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 41 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S53025D | 23 | 949-950 | S55109D | 23 | 949-950 | S56321D | 23 | 949-950 | ||
| S53025S | 08 | 562-563 | S55109S | 05 | 299-301 | S56321S | 09 | 604-605 | ||
| S53026A | 08 | 562-563 | S55111A | 21 | 913-914 | S56322A | 08 | 564-566 | ||
| S53026A | 24 | 955-965 | S55111A | 24 | 955-965 | S56322A | 24 | 955-965 | ||
| S53026D | 23 | 949-950 | S55111D | 23 | 949-950 | S56322D | 23 | 949-950 | ||
| S53026S | 08 | 562-563 | S55111S | 05 | 299-301 | S56322S | 09 | 604-605 | ||
| S53031A | 08 | 562-563 | S55112A | 21 | 913-914 | S56329A | 08 | 564-566 | ||
| S53031A | 24 | 955-965 | S55112A | 24 | 955-965 | S56329A | 24 | 955-965 | ||
| S53031D | 23 | 949-950 | S55112D | 23 | 949-950 | S56329D | 23 | 949-950 | ||
| S53031S | 08 | 562-563 | S55112S | 05 | 299-301 | S56329S | 09 | 604-605 | ||
| S53032A | 08 | 562-563 | S55119A | 21 | 913-914 | S56391A | 21 | 913-914 | ||
| S53032A | 24 | 955-965 | S55119A | 24 | 955-965 | S56391A | 24 | 955-965 | ||
| S53032D | 23 | 949-950 | S55119D | 23 | 949-950 | S56391D | 23 | 949-950 | ||
| S53032S | 08 | 562-563 | S55119S | 05 | 299-301 | S56391S | 21 | 913-914 | ||
| S53033A | 08 | 562-563 | S55191A | 21 | 913-914 | S56392A | 21 | 913-914 | ||
| S53033A | 24 | 955-965 | S55191A | 24 | 955-965 | S56392A | 24 | 955-965 | ||
| S53033D | 23 | 949-950 | S55191D | 23 | 949-950 | S56392D | 23 | 949-950 | ||
| S53033S | 08 | 562-563 | S55191S | 05 | 299-301 | S56392S | 21 | 913-914 | ||
| S53091A | 08 | 562-563 | S55192A | 21 | 913-914 | S56399A | 21 | 913-914 | ||
| S53091A | 24 | 955-965 | S55192A | 24 | 955-965 | S56399A | 24 | 955-965 | ||
| S53091D | 23 | 949-950 | S55192D | 23 | 949-950 | S56399D | 23 | 949-950 | ||
| S53091S | 08 | 562-563 | S55192S | 05 | 299-301 | S56399S | 21 | 913-914 | ||
| S53092A | 08 | 562-563 | S55199A | 21 | 913-914 | S56401A | 21 | 913-914 | ||
| S53092A | 24 | 955-965 | S55199A | 24 | 955-965 | S56401A | 24 | 955-965 | ||
| S53092D | 23 | 949-950 | S55199D | 23 | 949-950 | S56401D | 23 | 949-950 | ||
| S53092S | 08 | 562-563 | S55199S | 05 | 299-301 | S56401S | 21 | 913-914 | ||
| S53093A | 08 | 562-563 | S55201A | 21 | 913-914 | S56402A | 21 | 913-914 | ||
| S53093A | 24 | 955-965 | S55201A | 24 | 955-965 | S56402A | 24 | 955-965 | ||
| S53093D | 23 | 949-950 | S55201D | 23 | 949-950 | S56402D | 23 | 949-950 | ||
| S53093S | 08 | 562-563 | S55201S | 05 | 299-301 | S56402S | 21 | 913-914 | ||
| S53094A | 08 | 562-563 | S55202A | 21 | 913-914 | S56403A | 21 | 913-914 | ||
| S53094A | 24 | 955-965 | S55202A | 24 | 955-965 | S56403A | 24 | 955-965 | ||
| S53094D | 23 | 949-950 | S55202D | 23 | 949-950 | S56403D | 23 | 949-950 | ||
| S53094S | 08 | 562-563 | S55202S | 05 | 299-301 | S56403S | 21 | 913-914 | ||
| S53095A | 08 | 562-563 | S55209A | 21 | 913-914 | S56404A | 21 | 913-914 | ||
| S53095A | 24 | 955-965 | S55209A | 24 | 955-965 | S56404A | 24 | 955-965 | ||
| S53095D | 23 | 949-950 | S55209D | 23 | 949-950 | S56404D | 23 | 949-950 | ||
| S53095S | 08 | 562-563 | S55209S | 05 | 299-301 | S56404S | 21 | 913-914 | ||
| S53096A | 08 | 562-563 | S55211A | 21 | 913-914 | S56405A | 21 | 913-914 | ||
| S53096A | 24 | 955-965 | S55211A | 24 | 955-965 | S56405A | 24 | 955-965 | ||
| S53096D | 23 | 949-950 | S55211D | 23 | 949-950 | S56405D | 23 | 949-950 | ||
| S53096S | 08 | 562-563 | S55211S | 05 | 299-301 | S56405S | 21 | 913-914 | ||
| S53101A | 08 | 562-563 | S55212A | 21 | 913-914 | S56406A | 21 | 913-914 | ||
| S53101A | 24 | 955-965 | S55212A | 24 | 955-965 | S56406A | 24 | 955-965 | ||
| S53101D | 23 | 949-950 | S55212D | 23 | 949-950 | S56406D | 23 | 949-950 | ||
| S53101S | 08 | 562-563 | S55212S | 05 | 299-301 | S56406S | 21 | 913-914 | ||
| S53102A | 08 | 562-563 | S55219A | 21 | 913-914 | S56407A | 21 | 913-914 | ||
| S53102A | 24 | 955-965 | S55219A | 24 | 955-965 | S56407A | 24 | 955-965 | ||
| S53102D | 23 | 949-950 | S55219D | 23 | 949-950 | S56407D | 23 | 949-950 | ||
