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 30 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S15009D | 23 | 949-950 | S20172D | 23 | 949-950 | S21221D | 23 | 949-950 | ||
| S15009S | 05 | 299-301 | S20172S | 09 | 604-605 | S21221S | 09 | 604-605 | ||
| S15011A | 15 | 793 | S20179A | 09 | 604-605 | S21222A | 09 | 604-605 | ||
| S15011A | 21 | 913-914 | S20179A | 24 | 955-965 | S21222A | 24 | 955-965 | ||
| S15011A | 24 | 955-965 | S20179D | 23 | 949-950 | S21222D | 23 | 949-950 | ||
| S15011D | 23 | 949-950 | S20179S | 09 | 604-605 | S21222S | 09 | 604-605 | ||
| S15011S | 05 | 299-301 | S2020XA | 09 | 604-605 | S21229A | 09 | 604-605 | ||
| S15012A | 15 | 793 | S2020XA | 24 | 955-965 | S21229A | 24 | 955-965 | ||
| S15012A | 21 | 913-914 | S2020XD | 23 | 949-950 | S21229D | 23 | 949-950 | ||
| S15012A | 24 | 955-965 | S2020XS | 09 | 604-605 | S21229S | 09 | 604-605 | ||
| S15012D | 23 | 949-950 | S20211A | 09 | 604-605 | S21231A | 09 | 604-605 | ||
| S15012S | 05 | 299-301 | S20211A | 24 | 955-965 | S21231A | 24 | 955-965 | ||
| S15019A | 15 | 793 | S20211D | 23 | 949-950 | S21231D | 23 | 949-950 | ||
| S15019A | 21 | 913-914 | S20211S | 09 | 604-605 | S21231S | 09 | 604-605 | ||
| S15019A | 24 | 955-965 | S20212A | 09 | 604-605 | S21232A | 09 | 604-605 | ||
| S15019D | 23 | 949-950 | S20212A | 24 | 955-965 | S21232A | 24 | 955-965 | ||
| S15019S | 05 | 299-301 | S20212D | 23 | 949-950 | S21232D | 23 | 949-950 | ||
| S15021A | 15 | 793 | S20212S | 09 | 604-605 | S21232S | 09 | 604-605 | ||
| S15021A | 21 | 913-914 | S20219A | 09 | 604-605 | S21239A | 09 | 604-605 | ||
| S15021A | 24 | 955-965 | S20219A | 24 | 955-965 | S21239A | 24 | 955-965 | ||
| S15021D | 23 | 949-950 | S20219D | 23 | 949-950 | S21239D | 23 | 949-950 | ||
| S15021S | 05 | 299-301 | S20219S | 09 | 604-605 | S21239S | 09 | 604-605 | ||
| S15022A | 15 | 793 | S20221A | 09 | 604-605 | S21241A | 09 | 604-605 | ||
| S15022A | 21 | 913-914 | S20221A | 24 | 955-965 | S21241A | 24 | 955-965 | ||
| S15022A | 24 | 955-965 | S20221D | 23 | 949-950 | S21241D | 23 | 949-950 | ||
| S15022D | 23 | 949-950 | S20221S | 09 | 604-605 | S21241S | 09 | 604-605 | ||
| S15022S | 05 | 299-301 | S20222A | 09 | 604-605 | S21242A | 09 | 604-605 | ||
| S15029A | 15 | 793 | S20222A | 24 | 955-965 | S21242A | 24 | 955-965 | ||
| S15029A | 21 | 913-914 | S20222D | 23 | 949-950 | S21242D | 23 | 949-950 | ||
| S15029A | 24 | 955-965 | S20222S | 09 | 604-605 | S21242S | 09 | 604-605 | ||
| S15029D | 23 | 949-950 | S20229A | 09 | 604-605 | S21249A | 09 | 604-605 | ||
| S15029S | 05 | 299-301 | S20229A | 24 | 955-965 | S21249A | 24 | 955-965 | ||
| S15091A | 15 | 793 | S20229D | 23 | 949-950 | S21249D | 23 | 949-950 | ||
| S15091A | 21 | 913-914 | S20229S | 09 | 604-605 | S21249S | 09 | 604-605 | ||
| S15091A | 24 | 955-965 | S20301A | 09 | 604-605 | S21251A | 09 | 604-605 | ||
| S15091D | 23 | 949-950 | S20301A | 24 | 955-965 | S21251A | 24 | 955-965 | ||
| S15091S | 05 | 299-301 | S20301D | 23 | 949-950 | S21251D | 23 | 949-950 | ||
| S15092A | 15 | 793 | S20301S | 09 | 604-605 | S21251S | 09 | 604-605 | ||
| S15092A | 21 | 913-914 | S20302A | 09 | 604-605 | S21252A | 09 | 604-605 | ||
| S15092A | 24 | 955-965 | S20302A | 24 | 955-965 | S21252A | 24 | 955-965 | ||
| S15092D | 23 | 949-950 | S20302D | 23 | 949-950 | S21252D | 23 | 949-950 | ||
| S15092S | 05 | 299-301 | S20302S | 09 | 604-605 | S21252S | 09 | 604-605 | ||
| S15099A | 15 | 793 | S20309A | 09 | 604-605 | S21259A | 09 | 604-605 | ||
| S15099A | 21 | 913-914 | S20309A | 24 | 955-965 | S21259A | 24 | 955-965 | ||
| S15099A | 24 | 955-965 | S20309D | 23 | 949-950 | S21259D | 23 | 949-950 | ||
| S15099D | 23 | 949-950 | S20309S | 09 | 604-605 | S21259S | 09 | 604-605 | ||
| S15099S | 05 | 299-301 | S20311A | 09 | 604-605 | S21301A | 21 | 913-914 | ||
| S15101A | Pre | 011-013 | S20311A | 24 | 955-965 | S21301A | 24 | 955-965 | ||
| S15101A | 21 | 913-914 | S20311D | 23 | 949-950 | S21301D | 23 | 949-950 | ||
