | S1234XK | 08 | 564-566 | ||
| S069X4A | 01 | 082-084 | S1115XD | 23 | 949-950 | S1234XS | 08 | 551-552 | ||
| S069X4A | 24 | 955-965 | S1115XS | 09 | 604-605 | S12350A | 08 | 551-552 | ||
| S069X4D | 23 | 949-950 | S1120XA | Pre | 011-013 | S12350A | 24 | 955-965 | ||
| S069X4S | 01 | 091-093 | S1120XA | 03 | 154-156 | S12350B | 08 | 551-552 | ||
| S069X5A | 01 | 082-084 | S1120XA | 24 | 955-965 | S12350B | 24 | 955-965 | ||
| S069X5A | 24 | 955-965 | S1120XD | 23 | 949-950 | S12350D | 08 | 559-561 | ||
| S069X5D | 23 | 949-950 | S1120XS | 09 | 604-605 | S12350G | 08 | 559-561 | ||
| S069X5S | 01 | 091-093 | S1121XA | Pre | 011-013 | S12350K | 08 | 564-566 | ||
| S069X6A | 01 | 082-084 | S1121XA | 03 | 154-156 | S12350S | 08 | 551-552 | ||
| S069X6A | 24 | 955-965 | S1121XA | 24 | 955-965 | S12351A | 08 | 551-552 | ||
| S069X6D | 23 | 949-950 | S1121XD | 23 | 949-950 | S12351A | 24 | 955-965 | ||
| S069X6S | 01 | 091-093 | S1121XS | 09 | 604-605 | S12351B | 08 | 551-552 | ||
| S069X7A | 01 | 082-084 | S1122XA | Pre | 011-013 | S12351B | 24 | 955-965 | ||
| S069X7A | 24 | 955-965 | S1122XA | 03 | 154-156 | S12351D | 08 | 559-561 | ||
| S069X7D | 23 | 949-950 | S1122XA | 24 | 955-965 | S12351G | 08 | 559-561 | ||
| S069X7S | 01 | 091-093 | S1122XD | 23 | 949-950 | S12351K | 08 | 564-566 | ||
| S069X8A | 01 | 082-084 | S1122XS | 09 | 604-605 | S12351S | 08 | 551-552 | ||
| S069X8A | 24 | 955-965 | S1123XA | Pre | 011-013 | S12390A | 08 | 551-552 | ||
| S069X8D | 23 | 949-950 | S1123XA | 03 | 154-156 | S12390A | 24 | 955-965 | ||
| S069X8S | 01 | 091-093 | S1123XA | 24 | 955-965 | S12390B | 08 | 551-552 | ||
| S069X9A | 01 | 082-084 | S1123XD | 23 | 949-950 | S12390B | 24 | 955-965 | ||
| S069X9A | 24 | 955-965 | S1123XS | 09 | 604-605 | S12390D | 08 | 559-561 | ||
| S069X9D | 23 | 949-950 | S1124XA | Pre | 011-013 | S12390G | 08 | 559-561 | ||
| S069X9S | 01 | 091-093 | S1124XA | 03 | 154-156 | S12390K | 08 | 564-566 | ||
| S070XXA | Pre | 011-013 | S1124XA | 24 | 955-965 | S12390S | 08 | 551-552 | ||
| S070XXA | 21 | 913-914 | S1124XD | 23 | 949-950 | S12391A | 08 | 551-552 | ||
| S070XXA | 24 | 955-965 | S1124XS | 09 | 604-605 | S12391A | 24 | 955-965 | ||
| S070XXD | 23 | 949-950 | S1125XA | Pre | 011-013 | S12391B | 08 | 551-552 | ||
| S070XXS | 09 | 604-605 | S1125XA | 03 | 154-156 | S12391B | 24 | 955-965 | ||
| S071XXA | Pre | 011-013 | S1125XA | 24 | 955-965 | S12391D | 08 | 559-561 | ||
| S071XXA | 21 | 913-914 | S1125XD | 23 | 949-950 | S12391G | 08 | 559-561 | ||
| S071XXA | 24 | 955-965 | S1125XS | 09 | 604-605 | S12391K | 08 | 564-566 | ||