| S53102S | 08 | 562-563 | S55219S | 05 | 299-301 | S56407S | 21 | 913-914 | ||
| S53103A | 08 | 562-563 | S55291A | 21 | 913-914 | S56408A | 21 | 913-914 | ||
| S53103A | 24 | 955-965 | S55291A | 24 | 955-965 | S56408A | 24 | 955-965 | ||
| S53103D | 23 | 949-950 | S55291D | 23 | 949-950 | S56408D | 23 | 949-950 | ||
| S53103S | 08 | 562-563 | S55291S | 05 | 299-301 | S56408S | 21 | 913-914 | ||
| S53104A | 08 | 562-563 | S55292A | 21 | 913-914 | S56409A | 21 | 913-914 | ||
| S53104A | 24 | 955-965 | S55292A | 24 | 955-965 | S56409A | 24 | 955-965 | ||
| S53104D | 23 | 949-950 | S55292D | 23 | 949-950 | S56409D | 23 | 949-950 | ||
| S53104S | 08 | 562-563 | S55292S | 05 | 299-301 | S56409S | 21 | 913-914 | ||
| S53105A | 08 | 562-563 | S55299A | 21 | 913-914 | S56411A | 08 | 562-563 | ||
| S53105A | 24 | 955-965 | S55299A | 24 | 955-965 | S56411A | 24 | 955-965 | ||
| S53105D | 23 | 949-950 | S55299D | 23 | 949-950 | S56411D | 23 | 949-950 | ||
| S53105S | 08 | 562-563 | S55299S | 05 | 299-301 | S56411S | 08 | 562-563 | ||
| S53106A | 08 | 562-563 | S55801A | 21 | 913-914 | S56412A | 08 | 562-563 | ||
| S53106A | 24 | 955-965 | S55801A | 24 | 955-965 | S56412A | 24 | 955-965 | ||
| S53106D | 23 | 949-950 | S55801D | 23 | 949-950 | S56412D | 23 | 949-950 | ||
| S53106S | 08 | 562-563 | S55801S | 05 | 299-301 | S56412S | 08 | 562-563 | ||
| S53111A | 08 | 562-563 | S55802A | 21 | 913-914 | S56413A | 08 | 562-563 | ||
| S53111A | 24 | 955-965 | S55802A | 24 | 955-965 | S56413A | 24 | 955-965 | ||
| S53111D | 23 | 949-950 | S55802D | 23 | 949-950 | S56413D | 23 | 949-950 | ||
| S53111S | 08 | 562-563 | S55802S | 05 | 299-301 | S56413S | 08 | 562-563 | ||
| S53112A | 08 | 562-563 | S55809A | 21 | 913-914 | S56414A | 08 | 562-563 | ||
| S53112A | 24 | 955-965 | S55809A | 24 | 955-965 | S56414A | 24 | 955-965 | ||
| S53112D | 23 | 949-950 | S55809D | 23 | 949-950 | S56414D | 23 | 949-950 | ||
| S53112S | 08 | 562-563 | S55809S | 05 | 299-301 | S56414S | 08 | 562-563 | ||
| S53113A | 08 | 562-563 | S55811A | 21 | 913-914 | S56415A | 08 | 562-563 | ||
| S53113A | 24 | 955-965 | S55811A | 24 | 955-965 | S56415A | 24 | 955-965 | ||
| S53113D | 23 | 949-950 | S55811D | 23 | 949-950 | S56415D | 23 | 949-950 | ||
| S53113S | 08 | 562-563 | S55811S | 05 | 299-301 | S56415S | 08 | 562-563 | ||
| S53114A | 08 | 562-563 | S55812A | 21 | 913-914 | S56416A | 08 | 562-563 | ||
| S53114A | 24 | 955-965 | S55812A | 24 | 955-965 | S56416A | 24 | 955-965 | ||
| S53114D | 23 | 949-950 | S55812D | 23 | 949-950 | S56416D | 23 | 949-950 | ||
| S53114S | 08 | 562-563 | S55812S | 05 | 299-301 | S56416S | 08 | 562-563 | ||
| S53115A | 08 | 562-563 | S55819A | 21 | 913-914 | S56417A | 08 | 562-563 | ||
| S53115A | 24 | 955-965 | S55819A | 24 | 955-965 | S56417A | 24 | 955-965 | ||
| S53115D | 23 | 949-950 | S55819D | 23 | 949-950 | S56417D | 23 | 949-950 | ||
| S53115S | 08 | 562-563 | S55819S | 05 | 299-301 | S56417S | 08 | 562-563 | ||
| S53116A | 08 | 562-563 | S55891A | 21 | 913-914 | S56418A | 08 | 562-563 | ||
| S53116A | 24 | 955-965 | S55891A | 24 | 955-965 | S56418A | 24 | 955-965 | ||
| S53116D | 23 | 949-950 | S55891D | 23 | 949-950 | S56418D | 23 | 949-950 | ||
| S53116S | 08 | 562-563 | S55891S | 05 | 299-301 | S56418S | 08 | 562-563 | ||
| S53121A | 08 | 562-563 | S55892A | 21 | 913-914 | S56419A | 08 | 562-563 | ||
| S53121A | 24 | 955-965 | S55892A | 24 | 955-965 | S56419A | 24 | 955-965 | ||
| S53121D | 23 | 949-950 | S55892D | 23 | 949-950 | S56419D | 23 | 949-950 | ||
| S53121S | 08 | 562-563 | S55892S | 05 | 299-301 | S56419S | 08 | 562-563 | ||
| S53122A | 08 | 562-563 | S55899A | 21 | 913-914 | S56421A | 08 | 564-566 | ||
| S53122A | 24 | 955-965 | S55899A | 24 | 955-965 | S56421A | 24 | 955-965 | ||
| S53122D | 23 | 949-950 | S55899D | 23 | 949-950 | S56421D | 23 | 949-950 | ||
| S53122S | 08 | 562-563 | S55899S | 05 | 299-301 | S56421S | 09 | 604-605 | ||
| S53123A | 08 | 562-563 | S55901A | 21 | 913-914 | S56422A | 08 | 564-566 | ||
