CVALIDITYFLG=5          20251001161E8814   B20                                                                                                                                                                                                                                     111111111002020202020102Code First w/ Condition PDX                       20251029                                                                                                                                                                                              VER=06.1.25 HIPPS=2AB11 GVF=05 GRC=00                06.1.252AB110500                                                                                  %
CVALIDITYFLG=5          20251001161H40841  E0839                                                                                                                                                                                                                                   111111111002020202020102Code First w/ Condition PDX                       20251029                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=01 GRC=03                06.1.25000000103                                                                                  %
CVALIDITYFLG=5          20251001161H40841  E0939                                                                                                                                                                                                                                   111111111002020202020102Code First w/ Condition PDX                       20251029                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=01 GRC=03                06.1.25000000103                                                                                  %
CVALIDITYFLG=5          20251001161H40841  E1039                                                                                                                                                                                                                                   111111111002020202020102Code First w/ Condition PDX                       20251029                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=01 GRC=03                06.1.25000000103                                                                                  %
CVALIDITYFLG=5          20251001161M363    D560                                                                                                                                                                                                                                    111111111002020202020102Code First w/ Condition PDX                       20251029                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=02 GRC=03                06.1.25000000203                                                                                  %
CVALIDITYFLG=5          20251001161M05A    D560                                                                                                                                                                                                                                    111111111002020202020102Code First w/ Condition PDX                       20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=00 GRC=05                06.1.25000000005                                                                                  %
CE_INFECT_Low_No   0001 202510011  B8801                                                                                                                                                                                                                                           000000000100000000000000 GROUP=B8801 K                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
CE_INFECT_Low_No   0002 202510011  B8809                                                                                                                                                                                                                                           000000000100000000000000 GROUP=B8809 K                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
CE_INFECT_Low_Hi   0011 202510011  A001    E11A    G8254                                                                                                                                                                                                                           000000000100000000000000 E11A SDX High COMO HIPPSPOS4=3 Add               20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA31 GVF=00 GRC=00                06.1.251KA310000                                                                                  %
CE_NEURRHB_Low_No  0056 202510011  G35C0                                                                                                                                                                                                                                           000000000100000000000000 GROUP=G35C0 B                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1BA11 GVF=00 GRC=00                06.1.251BA110000                                                                                  %
CE_CARDIAC_Low_No  0091 202510011  I27841                                                                                                                                                                                                                                          000000000100000000000000 GROUP=I27841 H                                   20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1HA11 GVF=00 GRC=00                06.1.251HA110000                                                                                  %
CE_WOUNDS_Low_No   0096 202510011  L02217                                                                                                                                                                                                                                          000000000100000000000000 GROUP=L02217 C                                   20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1CA11 GVF=00 GRC=00                06.1.251CA110000                                                                                  %
CE_GI/GU_Low_No    0242 202510011  N00B1                                                                                                                                                                                                                                           000000000100000000000000 GROUP=N00B1 J                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1JA11 GVF=00 GRC=00                06.1.251JA110000                                                                                  %
CE_OTHER_Low_No    0250 202510011  Q8981                                                                                                                                                                                                                                           000000000100000000000000 GROUP=Q8981 A                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1AA11 GVF=00 GRC=00                06.1.251AA110000                                                                                  %
CE_OTHER_Low_No    0251 202510011  Q8989                                                                                                                                                                                                                                           000000000100000000000000 GROUP=Q8989 A                                    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1AA11 GVF=00 GRC=00                06.1.251AA110000                                                                                  %
CE_INFECT_Low_Low  0719 202510011  A001    I110                                                                                                                                                                                                                                    000000000100000000000000 I110 SDX LOW COMO HIPPSPOS4=2 Modify             20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA21 GVF=00 GRC=00                06.1.251KA210000                                                                                  %
CE_INFECT_Low_Hi   0720 202510011  A001    I110    I70541                                                                                                                                                                                                                          000000000100000000000000 I110 SDX High COMO HIPPSPOS4=3 Modify            20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA31 GVF=00 GRC=00                06.1.251KA310000                                                                                  %
CE_RESPIRA_Low_No  0983 202510011  J40                                                                                                                                                                                                                                             000000000100000000000000 GROUP=J40 L                                      20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1LA11 GVF=00 GRC=00                06.1.251LA110000                                                                                  %
CE_RESPIRA_Low_No  0984 202510011  J410                                                                                                                                                                                                                                            000000000100000000000000 GROUP=J410 L                                     20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1LA11 GVF=00 GRC=00                06.1.251LA110000                                                                                  %
CE_RESPIRA_Low_No  0985 202510011  J411                                                                                                                                                                                                                                            000000000100000000000000 GROUP=J411 L                                     20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1LA11 GVF=00 GRC=00                06.1.251LA110000                                                                                  %
CE_MUSCRHB_Low_No  1084 202510011  S6291XA                                                                                                                                                                                                                                         000000000100000000000000 GROUP=S6291XA E                                  20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1EA11 GVF=00 GRC=00                06.1.251EA110000                                                                                  %
CE_MUSCRHB_Low_No  1085 202510011  S6291XB                                                                                                                                                                                                                                         000000000100000000000000 GROUP=S6291XB E                                  20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1EA11 GVF=00 GRC=00                06.1.251EA110000                                                                                  %
CE_MUSCRHB_Low_No  1086 202510011  S6291XD                                                                                                                                                                                                                                         000000000100000000000000 GROUP=S6291XD E                                  20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1EA11 GVF=00 GRC=00                06.1.251EA110000                                                                                  %