| S15101A | 24 | 955-965 | S20311S | 09 | 604-605 | S21301S | 09 | 604-605 | ||
| S15101D | 23 | 949-950 | S20312A | 09 | 604-605 | S21302A | 21 | 913-914 | ||
| S15101S | 05 | 299-301 | S20312A | 24 | 955-965 | S21302A | 24 | 955-965 | ||
| S15102A | Pre | 011-013 | S20312D | 23 | 949-950 | S21302D | 23 | 949-950 | ||
| S15102A | 21 | 913-914 | S20312S | 09 | 604-605 | S21302S | 09 | 604-605 | ||
| S15102A | 24 | 955-965 | S20319A | 09 | 604-605 | S21309A | 21 | 913-914 | ||
| S15102D | 23 | 949-950 | S20319A | 24 | 955-965 | S21309A | 24 | 955-965 | ||
| S15102S | 05 | 299-301 | S20319D | 23 | 949-950 | S21309D | 23 | 949-950 | ||
| S15109A | Pre | 011-013 | S20319S | 09 | 604-605 | S21309S | 09 | 604-605 | ||
| S15109A | 21 | 913-914 | S20321A | 09 | 606-607 | S21311A | 21 | 913-914 | ||
| S15109A | 24 | 955-965 | S20321A | 24 | 955-965 | S21311A | 24 | 955-965 | ||
| S15109D | 23 | 949-950 | S20321D | 23 | 949-950 | S21311D | 23 | 949-950 | ||
| S15109S | 05 | 299-301 | S20321S | 09 | 604-605 | S21311S | 09 | 604-605 | ||
| S15111A | Pre | 011-013 | S20322A | 09 | 606-607 | S21312A | 21 | 913-914 | ||
| S15111A | 21 | 913-914 | S20322A | 24 | 955-965 | S21312A | 24 | 955-965 | ||
| S15111A | 24 | 955-965 | S20322D | 23 | 949-950 | S21312D | 23 | 949-950 | ||
| S15111D | 23 | 949-950 | S20322S | 09 | 604-605 | S21312S | 09 | 604-605 | ||
| S15111S | 05 | 299-301 | S20329A | 09 | 606-607 | S21319A | 21 | 913-914 | ||
| S15112A | Pre | 011-013 | S20329A | 24 | 955-965 | S21319A | 24 | 955-965 | ||
| S15112A | 21 | 913-914 | S20329D | 23 | 949-950 | S21319D | 23 | 949-950 | ||
| S15112A | 24 | 955-965 | S20329S | 09 | 604-605 | S21319S | 09 | 604-605 | ||
| S15112D | 23 | 949-950 | S20341A | 09 | 604-605 | S21321A | 21 | 913-914 | ||
| S15112S | 05 | 299-301 | S20341A | 24 | 955-965 | S21321A | 24 | 955-965 | ||
| S15119A | Pre | 011-013 | S20341D | 23 | 949-950 | S21321D | 23 | 949-950 | ||
| S15119A | 21 | 913-914 | S20341S | 09 | 604-605 | S21321S | 09 | 604-605 | ||
| S15119A | 24 | 955-965 | S20342A | 09 | 604-605 | S21322A | 21 | 913-914 | ||
| S15119D | 23 | 949-950 | S20342A | 24 | 955-965 | S21322A | 24 | 955-965 | ||
| S15119S | 05 | 299-301 | S20342D | 23 | 949-950 | S21322D | 23 | 949-950 | ||
| S15121A | Pre | 011-013 | S20342S | 09 | 604-605 | S21322S | 09 | 604-605 | ||
| S15121A | 21 | 913-914 | S20349A | 09 | 604-605 | S21329A | 21 | 913-914 | ||
| S15121A | 24 | 955-965 | S20349A | 24 | 955-965 | S21329A | 24 | 955-965 | ||
| S15121D | 23 | 949-950 | S20349D | 23 | 949-950 | S21329D | 23 | 949-950 | ||
| S15121S | 05 | 299-301 | S20349S | 09 | 604-605 | S21329S | 09 | 604-605 | ||
| S15122A | Pre | 011-013 | S20351A | 09 | 604-605 | S21331A | 21 | 913-914 | ||
| S15122A | 21 | 913-914 | S20351A | 24 | 955-965 | S21331A | 24 | 955-965 | ||
| S15122A | 24 | 955-965 | S20351D | 23 | 949-950 | S21331D | 23 | 949-950 | ||
| S15122D | 23 | 949-950 | S20351S | 09 | 604-605 | S21331S | 09 | 604-605 | ||
| S15122S | 05 | 299-301 | S20352A | 09 | 604-605 | S21332A | 21 | 913-914 | ||
| S15129A | Pre | 011-013 | S20352A | 24 | 955-965 | S21332A | 24 | 955-965 | ||
| S15129A | 21 | 913-914 | S20352D | 23 | 949-950 | S21332D | 23 | 949-950 | ||
| S15129A | 24 | 955-965 | S20352S | 09 | 604-605 | S21332S | 09 | 604-605 | ||
| S15129D | 23 | 949-950 | S20359A | 09 | 604-605 | S21339A | 21 | 913-914 | ||
| S15129S | 05 | 299-301 | S20359A | 24 | 955-965 | S21339A | 24 | 955-965 | ||
| S15191A | Pre | 011-013 | S20359D | 23 | 949-950 | S21339D | 23 | 949-950 | ||
| S15191A | 21 | 913-914 | S20359S | 09 | 604-605 | S21339S | 09 | 604-605 | ||
| S15191A | 24 | 955-965 | S20361A | 09 | 606-607 | S21341A | 21 | 913-914 | ||
| S15191D | 23 | 949-950 | S20361A | 24 | 955-965 | S21341A | 24 | 955-965 | ||
| S15191S | 05 | 299-301 | S20361D | 23 | 949-950 | S21341D | 23 | 949-950 | ||
| S15192A | Pre | 011-013 | S20361S | 09 | 604-605 | S21341S | 09 | 604-605 | ||
| S15192A | 21 | 913-914 | S20362A | 09 | 606-607 | S21342A | 21 | 913-914 | ||