| S53123A | 24 | 955-965 | S55901A | 24 | 955-965 | S56422A | 24 | 955-965 | ||
| S53123D | 23 | 949-950 | S55901D | 23 | 949-950 | S56422D | 23 | 949-950 | ||
| S53123S | 08 | 562-563 | S55901S | 05 | 299-301 | S56422S | 09 | 604-605 | ||
| S53124A | 08 | 562-563 | S55902A | 21 | 913-914 | S56423A | 08 | 564-566 | ||
| S53124A | 24 | 955-965 | S55902A | 24 | 955-965 | S56423A | 24 | 955-965 | ||
| S53124D | 23 | 949-950 | S55902D | 23 | 949-950 | S56423D | 23 | 949-950 | ||
| S53124S | 08 | 562-563 | S55902S | 05 | 299-301 | S56423S | 09 | 604-605 | ||
| S53125A | 08 | 562-563 | S55909A | 21 | 913-914 | S56424A | 08 | 564-566 | ||
| S53125A | 24 | 955-965 | S55909A | 24 | 955-965 | S56424A | 24 | 955-965 | ||
| S53125D | 23 | 949-950 | S55909D | 23 | 949-950 | S56424D | 23 | 949-950 | ||
| S53125S | 08 | 562-563 | S55909S | 05 | 299-301 | S56424S | 09 | 604-605 | ||
| S53126A | 08 | 562-563 | S55911A | 21 | 913-914 | S56425A | 08 | 564-566 | ||
| S53126A | 24 | 955-965 | S55911A | 24 | 955-965 | S56425A | 24 | 955-965 | ||
| S53126D | 23 | 949-950 | S55911D | 23 | 949-950 | S56425D | 23 | 949-950 | ||
| S53126S | 08 | 562-563 | S55911S | 05 | 299-301 | S56425S | 09 | 604-605 | ||
| S53131A | 08 | 562-563 | S55912A | 21 | 913-914 | S56426A | 08 | 564-566 | ||
| S53131A | 24 | 955-965 | S55912A | 24 | 955-965 | S56426A | 24 | 955-965 | ||
| S53131D | 23 | 949-950 | S55912D | 23 | 949-950 | S56426D | 23 | 949-950 | ||
| S53131S | 08 | 562-563 | S55912S | 05 | 299-301 | S56426S | 09 | 604-605 | ||
| S53132A | 08 | 562-563 | S55919A | 21 | 913-914 | S56427A | 08 | 564-566 | ||
| S53132A | 24 | 955-965 | S55919A | 24 | 955-965 | S56427A | 24 | 955-965 | ||
| S53132D | 23 | 949-950 | S55919D | 23 | 949-950 | S56427D | 23 | 949-950 | ||
| S53132S | 08 | 562-563 | S55919S | 05 | 299-301 | S56427S | 09 | 604-605 | ||
| S53133A | 08 | 562-563 | S55991A | 21 | 913-914 | S56428A | 08 | 564-566 | ||
| S53133A | 24 | 955-965 | S55991A | 24 | 955-965 | S56428A | 24 | 955-965 | ||
| S53133D | 23 | 949-950 | S55991D | 23 | 949-950 | S56428D | 23 | 949-950 | ||
| S53133S | 08 | 562-563 | S55991S | 05 | 299-301 | S56428S | 09 | 604-605 | ||
| S53134A | 08 | 562-563 | S55992A | 21 | 913-914 | S56429A | 08 | 564-566 | ||
| S53134A | 24 | 955-965 | S55992A | 24 | 955-965 | S56429A | 24 | 955-965 | ||
| S53134D | 23 | 949-950 | S55992D | 23 | 949-950 | S56429D | 23 | 949-950 | ||
| S53134S | 08 | 562-563 | S55992S | 05 | 299-301 | S56429S | 09 | 604-605 | ||
| S53135A | 08 | 562-563 | S55999A | 21 | 913-914 | S56491A | 21 | 913-914 | ||
| S53135A | 24 | 955-965 | S55999A | 24 | 955-965 | S56491A | 24 | 955-965 | ||
| S53135D | 23 | 949-950 | S55999D | 23 | 949-950 | S56491D | 23 | 949-950 | ||
| S53135S | 08 | 562-563 | S55999S | 05 | 299-301 | S56491S | 21 | 913-914 | ||
| S53136A | 08 | 562-563 | S56001A | 21 | 913-914 | S56492A | 21 | 913-914 | ||
| S53136A | 24 | 955-965 | S56001A | 24 | 955-965 | S56492A | 24 | 955-965 | ||
| S53136D | 23 | 949-950 | S56001D | 23 | 949-950 | S56492D | 23 | 949-950 | ||
| S53136S | 08 | 562-563 | S56001S | 21 | 913-914 | S56492S | 21 | 913-914 | ||
| S53141A | 08 | 562-563 | S56002A | 21 | 913-914 | S56493A | 21 | 913-914 | ||
| S53141A | 24 | 955-965 | S56002A | 24 | 955-965 | S56493A | 24 | 955-965 | ||
| S53141D | 23 | 949-950 | S56002D | 23 | 949-950 | S56493D | 23 | 949-950 | ||
| S53141S | 08 | 562-563 | S56002S | 21 | 913-914 | S56493S | 21 | 913-914 | ||
| S53142A | 08 | 562-563 | S56009A | 21 | 913-914 | S56494A | 21 | 913-914 | ||
| S53142A | 24 | 955-965 | S56009A | 24 | 955-965 | S56494A | 24 | 955-965 | ||
| S53142D | 23 | 949-950 | S56009D | 23 | 949-950 | S56494D | 23 | 949-950 | ||
| S53142S | 08 | 562-563 | S56009S | 21 | 913-914 | S56494S | 21 | 913-914 | ||
| S53143A | 08 | 562-563 | S56011A | 08 | 562-563 | S56495A | 21 | 913-914 | ||
| S53143A | 24 | 955-965 | S56011A | 24 | 955-965 | S56495A | 24 | 955-965 | ||
| S53143D | 23 | 949-950 | S56011D | 23 | 949-950 | S56495D | 23 | 949-950 | ||