| S071XXD | 23 | 949-950 | S1180XA | Pre | 011-013 | S12391S | 08 | 551-552 | ||
| S071XXS | 09 | 604-605 | S1180XA | 09 | 604-605 | S12400A | 08 | 551-552 | ||
| S078XXA | Pre | 011-013 | S1180XA | 24 | 955-965 | S12400A | 24 | 955-965 | ||
| S078XXA | 21 | 913-914 | S1180XD | 23 | 949-950 | S12400B | 08 | 551-552 | ||
| S078XXA | 24 | 955-965 | S1180XS | 09 | 604-605 | S12400B | 24 | 955-965 | ||
| S078XXD | 23 | 949-950 | S1181XA | Pre | 011-013 | S12400D | 08 | 559-561 | ||
| S078XXS | 09 | 604-605 | S1181XA | 09 | 604-605 | S12400G | 08 | 559-561 | ||
| S079XXA | Pre | 011-013 | S1181XA | 24 | 955-965 | S12400K | 08 | 564-566 | ||
| S079XXA | 21 | 913-914 | S1181XD | 23 | 949-950 | S12400S | 08 | 551-552 | ||
| S079XXA | 24 | 955-965 | S1181XS | 09 | 604-605 | S12401A | 08 | 551-552 | ||
| S079XXD | 23 | 949-950 | S1182XA | Pre | 011-013 | S12401A | 24 | 955-965 | ||
| S079XXS | 09 | 604-605 | S1182XA | 09 | 604-605 | S12401B | 08 | 551-552 | ||
| S080XXA | 09 | 604-605 | S1182XA | 24 | 955-965 | S12401B | 24 | 955-965 | ||
| S080XXA | 24 | 955-965 | S1182XD | 23 | 949-950 | S12401D | 08 | 559-561 | ||
| S080XXD | 23 | 949-950 | S1182XS | 09 | 604-605 | S12401G | 08 | 559-561 | ||
| S080XXS | 09 | 604-605 | S1183XA | Pre | 011-013 | S12401K | 08 | 564-566 | ||
| S08111A | 03 | 154-156 | S1183XA | 09 | 604-605 | S12401S | 08 | 551-552 | ||
| S08111A | 24 | 955-965 | S1183XA | 24 | 955-965 | S12430A | 08 | 551-552 | ||
| S08111D | 23 | 949-950 | S1183XD | 23 | 949-950 | S12430A | 24 | 955-965 | ||
| S08111S | 09 | 604-605 | S1183XS | 09 | 604-605 | S12430B | 08 | 551-552 | ||
| S08112A | 03 | 154-156 | S1184XA | Pre | 011-013 | S12430B | 24 | 955-965 | ||
| S08112A | 24 | 955-965 | S1184XA | 09 | 604-605 | S12430D | 08 | 559-561 | ||
| S08112D | 23 | 949-950 | S1184XA | 24 | 955-965 | S12430G | 08 | 559-561 | ||
| S08112S | 09 | 604-605 | S1184XD | 23 | 949-950 | S12430K | 08 | 564-566 | ||
| S08119A | 03 | 154-156 | S1184XS | 09 | 604-605 | S12430S | 08 | 551-552 | ||
| S08119A | 24 | 955-965 | S1185XA | Pre | 011-013 | S12431A | 08 | 551-552 | ||
| S08119D | 23 | 949-950 | S1185XA | 09 | 604-605 | S12431A | 24 | 955-965 | ||
| S08119S | 09 | 604-605 | S1185XA | 24 | 955-965 | S12431B | 08 | 551-552 | ||
| S08121A | 03 | 154-156 | S1185XD | 23 | 949-950 | S12431B | 24 | 955-965 | ||
| S08121A | 24 | 955-965 | S1185XS | 09 | 604-605 | S12431D | 08 | 559-561 | ||
| S08121D | 23 | 949-950 | S1189XA | Pre | 011-013 | S12431G | 08 | 559-561 | ||
| S08121S | 09 | 604-605 | S1189XA | 09 | 604-605 | S12431K | 08 | 564-566 | ||