| S15192A | 24 | 955-965 | S20362A | 24 | 955-965 | S21342A | 24 | 955-965 | ||
| S15192D | 23 | 949-950 | S20362D | 23 | 949-950 | S21342D | 23 | 949-950 | ||
| S15192S | 05 | 299-301 | S20362S | 09 | 604-605 | S21342S | 09 | 604-605 | ||
| S15199A | Pre | 011-013 | S20369A | 09 | 606-607 | S21349A | 21 | 913-914 | ||
| S15199A | 21 | 913-914 | S20369A | 24 | 955-965 | S21349A | 24 | 955-965 | ||
| S15199A | 24 | 955-965 | S20369D | 23 | 949-950 | S21349D | 23 | 949-950 | ||
| S15199D | 23 | 949-950 | S20369S | 09 | 604-605 | S21349S | 09 | 604-605 | ||
| S15199S | 05 | 299-301 | S20371A | 09 | 604-605 | S21351A | 21 | 913-914 | ||
| S15201A | 15 | 793 | S20371A | 24 | 955-965 | S21351A | 24 | 955-965 | ||
| S15201A | 21 | 913-914 | S20371D | 23 | 949-950 | S21351D | 23 | 949-950 | ||
| S15201A | 24 | 955-965 | S20371S | 09 | 604-605 | S21351S | 09 | 604-605 | ||
| S15201D | 23 | 949-950 | S20372A | 09 | 604-605 | S21352A | 21 | 913-914 | ||
| S15201S | 05 | 299-301 | S20372A | 24 | 955-965 | S21352A | 24 | 955-965 | ||
| S15202A | 15 | 793 | S20372D | 23 | 949-950 | S21352D | 23 | 949-950 | ||
| S15202A | 21 | 913-914 | S20372S | 09 | 604-605 | S21352S | 09 | 604-605 | ||
| S15202A | 24 | 955-965 | S20379A | 09 | 604-605 | S21359A | 21 | 913-914 | ||
| S15202D | 23 | 949-950 | S20379A | 24 | 955-965 | S21359A | 24 | 955-965 | ||
| S15202S | 05 | 299-301 | S20379D | 23 | 949-950 | S21359D | 23 | 949-950 | ||
| S15209A | 15 | 793 | S20379S | 09 | 604-605 | S21359S | 09 | 604-605 | ||
| S15209A | 21 | 913-914 | S20401A | 09 | 604-605 | S21401A | 21 | 913-914 | ||
| S15209A | 24 | 955-965 | S20401A | 24 | 955-965 | S21401A | 24 | 955-965 | ||
| S15209D | 23 | 949-950 | S20401D | 23 | 949-950 | S21401D | 23 | 949-950 | ||
| S15209S | 05 | 299-301 | S20401S | 09 | 604-605 | S21401S | 09 | 604-605 | ||
| S15211A | 15 | 793 | S20402A | 09 | 604-605 | S21402A | 21 | 913-914 | ||
| S15211A | 21 | 913-914 | S20402A | 24 | 955-965 | S21402A | 24 | 955-965 | ||
| S15211A | 24 | 955-965 | S20402D | 23 | 949-950 | S21402D | 23 | 949-950 | ||
| S15211D | 23 | 949-950 | S20402S | 09 | 604-605 | S21402S | 09 | 604-605 | ||
| S15211S | 05 | 299-301 | S20409A | 09 | 604-605 | S21409A | 21 | 913-914 | ||
| S15212A | 15 | 793 | S20409A | 24 | 955-965 | S21409A | 24 | 955-965 | ||
| S15212A | 21 | 913-914 | S20409D | 23 | 949-950 | S21409D | 23 | 949-950 | ||
| S15212A | 24 | 955-965 | S20409S | 09 | 604-605 | S21409S | 09 | 604-605 | ||
| S15212D | 23 | 949-950 | S20411A | 09 | 604-605 | S21411A | 21 | 913-914 | ||
| S15212S | 05 | 299-301 | S20411A | 24 | 955-965 | S21411A | 24 | 955-965 | ||
| S15219A | 15 | 793 | S20411D | 23 | 949-950 | S21411D | 23 | 949-950 | ||
| S15219A | 21 | 913-914 | S20411S | 09 | 604-605 | S21411S | 09 | 604-605 | ||
| S15219A | 24 | 955-965 | S20412A | 09 | 604-605 | S21412A | 21 | 913-914 | ||
| S15219D | 23 | 949-950 | S20412A | 24 | 955-965 | S21412A | 24 | 955-965 | ||
| S15219S | 05 | 299-301 | S20412D | 23 | 949-950 | S21412D | 23 | 949-950 | ||
| S15221A | 15 | 793 | S20412S | 09 | 604-605 | S21412S | 09 | 604-605 | ||
| S15221A | 21 | 913-914 | S20419A | 09 | 604-605 | S21419A | 21 | 913-914 | ||
| S15221A | 24 | 955-965 | S20419A | 24 | 955-965 | S21419A | 24 | 955-965 | ||
| S15221D | 23 | 949-950 | S20419D | 23 | 949-950 | S21419D | 23 | 949-950 | ||
| S15221S | 05 | 299-301 | S20419S | 09 | 604-605 | S21419S | 09 | 604-605 | ||
| S15222A | 15 | 793 | S20421A | 09 | 606-607 | S21421A | 21 | 913-914 | ||
| S15222A | 21 | 913-914 | S20421A | 24 | 955-965 | S21421A | 24 | 955-965 | ||
| S15222A | 24 | 955-965 | S20421D | 23 | 949-950 | S21421D | 23 | 949-950 | ||
| S15222D | 23 | 949-950 | S20421S | 09 | 604-605 | S21421S | 09 | 604-605 | ||
| S15222S | 05 | 299-301 | S20422A | 09 | 606-607 | S21422A | 21 | 913-914 | ||
| S15229A | 15 | 793 | S20422A | 24 | 955-965 | S21422A | 24 | 955-965 | ||
| S15229A | 21 | 913-914 | S20422D | 23 | 949-950 | S21422D | 23 | 949-950 | ||
| S15229A | 24 | 955-965 | S20422S | 09 | 604-605 | S21422S | 09 | 604-605 | ||