| S53143S | 08 | 562-563 | S56011S | 08 | 562-563 | S56495S | 21 | 913-914 | ||
| S53144A | 08 | 562-563 | S56012A | 08 | 562-563 | S56496A | 21 | 913-914 | ||
| S53144A | 24 | 955-965 | S56012A | 24 | 955-965 | S56496A | 24 | 955-965 | ||
| S53144D | 23 | 949-950 | S56012D | 23 | 949-950 | S56496D | 23 | 949-950 | ||
| S53144S | 08 | 562-563 | S56012S | 08 | 562-563 | S56496S | 21 | 913-914 | ||
| S53145A | 08 | 562-563 | S56019A | 08 | 562-563 | S56497A | 21 | 913-914 | ||
| S53145A | 24 | 955-965 | S56019A | 24 | 955-965 | S56497A | 24 | 955-965 | ||
| S53145D | 23 | 949-950 | S56019D | 23 | 949-950 | S56497D | 23 | 949-950 | ||
| S53145S | 08 | 562-563 | S56019S | 08 | 562-563 | S56497S | 21 | 913-914 | ||
| S53146A | 08 | 562-563 | S56021A | 08 | 564-566 | S56498A | 21 | 913-914 | ||
| S53146A | 24 | 955-965 | S56021A | 24 | 955-965 | S56498A | 24 | 955-965 | ||
| S53146D | 23 | 949-950 | S56021D | 23 | 949-950 | S56498D | 23 | 949-950 | ||
| S53146S | 08 | 562-563 | S56021S | 09 | 604-605 | S56498S | 21 | 913-914 | ||
| S53191A | 08 | 562-563 | S56022A | 08 | 564-566 | S56499A | 21 | 913-914 | ||
| S53191A | 24 | 955-965 | S56022A | 24 | 955-965 | S56499A | 24 | 955-965 | ||
| S53191D | 23 | 949-950 | S56022D | 23 | 949-950 | S56499D | 23 | 949-950 | ||
| S53191S | 08 | 562-563 | S56022S | 09 | 604-605 | S56499S | 21 | 913-914 | ||
| S53192A | 08 | 562-563 | S56029A | 08 | 564-566 | S56501A | 21 | 913-914 | ||
| S53192A | 24 | 955-965 | S56029A | 24 | 955-965 | S56501A | 24 | 955-965 | ||
| S53192D | 23 | 949-950 | S56029D | 23 | 949-950 | S56501D | 23 | 949-950 | ||
| S53192S | 08 | 562-563 | S56029S | 09 | 604-605 | S56501S | 21 | 913-914 | ||
| S53193A | 08 | 562-563 | S56091A | 21 | 913-914 | S56502A | 21 | 913-914 | ||
| S53193A | 24 | 955-965 | S56091A | 24 | 955-965 | S56502A | 24 | 955-965 | ||
| S53193D | 23 | 949-950 | S56091D | 23 | 949-950 | S56502D | 23 | 949-950 | ||
| S53193S | 08 | 562-563 | S56091S | 21 | 913-914 | S56502S | 21 | 913-914 | ||
| S53194A | 08 | 562-563 | S56092A | 21 | 913-914 | S56509A | 21 | 913-914 | ||
| S53194A | 24 | 955-965 | S56092A | 24 | 955-965 | S56509A | 24 | 955-965 | ||
| S53194D | 23 | 949-950 | S56092D | 23 | 949-950 | S56509D | 23 | 949-950 | ||
| S53194S | 08 | 562-563 | S56092S | 21 | 913-914 | S56509S | 21 | 913-914 | ||
| S53195A | 08 | 562-563 | S56099A | 21 | 913-914 | S56511A | 08 | 562-563 | ||
| S53195A | 24 | 955-965 | S56099A | 24 | 955-965 | S56511A | 24 | 955-965 | ||
| S53195D | 23 | 949-950 | S56099D | 23 | 949-950 | S56511D | 23 | 949-950 | ||
| S53195S | 08 | 562-563 | S56099S | 21 | 913-914 | S56511S | 08 | 562-563 | ||
| S53196A | 08 | 562-563 | S56101A | 21 | 913-914 | S56512A | 08 | 562-563 | ||
| S53196A | 24 | 955-965 | S56101A | 24 | 955-965 | S56512A | 24 | 955-965 | ||
| S53196D | 23 | 949-950 | S56101D | 23 | 949-950 | S56512D | 23 | 949-950 | ||
| S53196S | 08 | 562-563 | S56101S | 21 | 913-914 | S56512S | 08 | 562-563 | ||
| S5320XA | 08 | 562-563 | S56102A | 21 | 913-914 | S56519A | 08 | 562-563 | ||
| S5320XA | 24 | 955-965 | S56102A | 24 | 955-965 | S56519A | 24 | 955-965 | ||
| S5320XD | 23 | 949-950 | S56102D | 23 | 949-950 | S56519D | 23 | 949-950 | ||
| S5320XS | 08 | 562-563 | S56102S | 21 | 913-914 | S56519S | 08 | 562-563 | ||
| S5321XA | 08 | 562-563 | S56103A | 21 | 913-914 | S56521A | 08 | 564-566 | ||
| S5321XA | 24 | 955-965 | S56103A | 24 | 955-965 | S56521A | 24 | 955-965 | ||
| S5321XD | 23 | 949-950 | S56103D | 23 | 949-950 | S56521D | 23 | 949-950 | ||
| S5321XS | 08 | 562-563 | S56103S | 21 | 913-914 | S56521S | 09 | 604-605 | ||
| S5322XA | 08 | 562-563 | S56104A | 21 | 913-914 | S56522A | 08 | 564-566 | ||
| S5322XA | 24 | 955-965 | S56104A | 24 | 955-965 | S56522A | 24 | 955-965 | ||
| S5322XD | 23 | 949-950 | S56104D | 23 | 949-950 | S56522D | 23 | 949-950 | ||
| S5322XS | 08 | 562-563 | S56104S | 21 | 913-914 | S56522S | 09 | 604-605 | ||
| S5330XA | 08 | 562-563 | S56105A | 21 | 913-914 | S56529A | 08 | 564-566 | ||
| S5330XA | 24 | 955-965 | S56105A | 24 | 955-965 | S56529A | 24 | 955-965 | ||