NOST_NA_NA_NA RC05 0481 202510011  S3163AA                                                                                                                                                                                                                                         000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=03 GRC=03                06.1.25000000303                                                                                  %
NOST_NA_NA_NA RC03 0684 202510011  B880                                                                                                                                                                                                                                            000000000100000000000000 B880 GROUP=NA Delete                             20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=06 GRC=03                06.1.25000000603                                                                                  %
NOST_NA_NA_NA RC03 0685 202510011  D71                                                                                                                                                                                                                                             000000000100000000000000 D71 GROUP=NA Delete                              20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=06 GRC=03                06.1.25000000603                                                                                  %
NOST_NA_NA_NA RC05 0592 202510011  W44H9XA                                                                                                                                                                                                                                         000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=04 GRC=03                06.1.25000000403                                                                                  %
CE_INFECT_Low_No   0593 202510011  A001    W44H9XA                                                                                                                                                                                                                                 000000000100000000000000 W44H9XA GROUP=NA Add IN SDX CLINICAL_GROUP=NA    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
NOST_NA_NA_NA RC05 0594 202510011  W44H9XD                                                                                                                                                                                                                                         000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=04 GRC=03                06.1.25000000403                                                                                  %
CE_INFECT_Low_No   0595 202510011  A001    W44H9XD                                                                                                                                                                                                                                 000000000100000000000000 W44H9XD GROUP=NA Add IN SDX CLINICAL_GROUP=NA    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
NOST_NA_NA_NA RC05 0712 202510011  F070                                                                                                                                                                                                                                            000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=01 GRC=03                06.1.25000000103                                                                                  %
CE_INFECT_Low_No   0713 202510011  A001    F070                                                                                                                                                                                                                                    000000000100000000000000 F070 GROUP=NA Modify IN SDX CLINICAL_GROUP=NA    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
CE_INFECT_Low_Hi   0714 202510011  A001    F070    L97116                                                                                                                                                                                                                          000000000100000000000000 F070 SDX High COMO HIPPSPOS4=3 Modify            20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA31 GVF=00 GRC=00                06.1.251KA310000                                                                                  %
NOST_NA_NA_NA RC05 0715 202510011  F0781                                                                                                                                                                                                                                           000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=01 GRC=03                06.1.25000000103                                                                                  %
CE_INFECT_Low_No   0716 202510011  A001    F0781                                                                                                                                                                                                                                   000000000100000000000000 F0781 GROUP=NA Modify IN SDX CLINICAL_GROUP=NA   20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
CE_INFECT_Low_Hi   0717 202510011  A001    F0781   I70544                                                                                                                                                                                                                          000000000100000000000000 F0781 SDX High COMO HIPPSPOS4=3 Modify           20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA31 GVF=00 GRC=00                06.1.251KA310000                                                                                  %
NOST_NA_NA_NA RC03 0708 202510011  Z5986                                                                                                                                                                                                                                           000000000100000000000000 Z5986 GROUP=NA Delete                            20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=06 GRC=03                06.1.25000000603                                                                                  %
NOST_NA_NA_NA RC03 0709 202510011  Z841                                                                                                                                                                                                                                            000000000100000000000000 Z841 GROUP=NA Delete                             20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=06 GRC=03                06.1.25000000603                                                                                  %
NOST_NA_NA_NA RC05 0164 202510011  L98A193                                                                                                                                                                                                                                         000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=03 GRC=03                06.1.25000000303                                                                                  %
CE_INFECT_Low_No   0165 202510011  A001    L98A193                                                                                                                                                                                                                                 000000000100000000000000 L98A193 GROUP=NA Add IN SDX CLINICAL_GROUP=NA    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
NOST_NA_NA_NA RC05 0166 202510011  L98A194                                                                                                                                                                                                                                         000000000100000000000000 CLINICAL_GROUP=NA                                20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=00000 GVF=03 GRC=03                06.1.25000000303                                                                                  %
CE_INFECT_Low_No   0167 202510011  A001    L98A194                                                                                                                                                                                                                                 000000000100000000000000 L98A194 GROUP=NA Add IN SDX CLINICAL_GROUP=NA    20251030                                                                                                                                                                                              VER=06.1.25 HIPPS=1KA11 GVF=00 GRC=00                06.1.251KA110000                                                                                  %
SUBCHAPTER A00-A09      20251001161A080    A0105                                                                                                                                                                                                                                   000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER A15-A19      20251001161A1884   A1854                                                                                                                                                                                                                                   000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER A20-A28      20251001161A282    A259                                                                                                                                                                                                                                    000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER B00-B09      20251001161B084    B079                                                                                                                                                                                                                                    000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER B10-B10      20251001161B1001   B1009                                                                                                                                                                                                                                   000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2BA11                                          06.1.252BA110000                                                                                  %
SUBCHAPTER B15-B19      20251001161B1910   B1910                                                                                                                                                                                                                                   000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER C00-C14      20251001161C098    C113                                                                                                                                                                                                                                    000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER C15-C26      20251001161C163    C170                                                                                                                                                                                                                                    000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
SUBCHAPTER C30-C39      20251001161C322    C323                                                                                                                                                                                                                                    000000000100000000000000                                                  20251030                                                                                                                                                                                              HIPPS=2KA11                                          06.1.252KA110000                                                                                  %