| S15229D | 23 | 949-950 | S20429A | 09 | 606-607 | S21429A | 21 | 913-914 | ||
| S15229S | 05 | 299-301 | S20429A | 24 | 955-965 | S21429A | 24 | 955-965 | ||
| S15291A | 15 | 793 | S20429D | 23 | 949-950 | S21429D | 23 | 949-950 | ||
| S15291A | 21 | 913-914 | S20429S | 09 | 604-605 | S21429S | 09 | 604-605 | ||
| S15291A | 24 | 955-965 | S20441A | 09 | 604-605 | S21431A | 21 | 913-914 | ||
| S15291D | 23 | 949-950 | S20441A | 24 | 955-965 | S21431A | 24 | 955-965 | ||
| S15291S | 05 | 299-301 | S20441D | 23 | 949-950 | S21431D | 23 | 949-950 | ||
| S15292A | 15 | 793 | S20441S | 09 | 604-605 | S21431S | 09 | 604-605 | ||
| S15292A | 21 | 913-914 | S20442A | 09 | 604-605 | S21432A | 21 | 913-914 | ||
| S15292A | 24 | 955-965 | S20442A | 24 | 955-965 | S21432A | 24 | 955-965 | ||
| S15292D | 23 | 949-950 | S20442D | 23 | 949-950 | S21432D | 23 | 949-950 | ||
| S15292S | 05 | 299-301 | S20442S | 09 | 604-605 | S21432S | 09 | 604-605 | ||
| S15299A | 15 | 793 | S20449A | 09 | 604-605 | S21439A | 21 | 913-914 | ||
| S15299A | 21 | 913-914 | S20449A | 24 | 955-965 | S21439A | 24 | 955-965 | ||
| S15299A | 24 | 955-965 | S20449D | 23 | 949-950 | S21439D | 23 | 949-950 | ||
| S15299D | 23 | 949-950 | S20449S | 09 | 604-605 | S21439S | 09 | 604-605 | ||
| S15299S | 05 | 299-301 | S20451A | 09 | 604-605 | S21441A | 21 | 913-914 | ||
| S15301A | 15 | 793 | S20451A | 24 | 955-965 | S21441A | 24 | 955-965 | ||
| S15301A | 21 | 913-914 | S20451D | 23 | 949-950 | S21441D | 23 | 949-950 | ||
| S15301A | 24 | 955-965 | S20451S | 09 | 604-605 | S21441S | 09 | 604-605 | ||
| S15301D | 23 | 949-950 | S20452A | 09 | 604-605 | S21442A | 21 | 913-914 | ||
| S15301S | 05 | 299-301 | S20452A | 24 | 955-965 | S21442A | 24 | 955-965 | ||
| S15302A | 15 | 793 | S20452D | 23 | 949-950 | S21442D | 23 | 949-950 | ||
| S15302A | 21 | 913-914 | S20452S | 09 | 604-605 | S21442S | 09 | 604-605 | ||
| S15302A | 24 | 955-965 | S20459A | 09 | 604-605 | S21449A | 21 | 913-914 | ||
| S15302D | 23 | 949-950 | S20459A | 24 | 955-965 | S21449A | 24 | 955-965 | ||
| S15302S | 05 | 299-301 | S20459D | 23 | 949-950 | S21449D | 23 | 949-950 | ||
| S15309A | 15 | 793 | S20459S | 09 | 604-605 | S21449S | 09 | 604-605 | ||
| S15309A | 21 | 913-914 | S20461A | 09 | 606-607 | S21451A | 21 | 913-914 | ||
| S15309A | 24 | 955-965 | S20461A | 24 | 955-965 | S21451A | 24 | 955-965 | ||
| S15309D | 23 | 949-950 | S20461D | 23 | 949-950 | S21451D | 23 | 949-950 | ||
| S15309S | 05 | 299-301 | S20461S | 09 | 604-605 | S21451S | 09 | 604-605 | ||
| S15311A | 15 | 793 | S20462A | 09 | 606-607 | S21452A | 21 | 913-914 | ||
| S15311A | 21 | 913-914 | S20462A | 24 | 955-965 | S21452A | 24 | 955-965 | ||
| S15311A | 24 | 955-965 | S20462D | 23 | 949-950 | S21452D | 23 | 949-950 | ||
| S15311D | 23 | 949-950 | S20462S | 09 | 604-605 | S21452S | 09 | 604-605 | ||
| S15311S | 05 | 299-301 | S20469A | 09 | 606-607 | S21459A | 21 | 913-914 | ||
| S15312A | 15 | 793 | S20469A | 24 | 955-965 | S21459A | 24 | 955-965 | ||
| S15312A | 21 | 913-914 | S20469D | 23 | 949-950 | S21459D | 23 | 949-950 | ||
| S15312A | 24 | 955-965 | S20469S | 09 | 604-605 | S21459S | 09 | 604-605 | ||
| S15312D | 23 | 949-950 | S20471A | 09 | 604-605 | S2190XA | 09 | 604-605 | ||
| S15312S | 05 | 299-301 | S20471A | 24 | 955-965 | S2190XA | 24 | 955-965 | ||
| S15319A | 15 | 793 | S20471D | 23 | 949-950 | S2190XD | 23 | 949-950 | ||
| S15319A | 21 | 913-914 | S20471S | 09 | 604-605 | S2190XS | 09 | 604-605 | ||
| S15319A | 24 | 955-965 | S20472A | 09 | 604-605 | S2191XA | 09 | 604-605 | ||
| S15319D | 23 | 949-950 | S20472A | 24 | 955-965 | S2191XA | 24 | 955-965 | ||
| S15319S | 05 | 299-301 | S20472D | 23 | 949-950 | S2191XD | 23 | 949-950 | ||
| S15321A | 15 | 793 | S20472S | 09 | 604-605 | S2191XS | 09 | 604-605 | ||
| S15321A | 21 | 913-914 | S20479A | 09 | 604-605 | S2192XA | 21 | 913-914 | ||
| S15321A | 24 | 955-965 | S20479A | 24 | 955-965 | S2192XA | 24 | 955-965 | ||