| S5330XD | 23 | 949-950 | S56105D | 23 | 949-950 | S56529D | 23 | 949-950 | ||
| S5330XS | 08 | 562-563 | S56105S | 21 | 913-914 | S56529S | 09 | 604-605 | ||
| S5331XA | 08 | 562-563 | S56106A | 21 | 913-914 | S56591A | 21 | 913-914 | ||
| S5331XA | 24 | 955-965 | S56106A | 24 | 955-965 | S56591A | 24 | 955-965 | ||
| S5331XD | 23 | 949-950 | S56106D | 23 | 949-950 | S56591D | 23 | 949-950 | ||
| S5331XS | 08 | 562-563 | S56106S | 21 | 913-914 | S56591S | 21 | 913-914 | ||
| S5332XA | 08 | 562-563 | S56107A | 21 | 913-914 | S56592A | 21 | 913-914 | ||
| S5332XA | 24 | 955-965 | S56107A | 24 | 955-965 | S56592A | 24 | 955-965 | ||
| S5332XD | 23 | 949-950 | S56107D | 23 | 949-950 | S56592D | 23 | 949-950 | ||
| S5332XS | 08 | 562-563 | S56107S | 21 | 913-914 | S56592S | 21 | 913-914 | ||
| S53401A | 08 | 562-563 | S56108A | 21 | 913-914 | S56599A | 21 | 913-914 | ||
| S53401A | 24 | 955-965 | S56108A | 24 | 955-965 | S56599A | 24 | 955-965 | ||
| S53401D | 23 | 949-950 | S56108D | 23 | 949-950 | S56599D | 23 | 949-950 | ||
| S53401S | 08 | 562-563 | S56108S | 21 | 913-914 | S56599S | 21 | 913-914 | ||
| S53402A | 08 | 562-563 | S56109A | 21 | 913-914 | S56801A | 21 | 913-914 | ||
| S53402A | 24 | 955-965 | S56109A | 24 | 955-965 | S56801A | 24 | 955-965 | ||
| S53402D | 23 | 949-950 | S56109D | 23 | 949-950 | S56801D | 23 | 949-950 | ||
| S53402S | 08 | 562-563 | S56109S | 21 | 913-914 | S56801S | 21 | 913-914 | ||
| S53409A | 08 | 562-563 | S56111A | 08 | 562-563 | S56802A | 21 | 913-914 | ||
| S53409A | 24 | 955-965 | S56111A | 24 | 955-965 | S56802A | 24 | 955-965 | ||
| S53409D | 23 | 949-950 | S56111D | 23 | 949-950 | S56802D | 23 | 949-950 | ||
| S53409S | 08 | 562-563 | S56111S | 08 | 562-563 | S56802S | 21 | 913-914 | ||
| S53411A | 08 | 562-563 | S56112A | 08 | 562-563 | S56809A | 21 | 913-914 | ||
| S53411A | 24 | 955-965 | S56112A | 24 | 955-965 | S56809A | 24 | 955-965 | ||
| S53411D | 23 | 949-950 | S56112D | 23 | 949-950 | S56809D | 23 | 949-950 | ||
| S53411S | 08 | 562-563 | S56112S | 08 | 562-563 | S56809S | 21 | 913-914 | ||
| S53412A | 08 | 562-563 | S56113A | 08 | 562-563 | S56811A | 08 | 562-563 | ||
| S53412A | 24 | 955-965 | S56113A | 24 | 955-965 | S56811A | 24 | 955-965 | ||
| S53412D | 23 | 949-950 | S56113D | 23 | 949-950 | S56811D | 23 | 949-950 | ||
| S53412S | 08 | 562-563 | S56113S | 08 | 562-563 | S56811S | 08 | 562-563 | ||
| S53419A | 08 | 562-563 | S56114A | 08 | 562-563 | S56812A | 08 | 562-563 | ||
| S53419A | 24 | 955-965 | S56114A | 24 | 955-965 | S56812A | 24 | 955-965 | ||
| S53419D | 23 | 949-950 | S56114D | 23 | 949-950 | S56812D | 23 | 949-950 | ||
| S53419S | 08 | 562-563 | S56114S | 08 | 562-563 | S56812S | 08 | 562-563 | ||
| S53421A | 08 | 562-563 | S56115A | 08 | 562-563 | S56819A | 08 | 562-563 | ||
| S53421A | 24 | 955-965 | S56115A | 24 | 955-965 | S56819A | 24 | 955-965 | ||
| S53421D | 23 | 949-950 | S56115D | 23 | 949-950 | S56819D | 23 | 949-950 | ||
| S53421S | 08 | 562-563 | S56115S | 08 | 562-563 | S56819S | 08 | 562-563 | ||
| S53422A | 08 | 562-563 | S56116A | 08 | 562-563 | S56821A | 08 | 564-566 | ||
| S53422A | 24 | 955-965 | S56116A | 24 | 955-965 | S56821A | 24 | 955-965 | ||
| S53422D | 23 | 949-950 | S56116D | 23 | 949-950 | S56821D | 23 | 949-950 | ||
| S53422S | 08 | 562-563 | S56116S | 08 | 562-563 | S56821S | 09 | 604-605 | ||
| S53429A | 08 | 562-563 | S56117A | 08 | 562-563 | S56822A | 08 | 564-566 | ||
| S53429A | 24 | 955-965 | S56117A | 24 | 955-965 | S56822A | 24 | 955-965 | ||
| S53429D | 23 | 949-950 | S56117D | 23 | 949-950 | S56822D | 23 | 949-950 | ||
| S53429S | 08 | 562-563 | S56117S | 08 | 562-563 | S56822S | 09 | 604-605 | ||
| S53431A | 08 | 562-563 | S56118A | 08 | 562-563 | S56829A | 08 | 564-566 | ||
| S53431A | 24 | 955-965 | S56118A | 24 | 955-965 | S56829A | 24 | 955-965 | ||
| S53431D | 23 | 949-950 | S56118D | 23 | 949-950 | S56829D | 23 | 949-950 | ||
| S53431S | 08 | 562-563 | S56118S | 08 | 562-563 | S56829S | 09 | 604-605 | ||