| S08122A | 03 | 154-156 | S1189XA | 24 | 955-965 | S12431S | 08 | 551-552 | ||
| S08122A | 24 | 955-965 | S1189XD | 23 | 949-950 | S1244XA | 08 | 551-552 | ||
| S08122D | 23 | 949-950 | S1189XS | 09 | 604-605 | S1244XA | 24 | 955-965 | ||
| S08122S | 09 | 604-605 | S1190XA | Pre | 011-013 | S1244XB | 08 | 551-552 | ||
| S08129A | 03 | 154-156 | S1190XA | 09 | 604-605 | S1244XB | 24 | 955-965 | ||
| S08129A | 24 | 955-965 | S1190XA | 24 | 955-965 | S1244XD | 08 | 559-561 | ||
| S08129D | 23 | 949-950 | S1190XD | 23 | 949-950 | S1244XG | 08 | 559-561 | ||
| S08129S | 09 | 604-605 | S1190XS | 09 | 604-605 | S1244XK | 08 | 564-566 | ||
| S08811A | Pre | 011-013 | S1191XA | Pre | 011-013 | S1244XS | 08 | 551-552 | ||
| S08811A | 03 | 154-156 | S1191XA | 09 | 604-605 | S12450A | 08 | 551-552 | ||
| S08811A | 24 | 955-965 | S1191XA | 24 | 955-965 | S12450A | 24 | 955-965 | ||
| S08811D | 23 | 949-950 | S1191XD | 23 | 949-950 | S12450B | 08 | 551-552 | ||
| S08811S | 09 | 604-605 | S1191XS | 09 | 604-605 | S12450B | 24 | 955-965 | ||
| S08812A | Pre | 011-013 | S1192XA | Pre | 011-013 | S12450D | 08 | 559-561 | ||
| S08812A | 03 | 154-156 | S1192XA | 09 | 604-605 | S12450G | 08 | 559-561 | ||
| S08812A | 24 | 955-965 | S1192XA | 24 | 955-965 | S12450K | 08 | 564-566 | ||
| S08812D | 23 | 949-950 | S1192XD | 23 | 949-950 | S12450S | 08 | 551-552 | ||
| S08812S | 09 | 604-605 | S1192XS | 09 | 604-605 | S12451A | 08 | 551-552 | ||
| S0889XA | 09 | 604-605 | S1193XA | Pre | 011-013 | S12451A | 24 | 955-965 | ||
| S0889XA | 24 | 955-965 | S1193XA | 09 | 604-605 | S12451B | 08 | 551-552 | ||
| S0889XD | 23 | 949-950 | S1193XA | 24 | 955-965 | S12451B | 24 | 955-965 | ||
| S0889XS | 09 | 604-605 | S1193XD | 23 | 949-950 | S12451D | 08 | 559-561 | ||
| S090XXA | Pre | 011-013 | S1193XS | 09 | 604-605 | S12451G | 08 | 559-561 | ||
| S090XXA | 21 | 913-914 | S1194XA | Pre | 011-013 | S12451K | 08 | 564-566 | ||
| S090XXA | 24 | 955-965 | S1194XA | 09 | 604-605 | S12451S | 08 | 551-552 | ||
| S090XXD | 23 | 949-950 | S1194XA | 24 | 955-965 | S12490A | 08 | 551-552 | ||
| S090XXS | 05 | 299-301 | S1194XD | 23 | 949-950 | S12490A | 24 | 955-965 | ||
| S0910XA | Pre | 011-013 | S1194XS | 09 | 604-605 | S12490B | 08 | 551-552 | ||
| S0910XA | 21 | 913-914 | S1195XA | Pre | 011-013 | S12490B | 24 | 955-965 | ||
| S0910XA | 24 | 955-965 | S1195XA | 09 | 604-605 | S12490D | 08 | 559-561 | ||
| S0910XD | 23 | 949-950 | S1195XA | 24 | 955-965 | S12490G | 08 | 559-561 | ||
| S0910XS | 21 | 913-914 | S1195XD | 23 | 949-950 | S12490K | 08 | 564-566 | ||