| S15321D | 23 | 949-950 | S20479D | 23 | 949-950 | S2192XD | 23 | 949-950 | ||
| S15321S | 05 | 299-301 | S20479S | 09 | 604-605 | S2192XS | 09 | 604-605 | ||
| S15322A | 15 | 793 | S2090XA | 09 | 604-605 | S2193XA | 09 | 604-605 | ||
| S15322A | 21 | 913-914 | S2090XA | 24 | 955-965 | S2193XA | 24 | 955-965 | ||
| S15322A | 24 | 955-965 | S2090XD | 23 | 949-950 | S2193XD | 23 | 949-950 | ||
| S15322D | 23 | 949-950 | S2090XS | 09 | 604-605 | S2193XS | 09 | 604-605 | ||
| S15322S | 05 | 299-301 | S2091XA | 09 | 604-605 | S2194XA | 21 | 913-914 | ||
| S15329A | 15 | 793 | S2091XA | 24 | 955-965 | S2194XA | 24 | 955-965 | ||
| S15329A | 21 | 913-914 | S2091XD | 23 | 949-950 | S2194XD | 23 | 949-950 | ||
| S15329A | 24 | 955-965 | S2091XS | 09 | 604-605 | S2194XS | 09 | 604-605 | ||
| S15329D | 23 | 949-950 | S2092XA | 09 | 606-607 | S2195XA | 09 | 604-605 | ||
| S15329S | 05 | 299-301 | S2092XA | 24 | 955-965 | S2195XA | 24 | 955-965 | ||
| S15391A | 15 | 793 | S2092XD | 23 | 949-950 | S2195XD | 23 | 949-950 | ||
| S15391A | 21 | 913-914 | S2092XS | 09 | 604-605 | S2195XS | 09 | 604-605 | ||
| S15391A | 24 | 955-965 | S2094XA | 09 | 604-605 | S22000A | 08 | 551-552 | ||
| S15391D | 23 | 949-950 | S2094XA | 24 | 955-965 | S22000A | 24 | 955-965 | ||
| S15391S | 05 | 299-301 | S2094XD | 23 | 949-950 | S22000B | 08 | 551-552 | ||
| S15392A | 15 | 793 | S2094XS | 09 | 604-605 | S22000B | 24 | 955-965 | ||
| S15392A | 21 | 913-914 | S2095XA | 09 | 604-605 | S22000D | 08 | 559-561 | ||
| S15392A | 24 | 955-965 | S2095XA | 24 | 955-965 | S22000G | 08 | 559-561 | ||
| S15392D | 23 | 949-950 | S2095XD | 23 | 949-950 | S22000K | 08 | 564-566 | ||
| S15392S | 05 | 299-301 | S2095XS | 09 | 604-605 | S22000S | 08 | 551-552 | ||
| S15399A | 15 | 793 | S2096XA | 09 | 606-607 | S22001A | 08 | 551-552 | ||
| S15399A | 21 | 913-914 | S2096XA | 24 | 955-965 | S22001A | 24 | 955-965 | ||
| S15399A | 24 | 955-965 | S2096XD | 23 | 949-950 | S22001B | 08 | 551-552 | ||
| S15399D | 23 | 949-950 | S2096XS | 09 | 604-605 | S22001B | 24 | 955-965 | ||
| S15399S | 05 | 299-301 | S2097XA | 09 | 604-605 | S22001D | 08 | 559-561 | ||
| S158XXA | Pre | 011-013 | S2097XA | 24 | 955-965 | S22001G | 08 | 559-561 | ||
| S158XXA | 21 | 913-914 | S2097XD | 23 | 949-950 | S22001K | 08 | 564-566 | ||
| S158XXA | 24 | 955-965 | S2097XS | 09 | 604-605 | S22001S | 08 | 551-552 | ||
| S158XXD | 23 | 949-950 | S21001A | 09 | 604-605 | S22002A | 08 | 551-552 | ||
| S158XXS | 05 | 299-301 | S21001A | 24 | 955-965 | S22002A | 24 | 955-965 | ||
| S159XXA | Pre | 011-013 | S21001D | 23 | 949-950 | S22002B | 08 | 551-552 | ||
| S159XXA | 21 | 913-914 | S21001S | 09 | 604-605 | S22002B | 24 | 955-965 | ||
| S159XXA | 24 | 955-965 | S21002A | 09 | 604-605 | S22002D | 08 | 559-561 | ||
| S159XXD | 23 | 949-950 | S21002A | 24 | 955-965 | S22002G | 08 | 559-561 | ||
| S159XXS | 05 | 299-301 | S21002D | 23 | 949-950 | S22002K | 08 | 564-566 | ||
| S161XXA | 08 | 551-552 | S21002S | 09 | 604-605 | S22002S | 08 | 551-552 | ||
| S161XXA | 24 | 955-965 | S21009A | 09 | 604-605 | S22008A | 08 | 551-552 | ||
| S161XXD | 23 | 949-950 | S21009A | 24 | 955-965 | S22008A | 24 | 955-965 | ||
| S161XXS | 08 | 562-563 | S21009D | 23 | 949-950 | S22008B | 08 | 551-552 | ||
| S162XXA | Pre | 011-013 | S21009S | 09 | 604-605 | S22008B | 24 | 955-965 | ||
| S162XXA | 09 | 604-605 | S21011A | 09 | 604-605 | S22008D | 08 | 559-561 | ||
| S162XXA | 24 | 955-965 | S21011A | 24 | 955-965 | S22008G | 08 | 559-561 | ||
| S162XXD | 23 | 949-950 | S21011D | 23 | 949-950 | S22008K | 08 | 564-566 | ||
| S162XXS | 09 | 604-605 | S21011S | 09 | 604-605 | S22008S | 08 | 551-552 | ||
| S168XXA | Pre | 011-013 | S21012A | 09 | 604-605 | S22009A | 08 | 551-552 | ||
| S168XXA | 21 | 913-914 | S21012A | 24 | 955-965 | S22009A | 24 | 955-965 | ||
| S168XXA | 24 | 955-965 | S21012D | 23 | 949-950 | S22009B | 08 | 551-552 | ||
| S168XXD | 23 | 949-950 | S21012S | 09 | 604-605 | S22009B | 24 | 955-965 | ||
| S168XXS | 21 | 913-914 | S21019A | 09 | 604-605 | S22009D | 08 | 559-561 | ||