| S53432A | 08 | 562-563 | S56119A | 08 | 562-563 | S56891A | 21 | 913-914 | ||
| S53432A | 24 | 955-965 | S56119A | 24 | 955-965 | S56891A | 24 | 955-965 | ||
| S53432D | 23 | 949-950 | S56119D | 23 | 949-950 | S56891D | 23 | 949-950 | ||
| S53432S | 08 | 562-563 | S56119S | 08 | 562-563 | S56891S | 21 | 913-914 | ||
| S53439A | 08 | 562-563 | S56121A | 08 | 564-566 | S56892A | 21 | 913-914 | ||
| S53439A | 24 | 955-965 | S56121A | 24 | 955-965 | S56892A | 24 | 955-965 | ||
| S53439D | 23 | 949-950 | S56121D | 23 | 949-950 | S56892D | 23 | 949-950 | ||
| S53439S | 08 | 562-563 | S56121S | 09 | 604-605 | S56892S | 21 | 913-914 | ||
| S53441A | 08 | 562-563 | S56122A | 08 | 564-566 | S56899A | 21 | 913-914 | ||
| S53441A | 24 | 955-965 | S56122A | 24 | 955-965 | S56899A | 24 | 955-965 | ||
| S53441D | 23 | 949-950 | S56122D | 23 | 949-950 | S56899D | 23 | 949-950 | ||
| S53441S | 08 | 562-563 | S56122S | 09 | 604-605 | S56899S | 21 | 913-914 | ||
| S53442A | 08 | 562-563 | S56123A | 08 | 564-566 | S56901A | 21 | 913-914 | ||
| S53442A | 24 | 955-965 | S56123A | 24 | 955-965 | S56901A | 24 | 955-965 | ||
| S53442D | 23 | 949-950 | S56123D | 23 | 949-950 | S56901D | 23 | 949-950 | ||
| S53442S | 08 | 562-563 | S56123S | 09 | 604-605 | S56901S | 21 | 913-914 | ||
| S53449A | 08 | 562-563 | S56124A | 08 | 564-566 | S56902A | 21 | 913-914 | ||
| S53449A | 24 | 955-965 | S56124A | 24 | 955-965 | S56902A | 24 | 955-965 | ||
| S53449D | 23 | 949-950 | S56124D | 23 | 949-950 | S56902D | 23 | 949-950 | ||
| S53449S | 08 | 562-563 | S56124S | 09 | 604-605 | S56902S | 21 | 913-914 | ||
| S53491A | 08 | 562-563 | S56125A | 08 | 564-566 | S56909A | 21 | 913-914 | ||
| S53491A | 24 | 955-965 | S56125A | 24 | 955-965 | S56909A | 24 | 955-965 | ||
| S53491D | 23 | 949-950 | S56125D | 23 | 949-950 | S56909D | 23 | 949-950 | ||
| S53491S | 08 | 562-563 | S56125S | 09 | 604-605 | S56909S | 21 | 913-914 | ||
| S53492A | 08 | 562-563 | S56126A | 08 | 564-566 | S56911A | 08 | 562-563 | ||
| S53492A | 24 | 955-965 | S56126A | 24 | 955-965 | S56911A | 24 | 955-965 | ||
| S53492D | 23 | 949-950 | S56126D | 23 | 949-950 | S56911D | 23 | 949-950 | ||
| S53492S | 08 | 562-563 | S56126S | 09 | 604-605 | S56911S | 08 | 562-563 | ||
| S53499A | 08 | 562-563 | S56127A | 08 | 564-566 | S56912A | 08 | 562-563 | ||
| S53499A | 24 | 955-965 | S56127A | 24 | 955-965 | S56912A | 24 | 955-965 | ||
| S53499D | 23 | 949-950 | S56127D | 23 | 949-950 | S56912D | 23 | 949-950 | ||
| S53499S | 08 | 562-563 | S56127S | 09 | 604-605 | S56912S | 08 | 562-563 | ||
| S5400XA | 01 | 073-074 | S56128A | 08 | 564-566 | S56919A | 08 | 562-563 | ||
| S5400XA | 24 | 955-965 | S56128A | 24 | 955-965 | S56919A | 24 | 955-965 | ||
| S5400XD | 23 | 949-950 | S56128D | 23 | 949-950 | S56919D | 23 | 949-950 | ||
| S5400XS | 01 | 091-093 | S56128S | 09 | 604-605 | S56919S | 08 | 562-563 | ||
| S5401XA | 01 | 073-074 | S56129A | 08 | 564-566 | S56921A | 08 | 564-566 | ||
| S5401XA | 24 | 955-965 | S56129A | 24 | 955-965 | S56921A | 24 | 955-965 | ||
| S5401XD | 23 | 949-950 | S56129D | 23 | 949-950 | S56921D | 23 | 949-950 | ||
| S5401XS | 01 | 091-093 | S56129S | 09 | 604-605 | S56921S | 09 | 604-605 | ||
| S5402XA | 01 | 073-074 | S56191A | 21 | 913-914 | S56922A | 08 | 564-566 | ||
| S5402XA | 24 | 955-965 | S56191A | 24 | 955-965 | S56922A | 24 | 955-965 | ||
| S5402XD | 23 | 949-950 | S56191D | 23 | 949-950 | S56922D | 23 | 949-950 | ||
| S5402XS | 01 | 091-093 | S56191S | 21 | 913-914 | S56922S | 09 | 604-605 | ||
| S5410XA | 01 | 073-074 | S56192A | 21 | 913-914 | S56929A | 08 | 564-566 | ||
| S5410XA | 24 | 955-965 | S56192A | 24 | 955-965 | S56929A | 24 | 955-965 | ||
| S5410XD | 23 | 949-950 | S56192D | 23 | 949-950 | S56929D | 23 | 949-950 | ||
| S5410XS | 01 | 091-093 | S56192S | 21 | 913-914 | S56929S | 09 | 604-605 | ||
| S5411XA | 01 | 073-074 | S56193A | 21 | 913-914 | S56991A | 21 | 913-914 | ||
| S5411XA | 24 | 955-965 | S56193A | 24 | 955-965 | S56991A | 24 | 955-965 | ||