| S0911XA | Pre | 011-013 | S1195XS | 09 | 604-605 | S12490S | 08 | 551-552 | ||
| S0911XA | 21 | 913-914 | S12000A | 08 | 551-552 | S12491A | 08 | 551-552 | ||
| S0911XA | 24 | 955-965 | S12000A | 24 | 955-965 | S12491A | 24 | 955-965 | ||
| S0911XD | 23 | 949-950 | S12000B | 08 | 551-552 | S12491B | 08 | 551-552 | ||
| S0911XS | 08 | 562-563 | S12000B | 24 | 955-965 | S12491B | 24 | 955-965 | ||
| S0912XA | 09 | 604-605 | S12000D | 08 | 559-561 | S12491D | 08 | 559-561 | ||
| S0912XA | 24 | 955-965 | S12000G | 08 | 559-561 | S12491G | 08 | 559-561 | ||
| S0912XD | 23 | 949-950 | S12000K | 08 | 564-566 | S12491K | 08 | 564-566 | ||
| S0912XS | 09 | 604-605 | S12000S | 08 | 551-552 | S12491S | 08 | 551-552 | ||
| S0919XA | Pre | 011-013 | S12001A | 08 | 551-552 | S12500A | 08 | 551-552 | ||
| S0919XA | 21 | 913-914 | S12001A | 24 | 955-965 | S12500A | 24 | 955-965 | ||
| S0919XA | 24 | 955-965 | S12001B | 08 | 551-552 | S12500B | 08 | 551-552 | ||
| S0919XD | 23 | 949-950 | S12001B | 24 | 955-965 | S12500B | 24 | 955-965 | ||
| S0919XS | 21 | 913-914 | S12001D | 08 | 559-561 | S12500D | 08 | 559-561 | ||
| S0920XA | 03 | 154-156 | S12001G | 08 | 559-561 | S12500G | 08 | 559-561 | ||
| S0920XA | 24 | 955-965 | S12001K | 08 | 564-566 | S12500K | 08 | 564-566 | ||
| S0920XD | 23 | 949-950 | S12001S | 08 | 551-552 | S12500S | 08 | 551-552 | ||
| S0920XS | 21 | 913-914 | S1201XA | 08 | 551-552 | S12501A | 08 | 551-552 | ||
| S0921XA | 03 | 154-156 | S1201XA | 24 | 955-965 | S12501A | 24 | 955-965 | ||
| S0921XA | 24 | 955-965 | S1201XB | 08 | 551-552 | S12501B | 08 | 551-552 | ||
| S0921XD | 23 | 949-950 | S1201XB | 24 | 955-965 | S12501B | 24 | 955-965 | ||
| S0921XS | 09 | 604-605 | S1201XD | 08 | 559-561 | S12501D | 08 | 559-561 | ||
| S0922XA | 03 | 154-156 | S1201XG | 08 | 559-561 | S12501G | 08 | 559-561 | ||
| S0922XA | 24 | 955-965 | S1201XK | 08 | 564-566 | S12501K | 08 | 564-566 | ||
| S0922XD | 23 | 949-950 | S1201XS | 08 | 551-552 | S12501S | 08 | 551-552 | ||
| S0922XS | 09 | 604-605 | S1202XA | 08 | 551-552 | S12530A | 08 | 551-552 | ||
| S09301A | 03 | 154-156 | S1202XA | 24 | 955-965 | S12530A | 24 | 955-965 | ||
| S09301A | 24 | 955-965 | S1202XB | 08 | 551-552 | S12530B | 08 | 551-552 | ||
| S09301D | 23 | 949-950 | S1202XB | 24 | 955-965 | S12530B | 24 | 955-965 | ||
| S09301S | 21 | 913-914 | S1202XD | 08 | 559-561 | S12530D | 08 | 559-561 | ||
| S09302A | 03 | 154-156 | S1202XG | 08 | 559-561 | S12530G | 08 | 559-561 | ||
| S09302A | 24 | 955-965 | S1202XK | 08 | 564-566 | S12530K | 08 | 564-566 | ||