| S169XXA | Pre | 011-013 | S21019A | 24 | 955-965 | S22009G | 08 | 559-561 | ||
| S169XXA | 21 | 913-914 | S21019D | 23 | 949-950 | S22009K | 08 | 564-566 | ||
| S169XXA | 24 | 955-965 | S21019S | 09 | 604-605 | S22009S | 08 | 551-552 | ||
| S169XXD | 23 | 949-950 | S21021A | 09 | 604-605 | S22010A | 08 | 551-552 | ||
| S169XXS | 21 | 913-914 | S21021A | 24 | 955-965 | S22010A | 24 | 955-965 | ||
| S170XXA | Pre | 011-013 | S21021D | 23 | 949-950 | S22010B | 08 | 551-552 | ||
| S170XXA | 21 | 913-914 | S21021S | 09 | 604-605 | S22010B | 24 | 955-965 | ||
| S170XXA | 24 | 955-965 | S21022A | 09 | 604-605 | S22010D | 08 | 559-561 | ||
| S170XXD | 23 | 949-950 | S21022A | 24 | 955-965 | S22010G | 08 | 559-561 | ||
| S170XXS | 09 | 604-605 | S21022D | 23 | 949-950 | S22010K | 08 | 564-566 | ||
| S178XXA | Pre | 011-013 | S21022S | 09 | 604-605 | S22010S | 08 | 551-552 | ||
| S178XXA | 21 | 913-914 | S21029A | 09 | 604-605 | S22011A | 08 | 551-552 | ||
| S178XXA | 24 | 955-965 | S21029A | 24 | 955-965 | S22011A | 24 | 955-965 | ||
| S178XXD | 23 | 949-950 | S21029D | 23 | 949-950 | S22011B | 08 | 551-552 | ||
| S178XXS | 09 | 604-605 | S21029S | 09 | 604-605 | S22011B | 24 | 955-965 | ||
| S179XXA | Pre | 011-013 | S21031A | 09 | 604-605 | S22011D | 08 | 559-561 | ||
| S179XXA | 21 | 913-914 | S21031A | 24 | 955-965 | S22011G | 08 | 559-561 | ||
| S179XXA | 24 | 955-965 | S21031D | 23 | 949-950 | S22011K | 08 | 564-566 | ||
| S179XXD | 23 | 949-950 | S21031S | 09 | 604-605 | S22011S | 08 | 551-552 | ||
| S179XXS | 09 | 604-605 | S21032A | 09 | 604-605 | S22012A | 08 | 551-552 | ||
| S1980XA | Pre | 011-013 | S21032A | 24 | 955-965 | S22012A | 24 | 955-965 | ||
| S1980XA | 21 | 913-914 | S21032D | 23 | 949-950 | S22012B | 08 | 551-552 | ||
| S1980XA | 24 | 955-965 | S21032S | 09 | 604-605 | S22012B | 24 | 955-965 | ||
| S1980XD | 23 | 949-950 | S21039A | 09 | 604-605 | S22012D | 08 | 559-561 | ||
| S1980XS | 21 | 913-914 | S21039A | 24 | 955-965 | S22012G | 08 | 559-561 | ||
| S1981XA | Pre | 011-013 | S21039D | 23 | 949-950 | S22012K | 08 | 564-566 | ||
| S1981XA | 21 | 913-914 | S21039S | 09 | 604-605 | S22012S | 08 | 551-552 | ||
| S1981XA | 24 | 955-965 | S21041A | 09 | 604-605 | S22018A | 08 | 551-552 | ||
| S1981XD | 23 | 949-950 | S21041A | 24 | 955-965 | S22018A | 24 | 955-965 | ||
| S1981XS | 21 | 913-914 | S21041D | 23 | 949-950 | S22018B | 08 | 551-552 | ||
| S1982XA | Pre | 011-013 | S21041S | 09 | 604-605 | S22018B | 24 | 955-965 | ||
| S1982XA | 21 | 913-914 | S21042A | 09 | 604-605 | S22018D | 08 | 559-561 | ||
| S1982XA | 24 | 955-965 | S21042A | 24 | 955-965 | S22018G | 08 | 559-561 | ||
| S1982XD | 23 | 949-950 | S21042D | 23 | 949-950 | S22018K | 08 | 564-566 | ||
| S1982XS | 21 | 913-914 | S21042S | 09 | 604-605 | S22018S | 08 | 551-552 | ||
| S1983XA | Pre | 011-013 | S21049A | 09 | 604-605 | S22019A | 08 | 551-552 | ||
| S1983XA | 21 | 913-914 | S21049A | 24 | 955-965 | S22019A | 24 | 955-965 | ||
| S1983XA | 24 | 955-965 | S21049D | 23 | 949-950 | S22019B | 08 | 551-552 | ||
| S1983XD | 23 | 949-950 | S21049S | 09 | 604-605 | S22019B | 24 | 955-965 | ||
| S1983XS | 21 | 913-914 | S21051A | 09 | 604-605 | S22019D | 08 | 559-561 | ||
| S1984XA | Pre | 011-013 | S21051A | 24 | 955-965 | S22019G | 08 | 559-561 | ||
| S1984XA | 21 | 913-914 | S21051D | 23 | 949-950 | S22019K | 08 | 564-566 | ||
| S1984XA | 24 | 955-965 | S21051S | 09 | 604-605 | S22019S | 08 | 551-552 | ||
| S1984XD | 23 | 949-950 | S21052A | 09 | 604-605 | S22020A | 08 | 551-552 | ||
| S1984XS | 21 | 913-914 | S21052A | 24 | 955-965 | S22020A | 24 | 955-965 | ||
| S1985XA | Pre | 011-013 | S21052D | 23 | 949-950 | S22020B | 08 | 551-552 | ||
| S1985XA | 21 | 913-914 | S21052S | 09 | 604-605 | S22020B | 24 | 955-965 | ||
| S1985XA | 24 | 955-965 | S21059A | 09 | 604-605 | S22020D | 08 | 559-561 | ||
| S1985XD | 23 | 949-950 | S21059A | 24 | 955-965 | S22020G | 08 | 559-561 | ||
| S1985XS | 21 | 913-914 | S21059D | 23 | 949-950 | S22020K | 08 | 564-566 | ||