| S5411XD | 23 | 949-950 | S56193D | 23 | 949-950 | S56991D | 23 | 949-950 | ||
| S5411XS | 01 | 091-093 | S56193S | 21 | 913-914 | S56991S | 21 | 913-914 | ||
| S5412XA | 01 | 073-074 | S56194A | 21 | 913-914 | S56992A | 21 | 913-914 | ||
| S5412XA | 24 | 955-965 | S56194A | 24 | 955-965 | S56992A | 24 | 955-965 | ||
| S5412XD | 23 | 949-950 | S56194D | 23 | 949-950 | S56992D | 23 | 949-950 | ||
| S5412XS | 01 | 091-093 | S56194S | 21 | 913-914 | S56992S | 21 | 913-914 | ||
| S5420XA | 01 | 073-074 | S56195A | 21 | 913-914 | S56999A | 21 | 913-914 | ||
| S5420XA | 24 | 955-965 | S56195A | 24 | 955-965 | S56999A | 24 | 955-965 | ||
| S5420XD | 23 | 949-950 | S56195D | 23 | 949-950 | S56999D | 23 | 949-950 | ||
| S5420XS | 01 | 091-093 | S56195S | 21 | 913-914 | S56999S | 21 | 913-914 | ||
| S5421XA | 01 | 073-074 | S56196A | 21 | 913-914 | S5700XA | 21 | 913-914 | ||
| S5421XA | 24 | 955-965 | S56196A | 24 | 955-965 | S5700XA | 24 | 955-965 | ||
| S5421XD | 23 | 949-950 | S56196D | 23 | 949-950 | S5700XD | 23 | 949-950 | ||
| S5421XS | 01 | 091-093 | S56196S | 21 | 913-914 | S5700XS | 09 | 604-605 | ||
| S5422XA | 01 | 073-074 | S56197A | 21 | 913-914 | S5701XA | 21 | 913-914 | ||
| S5422XA | 24 | 955-965 | S56197A | 24 | 955-965 | S5701XA | 24 | 955-965 | ||
| S5422XD | 23 | 949-950 | S56197D | 23 | 949-950 | S5701XD | 23 | 949-950 | ||
| S5422XS | 01 | 091-093 | S56197S | 21 | 913-914 | S5701XS | 09 | 604-605 | ||
| S5430XA | 01 | 073-074 | S56198A | 21 | 913-914 | S5702XA | 21 | 913-914 | ||
| S5430XA | 24 | 955-965 | S56198A | 24 | 955-965 | S5702XA | 24 | 955-965 | ||
| S5430XD | 23 | 949-950 | S56198D | 23 | 949-950 | S5702XD | 23 | 949-950 | ||
| S5430XS | 01 | 091-093 | S56198S | 21 | 913-914 | S5702XS | 09 | 604-605 | ||
| S5431XA | 01 | 073-074 | S56199A | 21 | 913-914 | S5780XA | 21 | 913-914 | ||
| S5431XA | 24 | 955-965 | S56199A | 24 | 955-965 | S5780XA | 24 | 955-965 | ||
| S5431XD | 23 | 949-950 | S56199D | 23 | 949-950 | S5780XD | 23 | 949-950 | ||
| S5431XS | 01 | 091-093 | S56199S | 21 | 913-914 | S5780XS | 09 | 604-605 | ||
| S5432XA | 01 | 073-074 | S56201A | 21 | 913-914 | S5781XA | 21 | 913-914 | ||
| S5432XA | 24 | 955-965 | S56201A | 24 | 955-965 | S5781XA | 24 | 955-965 | ||
| S5432XD | 23 | 949-950 | S56201D | 23 | 949-950 | S5781XD | 23 | 949-950 | ||
| S5432XS | 01 | 091-093 | S56201S | 21 | 913-914 | S5781XS | 09 | 604-605 | ||
| S548X1A | 01 | 073-074 | S56202A | 21 | 913-914 | S5782XA | 21 | 913-914 | ||
| S548X1A | 24 | 955-965 | S56202A | 24 | 955-965 | S5782XA | 24 | 955-965 | ||
| S548X1D | 23 | 949-950 | S56202D | 23 | 949-950 | S5782XD | 23 | 949-950 | ||
| S548X1S | 01 | 091-093 | S56202S | 21 | 913-914 | S5782XS | 09 | 604-605 | ||
| S548X2A | 01 | 073-074 | S56209A | 21 | 913-914 | S58011A | 21 | 913-914 | ||
| S548X2A | 24 | 955-965 | S56209A | 24 | 955-965 | S58011A | 24 | 955-965 | ||
| S548X2D | 23 | 949-950 | S56209D | 23 | 949-950 | S58011D | 23 | 949-950 | ||
| S548X2S | 01 | 091-093 | S56209S | 21 | 913-914 | S58011S | 08 | 559-561 | ||
| S548X9A | 01 | 073-074 | S56211A | 08 | 562-563 | S58012A | 21 | 913-914 | ||
| S548X9A | 24 | 955-965 | S56211A | 24 | 955-965 | S58012A | 24 | 955-965 | ||
| S548X9D | 23 | 949-950 | S56211D | 23 | 949-950 | S58012D | 23 | 949-950 | ||
| S548X9S | 01 | 091-093 | S56211S | 08 | 562-563 | S58012S | 08 | 559-561 | ||
| S5490XA | 01 | 073-074 | S56212A | 08 | 562-563 | S58019A | 21 | 913-914 | ||
| S5490XA | 24 | 955-965 | S56212A | 24 | 955-965 | S58019A | 24 | 955-965 | ||
| S5490XD | 23 | 949-950 | S56212D | 23 | 949-950 | S58019D | 23 | 949-950 | ||
| S5490XS | 01 | 091-093 | S56212S | 08 | 562-563 | S58019S | 08 | 559-561 | ||
| S5491XA | 01 | 073-074 | S56219A | 08 | 562-563 | S58021A | 21 | 913-914 | ||
| S5491XA | 24 | 955-965 | S56219A | 24 | 955-965 | S58021A | 24 | 955-965 | ||
| S5491XD | 23 | 949-950 | S56219D | 23 | 949-950 | S58021D | 23 | 949-950 | ||
| S5491XS | 01 | 091-093 | S56219S | 08 | 562-563 | S58021S | 08 | 559-561 | ||