| S09302D | 23 | 949-950 | S1202XS | 08 | 551-552 | S12530S | 08 | 551-552 | ||
| S09302S | 21 | 913-914 | S12030A | 08 | 551-552 | S12531A | 08 | 551-552 | ||
| S09309A | 03 | 154-156 | S12030A | 24 | 955-965 | S12531A | 24 | 955-965 | ||
| S09309A | 24 | 955-965 | S12030B | 08 | 551-552 | S12531B | 08 | 551-552 | ||
| S09309D | 23 | 949-950 | S12030B | 24 | 955-965 | S12531B | 24 | 955-965 | ||
| S09309S | 21 | 913-914 | S12030D | 08 | 559-561 | S12531D | 08 | 559-561 | ||
| S09311A | 03 | 154-156 | S12030G | 08 | 559-561 | S12531G | 08 | 559-561 | ||
| S09311A | 24 | 955-965 | S12030K | 08 | 564-566 | S12531K | 08 | 564-566 | ||
| S09311D | 23 | 949-950 | S12030S | 08 | 551-552 | S12531S | 08 | 551-552 | ||
| S09311S | 09 | 604-605 | S12031A | 08 | 551-552 | S1254XA | 08 | 551-552 | ||
| S09312A | 03 | 154-156 | S12031A | 24 | 955-965 | S1254XA | 24 | 955-965 | ||
| S09312A | 24 | 955-965 | S12031B | 08 | 551-552 | S1254XB | 08 | 551-552 | ||
| S09312D | 23 | 949-950 | S12031B | 24 | 955-965 | S1254XB | 24 | 955-965 | ||
| S09312S | 09 | 604-605 | S12031D | 08 | 559-561 | S1254XD | 08 | 559-561 | ||
| S09313A | 03 | 154-156 | S12031G | 08 | 559-561 | S1254XG | 08 | 559-561 | ||
| S09313A | 24 | 955-965 | S12031K | 08 | 564-566 | S1254XK | 08 | 564-566 | ||
| S09313D | 23 | 949-950 | S12031S | 08 | 551-552 | S1254XS | 08 | 551-552 | ||
| S09313S | 09 | 604-605 | S12040A | 08 | 551-552 | S12550A | 08 | 551-552 | ||
| S09319A | 03 | 154-156 | S12040A | 24 | 955-965 | S12550A | 24 | 955-965 | ||
| S09319A | 24 | 955-965 | S12040B | 08 | 551-552 | S12550B | 08 | 551-552 | ||
| S09319D | 23 | 949-950 | S12040B | 24 | 955-965 | S12550B | 24 | 955-965 | ||
| S09319S | 09 | 604-605 | S12040D | 08 | 559-561 | S12550D | 08 | 559-561 | ||
| S09391A | 03 | 154-156 | S12040G | 08 | 559-561 | S12550G | 08 | 559-561 | ||
| S09391A | 24 | 955-965 | S12040K | 08 | 564-566 | S12550K | 08 | 564-566 | ||
| S09391D | 23 | 949-950 | S12040S | 08 | 551-552 | S12550S | 08 | 551-552 | ||
| S09391S | 21 | 913-914 | S12041A | 08 | 551-552 | S12551A | 08 | 551-552 | ||
| S09392A | 03 | 154-156 | S12041A | 24 | 955-965 | S12551A | 24 | 955-965 | ||
| S09392A | 24 | 955-965 | S12041B | 08 | 551-552 | S12551B | 08 | 551-552 | ||
| S09392D | 23 | 949-950 | S12041B | 24 | 955-965 | S12551B | 24 | 955-965 | ||
| S09392S | 21 | 913-914 | S12041D | 08 | 559-561 | S12551D | 08 | 559-561 | ||
| S09399A | 03 | 154-156 | S12041G | 08 | 559-561 | S12551G | 08 | 559-561 |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
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