| S1989XA | Pre | 011-013 | S21059S | 09 | 604-605 | S22020S | 08 | 551-552 | ||
| S1989XA | 21 | 913-914 | S21101A | 09 | 604-605 | S22021A | 08 | 551-552 | ||
| S1989XA | 24 | 955-965 | S21101A | 24 | 955-965 | S22021A | 24 | 955-965 | ||
| S1989XD | 23 | 949-950 | S21101D | 23 | 949-950 | S22021B | 08 | 551-552 | ||
| S1989XS | 21 | 913-914 | S21101S | 09 | 604-605 | S22021B | 24 | 955-965 | ||
| S199XXA | Pre | 011-013 | S21102A | 09 | 604-605 | S22021D | 08 | 559-561 | ||
| S199XXA | 21 | 913-914 | S21102A | 24 | 955-965 | S22021G | 08 | 559-561 | ||
| S199XXA | 24 | 955-965 | S21102D | 23 | 949-950 | S22021K | 08 | 564-566 | ||
| S199XXD | 23 | 949-950 | S21102S | 09 | 604-605 | S22021S | 08 | 551-552 | ||
| S199XXS | 21 | 913-914 | S21109A | 09 | 604-605 | S22022A | 08 | 551-552 | ||
| S2000XA | 09 | 604-605 | S21109A | 24 | 955-965 | S22022A | 24 | 955-965 | ||
| S2000XA | 24 | 955-965 | S21109D | 23 | 949-950 | S22022B | 08 | 551-552 | ||
| S2000XD | 23 | 949-950 | S21109S | 09 | 604-605 | S22022B | 24 | 955-965 | ||
| S2000XS | 09 | 604-605 | S21111A | 09 | 604-605 | S22022D | 08 | 559-561 | ||
| S2001XA | 09 | 604-605 | S21111A | 24 | 955-965 | S22022G | 08 | 559-561 | ||
| S2001XA | 24 | 955-965 | S21111D | 23 | 949-950 | S22022K | 08 | 564-566 | ||
| S2001XD | 23 | 949-950 | S21111S | 09 | 604-605 | S22022S | 08 | 551-552 | ||
| S2001XS | 09 | 604-605 | S21112A | 09 | 604-605 | S22028A | 08 | 551-552 | ||
| S2002XA | 09 | 604-605 | S21112A | 24 | 955-965 | S22028A | 24 | 955-965 | ||
| S2002XA | 24 | 955-965 | S21112D | 23 | 949-950 | S22028B | 08 | 551-552 | ||
| S2002XD | 23 | 949-950 | S21112S | 09 | 604-605 | S22028B | 24 | 955-965 | ||
| S2002XS | 09 | 604-605 | S21119A | 09 | 604-605 | S22028D | 08 | 559-561 | ||
| S20101A | 09 | 604-605 | S21119A | 24 | 955-965 | S22028G | 08 | 559-561 | ||
| S20101A | 24 | 955-965 | S21119D | 23 | 949-950 | S22028K | 08 | 564-566 | ||
| S20101D | 23 | 949-950 | S21119S | 09 | 604-605 | S22028S | 08 | 551-552 | ||
| S20101S | 09 | 604-605 | S21121A | 21 | 913-914 | S22029A | 08 | 551-552 | ||
| S20102A | 09 | 604-605 | S21121A | 24 | 955-965 | S22029A | 24 | 955-965 | ||
| S20102A | 24 | 955-965 | S21121D | 23 | 949-950 | S22029B | 08 | 551-552 | ||
| S20102D | 23 | 949-950 | S21121S | 09 | 604-605 | S22029B | 24 | 955-965 | ||
| S20102S | 09 | 604-605 | S21122A | 21 | 913-914 | S22029D | 08 | 559-561 | ||
| S20109A | 09 | 604-605 | S21122A | 24 | 955-965 | S22029G | 08 | 559-561 | ||
| S20109A | 24 | 955-965 | S21122D | 23 | 949-950 | S22029K | 08 | 564-566 | ||
| S20109D | 23 | 949-950 | S21122S | 09 | 604-605 | S22029S | 08 | 551-552 | ||
| S20109S | 09 | 604-605 | S21129A | 21 | 913-914 | S22030A | 08 | 551-552 | ||
| S20111A | 09 | 604-605 | S21129A | 24 | 955-965 | S22030A | 24 | 955-965 | ||
| S20111A | 24 | 955-965 | S21129D | 23 | 949-950 | S22030B | 08 | 551-552 | ||
| S20111D | 23 | 949-950 | S21129S | 09 | 604-605 | S22030B | 24 | 955-965 | ||
| S20111S | 09 | 604-605 | S21131A | 09 | 604-605 | S22030D | 08 | 559-561 | ||
| S20112A | 09 | 604-605 | S21131A | 24 | 955-965 | S22030G | 08 | 559-561 | ||
| S20112A | 24 | 955-965 | S21131D | 23 | 949-950 | S22030K | 08 | 564-566 | ||
| S20112D | 23 | 949-950 | S21131S | 09 | 604-605 | S22030S | 08 | 551-552 | ||
| S20112S | 09 | 604-605 | S21132A | 09 | 604-605 | S22031A | 08 | 551-552 | ||
| S20119A | 09 | 604-605 | S21132A | 24 | 955-965 | S22031A | 24 | 955-965 | ||
| S20119A | 24 | 955-965 | S21132D | 23 | 949-950 | S22031B | 08 | 551-552 | ||
| S20119D | 23 | 949-950 | S21132S | 09 | 604-605 | S22031B | 24 | 955-965 | ||
| S20119S | 09 | 604-605 | S21139A | 09 | 604-605 | S22031D | 08 | 559-561 | ||
| S20121A | 09 | 606-607 | S21139A | 24 | 955-965 | S22031G | 08 | 559-561 | ||
| S20121A | 24 | 955-965 | S21139D | 23 | 949-950 | S22031K | 08 | 564-566 | ||
| S20121D | 23 | 949-950 | S21139S | 09 | 604-605 | S22031S | 08 | 551-552 | ||
| S20121S | 09 | 604-605 | S21141A | 21 | 913-914 | S22032A | 08 | 551-552 | ||