| S5492XA | 01 | 073-074 | S56221A | 08 | 564-566 | S58022A | 21 | 913-914 | ||
| S5492XA | 24 | 955-965 | S56221A | 24 | 955-965 | S58022A | 24 | 955-965 | ||
| S5492XD | 23 | 949-950 | S56221D | 23 | 949-950 | S58022D | 23 | 949-950 | ||
| S5492XS | 01 | 091-093 | S56221S | 09 | 604-605 | S58022S | 08 | 559-561 | ||
| S55001A | 21 | 913-914 | S56222A | 08 | 564-566 | S58029A | 21 | 913-914 | ||
| S55001A | 24 | 955-965 | S56222A | 24 | 955-965 | S58029A | 24 | 955-965 | ||
| S55001D | 23 | 949-950 | S56222D | 23 | 949-950 | S58029D | 23 | 949-950 | ||
| S55001S | 05 | 299-301 | S56222S | 09 | 604-605 | S58029S | 08 | 559-561 | ||
| S55002A | 21 | 913-914 | S56229A | 08 | 564-566 | S58111A | 21 | 913-914 | ||
| S55002A | 24 | 955-965 | S56229A | 24 | 955-965 | S58111A | 24 | 955-965 | ||
| S55002D | 23 | 949-950 | S56229D | 23 | 949-950 | S58111D | 23 | 949-950 | ||
| S55002S | 05 | 299-301 | S56229S | 09 | 604-605 | S58111S | 08 | 559-561 | ||
| S55009A | 21 | 913-914 | S56291A | 21 | 913-914 | S58112A | 21 | 913-914 | ||
| S55009A | 24 | 955-965 | S56291A | 24 | 955-965 | S58112A | 24 | 955-965 | ||
| S55009D | 23 | 949-950 | S56291D | 23 | 949-950 | S58112D | 23 | 949-950 | ||
| S55009S | 05 | 299-301 | S56291S | 21 | 913-914 | S58112S | 08 | 559-561 | ||
| S55011A | 21 | 913-914 | S56292A | 21 | 913-914 | S58119A | 21 | 913-914 | ||
| S55011A | 24 | 955-965 | S56292A | 24 | 955-965 | S58119A | 24 | 955-965 | ||
| S55011D | 23 | 949-950 | S56292D | 23 | 949-950 | S58119D | 23 | 949-950 | ||
| S55011S | 05 | 299-301 | S56292S | 21 | 913-914 | S58119S | 08 | 559-561 | ||
| S55012A | 21 | 913-914 | S56299A | 21 | 913-914 | S58121A | 21 | 913-914 | ||
| S55012A | 24 | 955-965 | S56299A | 24 | 955-965 | S58121A | 24 | 955-965 | ||
| S55012D | 23 | 949-950 | S56299D | 23 | 949-950 | S58121D | 23 | 949-950 | ||
| S55012S | 05 | 299-301 | S56299S | 21 | 913-914 | S58121S | 08 | 559-561 | ||
| S55019A | 21 | 913-914 | S56301A | 21 | 913-914 | S58122A | 21 | 913-914 | ||
| S55019A | 24 | 955-965 | S56301A | 24 | 955-965 | S58122A | 24 | 955-965 | ||
| S55019D | 23 | 949-950 | S56301D | 23 | 949-950 | S58122D | 23 | 949-950 | ||
| S55019S | 05 | 299-301 | S56301S | 21 | 913-914 | S58122S | 08 | 559-561 | ||
| S55091A | 21 | 913-914 | S56302A | 21 | 913-914 | S58129A | 21 | 913-914 | ||
| S55091A | 24 | 955-965 | S56302A | 24 | 955-965 | S58129A | 24 | 955-965 | ||
| S55091D | 23 | 949-950 | S56302D | 23 | 949-950 | S58129D | 23 | 949-950 | ||
| S55091S | 05 | 299-301 | S56302S | 21 | 913-914 | S58129S | 08 | 559-561 | ||
| S55092A | 21 | 913-914 | S56309A | 21 | 913-914 | S58911A | 21 | 913-914 | ||
| S55092A | 24 | 955-965 | S56309A | 24 | 955-965 | S58911A | 24 | 955-965 | ||
| S55092D | 23 | 949-950 | S56309D | 23 | 949-950 | S58911D | 23 | 949-950 | ||
| S55092S | 05 | 299-301 | S56309S | 21 | 913-914 | S58911S | 08 | 559-561 | ||
| S55099A | 21 | 913-914 | S56311A | 08 | 562-563 | S58912A | 21 | 913-914 | ||
| S55099A | 24 | 955-965 | S56311A | 24 | 955-965 | S58912A | 24 | 955-965 | ||
| S55099D | 23 | 949-950 | S56311D | 23 | 949-950 | S58912D | 23 | 949-950 | ||
| S55099S | 05 | 299-301 | S56311S | 08 | 562-563 | S58912S | 08 | 559-561 | ||
| S55101A | 21 | 913-914 | S56312A | 08 | 562-563 | S58919A | 21 | 913-914 | ||
| S55101A | 24 | 955-965 | S56312A | 24 | 955-965 | S58919A | 24 | 955-965 | ||
| S55101D | 23 | 949-950 | S56312D | 23 | 949-950 | S58919D | 23 | 949-950 | ||
| S55101S | 05 | 299-301 | S56312S | 08 | 562-563 | S58919S | 08 | 559-561 | ||
| S55102A | 21 | 913-914 | S56319A | 08 | 562-563 | S58921A | 21 | 913-914 | ||
| S55102A | 24 | 955-965 | S56319A | 24 | 955-965 | S58921A | 24 | 955-965 | ||
| S55102D | 23 | 949-950 | S56319D | 23 | 949-950 | S58921D | 23 | 949-950 | ||
| S55102S | 05 | 299-301 | S56319S | 08 | 562-563 | S58921S | 08 | 559-561 | ||
| S55109A | 21 | 913-914 | S56321A | 08 | 564-566 | S58922A | 21 | 913-914 | ||
| S55109A | 24 | 955-965 | S56321A | 24 | 955-965 | S58922A | 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 |