| S20122A | 09 | 606-607 | S21141A | 24 | 955-965 | S22032A | 24 | 955-965 | ||
| S20122A | 24 | 955-965 | S21141D | 23 | 949-950 | S22032B | 08 | 551-552 | ||
| S20122D | 23 | 949-950 | S21141S | 09 | 604-605 | S22032B | 24 | 955-965 | ||
| S20122S | 09 | 604-605 | S21142A | 21 | 913-914 | S22032D | 08 | 559-561 | ||
| S20129A | 09 | 606-607 | S21142A | 24 | 955-965 | S22032G | 08 | 559-561 | ||
| S20129A | 24 | 955-965 | S21142D | 23 | 949-950 | S22032K | 08 | 564-566 | ||
| S20129D | 23 | 949-950 | S21142S | 09 | 604-605 | S22032S | 08 | 551-552 | ||
| S20129S | 09 | 604-605 | S21149A | 21 | 913-914 | S22038A | 08 | 551-552 | ||
| S20141A | 09 | 604-605 | S21149A | 24 | 955-965 | S22038A | 24 | 955-965 | ||
| S20141A | 24 | 955-965 | S21149D | 23 | 949-950 | S22038B | 08 | 551-552 | ||
| S20141D | 23 | 949-950 | S21149S | 09 | 604-605 | S22038B | 24 | 955-965 | ||
| S20141S | 09 | 604-605 | S21151A | 09 | 604-605 | S22038D | 08 | 559-561 | ||
| S20142A | 09 | 604-605 | S21151A | 24 | 955-965 | S22038G | 08 | 559-561 | ||
| S20142A | 24 | 955-965 | S21151D | 23 | 949-950 | S22038K | 08 | 564-566 | ||
| S20142D | 23 | 949-950 | S21151S | 09 | 604-605 | S22038S | 08 | 551-552 | ||
| S20142S | 09 | 604-605 | S21152A | 09 | 604-605 | S22039A | 08 | 551-552 | ||
| S20149A | 09 | 604-605 | S21152A | 24 | 955-965 | S22039A | 24 | 955-965 | ||
| S20149A | 24 | 955-965 | S21152D | 23 | 949-950 | S22039B | 08 | 551-552 | ||
| S20149D | 23 | 949-950 | S21152S | 09 | 604-605 | S22039B | 24 | 955-965 | ||
| S20149S | 09 | 604-605 | S21159A | 09 | 604-605 | S22039D | 08 | 559-561 | ||
| S20151A | 09 | 604-605 | S21159A | 24 | 955-965 | S22039G | 08 | 559-561 | ||
| S20151A | 24 | 955-965 | S21159D | 23 | 949-950 | S22039K | 08 | 564-566 | ||
| S20151D | 23 | 949-950 | S21159S | 09 | 604-605 | S22039S | 08 | 551-552 | ||
| S20151S | 09 | 604-605 | S21201A | 09 | 604-605 | S22040A | 08 | 551-552 | ||
| S20152A | 09 | 604-605 | S21201A | 24 | 955-965 | S22040A | 24 | 955-965 | ||
| S20152A | 24 | 955-965 | S21201D | 23 | 949-950 | S22040B | 08 | 551-552 | ||
| S20152D | 23 | 949-950 | S21201S | 09 | 604-605 | S22040B | 24 | 955-965 | ||
| S20152S | 09 | 604-605 | S21202A | 09 | 604-605 | S22040D | 08 | 559-561 | ||
| S20159A | 09 | 604-605 | S21202A | 24 | 955-965 | S22040G | 08 | 559-561 | ||
| S20159A | 24 | 955-965 | S21202D | 23 | 949-950 | S22040K | 08 | 564-566 | ||
| S20159D | 23 | 949-950 | S21202S | 09 | 604-605 | S22040S | 08 | 551-552 | ||
| S20159S | 09 | 604-605 | S21209A | 09 | 604-605 | S22041A | 08 | 551-552 | ||
| S20161A | 09 | 606-607 | S21209A | 24 | 955-965 | S22041A | 24 | 955-965 | ||
| S20161A | 24 | 955-965 | S21209D | 23 | 949-950 | S22041B | 08 | 551-552 | ||
| S20161D | 23 | 949-950 | S21209S | 09 | 604-605 | S22041B | 24 | 955-965 | ||
| S20161S | 09 | 604-605 | S21211A | 09 | 604-605 | S22041D | 08 | 559-561 | ||
| S20162A | 09 | 606-607 | S21211A | 24 | 955-965 | S22041G | 08 | 559-561 | ||
| S20162A | 24 | 955-965 | S21211D | 23 | 949-950 | S22041K | 08 | 564-566 | ||
| S20162D | 23 | 949-950 | S21211S | 09 | 604-605 | S22041S | 08 | 551-552 | ||
| S20162S | 09 | 604-605 | S21212A | 09 | 604-605 | S22042A | 08 | 551-552 | ||
| S20169A | 09 | 606-607 | S21212A | 24 | 955-965 | S22042A | 24 | 955-965 | ||
| S20169A | 24 | 955-965 | S21212D | 23 | 949-950 | S22042B | 08 | 551-552 | ||
| S20169D | 23 | 949-950 | S21212S | 09 | 604-605 | S22042B | 24 | 955-965 | ||
| S20169S | 09 | 604-605 | S21219A | 09 | 604-605 | S22042D | 08 | 559-561 | ||
| S20171A | 09 | 604-605 | S21219A | 24 | 955-965 | S22042G | 08 | 559-561 | ||
| S20171A | 24 | 955-965 | S21219D | 23 | 949-950 | S22042K | 08 | 564-566 | ||
| S20171D | 23 | 949-950 | S21219S | 09 | 604-605 | S22042S | 08 | 551-552 | ||
| S20171S | 09 | 604-605 | S21221A | 09 | 604-605 | S22048A | 08 | 551-552 | ||
| S20172A | 09 | 604-605 | S21221A | 24 | 955-965 | S22048A | 24 | 955-965 | ||
| S20172A | 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 |