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 42 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S58922D | 23 | 949-950 | S59812A | 21 | 913-914 | S60453A | 09 | 604-605 | ||
| S58922S | 08 | 559-561 | S59812A | 24 | 955-965 | S60453A | 24 | 955-965 | ||
| S58929A | 21 | 913-914 | S59812D | 23 | 949-950 | S60453D | 23 | 949-950 | ||
| S58929A | 24 | 955-965 | S59812S | 21 | 913-914 | S60453S | 09 | 604-605 | ||
| S58929D | 23 | 949-950 | S59819A | 21 | 913-914 | S60454A | 09 | 604-605 | ||
| S58929S | 08 | 559-561 | S59819A | 24 | 955-965 | S60454A | 24 | 955-965 | ||
| S59001A | 08 | 562-563 | S59819D | 23 | 949-950 | S60454D | 23 | 949-950 | ||
| S59001A | 24 | 955-965 | S59819S | 21 | 913-914 | S60454S | 09 | 604-605 | ||
| S59001D | 08 | 559-561 | S59901A | 21 | 913-914 | S60455A | 09 | 604-605 | ||
| S59001G | 08 | 559-561 | S59901A | 24 | 955-965 | S60455A | 24 | 955-965 | ||
| S59001K | 08 | 564-566 | S59901D | 23 | 949-950 | S60455D | 23 | 949-950 | ||
| S59001P | 08 | 564-566 | S59901S | 21 | 913-914 | S60455S | 09 | 604-605 | ||
| S59001S | 08 | 559-561 | S59902A | 21 | 913-914 | S60456A | 09 | 604-605 | ||
| S59002A | 08 | 562-563 | S59902A | 24 | 955-965 | S60456A | 24 | 955-965 | ||
| S59002A | 24 | 955-965 | S59902D | 23 | 949-950 | S60456D | 23 | 949-950 | ||
| S59002D | 08 | 559-561 | S59902S | 21 | 913-914 | S60456S | 09 | 604-605 | ||
| S59002G | 08 | 559-561 | S59909A | 21 | 913-914 | S60457A | 09 | 604-605 | ||
| S59002K | 08 | 564-566 | S59909A | 24 | 955-965 | S60457A | 24 | 955-965 | ||
| S59002P | 08 | 564-566 | S59909D | 23 | 949-950 | S60457D | 23 | 949-950 | ||
| S59002S | 08 | 559-561 | S59909S | 21 | 913-914 | S60457S | 09 | 604-605 | ||
| S59009A | 08 | 562-563 | S59911A | 21 | 913-914 | S60458A | 09 | 604-605 | ||
| S59009A | 24 | 955-965 | S59911A | 24 | 955-965 | S60458A | 24 | 955-965 | ||
| S59009D | 08 | 559-561 | S59911D | 23 | 949-950 | S60458D | 23 | 949-950 | ||
| S59009G | 08 | 559-561 | S59911S | 21 | 913-914 | S60458S | 09 | 604-605 | ||
| S59009K | 08 | 564-566 | S59912A | 21 | 913-914 | S60459A | 09 | 604-605 | ||
| S59009P | 08 | 564-566 | S59912A | 24 | 955-965 | S60459A | 24 | 955-965 | ||
| S59009S | 08 | 559-561 | S59912D | 23 | 949-950 | S60459D | 23 | 949-950 | ||
| S59011A | 08 | 562-563 | S59912S | 21 | 913-914 | S60459S | 09 | 604-605 | ||
| S59011A | 24 | 955-965 | S59919A | 21 | 913-914 | S60460A | 09 | 606-607 | ||
| S59011D | 08 | 559-561 | S59919A | 24 | 955-965 | S60460A | 24 | 955-965 | ||
| S59011G | 08 | 559-561 | S59919D | 23 | 949-950 | S60460D | 23 | 949-950 | ||
| S59011K | 08 | 564-566 | S59919S | 21 | 913-914 | S60460S | 09 | 604-605 | ||
| S59011P | 08 | 564-566 | S6000XA | 09 | 604-605 | S60461A | 09 | 606-607 | ||
| S59011S | 08 | 559-561 | S6000XA | 24 | 955-965 | S60461A | 24 | 955-965 | ||
| S59012A | 08 | 562-563 | S6000XD | 23 | 949-950 | S60461D | 23 | 949-950 | ||
| S59012A | 24 | 955-965 | S6000XS | 09 | 604-605 | S60461S | 09 | 604-605 | ||
| S59012D | 08 | 559-561 | S60011A | 09 | 604-605 | S60462A | 09 | 606-607 | ||
| S59012G | 08 | 559-561 | S60011A | 24 | 955-965 | S60462A | 24 | 955-965 | ||
| S59012K | 08 | 564-566 | S60011D | 23 | 949-950 | S60462D | 23 | 949-950 | ||
| S59012P | 08 | 564-566 | S60011S | 09 | 604-605 | S60462S | 09 | 604-605 | ||
| S59012S | 08 | 559-561 | S60012A | 09 | 604-605 | S60463A | 09 | 606-607 | ||
| S59019A | 08 | 562-563 | S60012A | 24 | 955-965 | S60463A | 24 | 955-965 | ||
| S59019A | 24 | 955-965 | S60012D | 23 | 949-950 | S60463D | 23 | 949-950 | ||
| S59019D | 08 | 559-561 | S60012S | 09 | 604-605 | S60463S | 09 | 604-605 | ||
| S59019G | 08 | 559-561 | S60019A | 09 | 604-605 | S60464A | 09 | 606-607 | ||
| S59019K | 08 | 564-566 | S60019A | 24 | 955-965 | S60464A | 24 | 955-965 | ||
| S59019P | 08 | 564-566 | S60019D | 23 | 949-950 | S60464D | 23 | 949-950 | ||
| S59019S | 08 | 559-561 | S60019S | 09 | 604-605 | S60464S | 09 | 604-605 | ||
| S59021A | 08 | 562-563 | S60021A | 09 | 604-605 | S60465A | 09 | 606-607 | ||
| S59021A | 24 | 955-965 | S60021A | 24 | 955-965 | S60465A | 24 | 955-965 | ||
| S59021D | 08 | 559-561 | S60021D | 23 | 949-950 | S60465D | 23 | 949-950 | ||
| S59021G | 08 | 559-561 | S60021S | 09 | 604-605 | S60465S | 09 | 604-605 | ||
| S59021K | 08 | 564-566 | S60022A | 09 | 604-605 | S60466A | 09 | 606-607 | ||
| S59021P | 08 | 564-566 | S60022A | 24 | 955-965 | S60466A | 24 | 955-965 | ||
| S59021S | 08 | 559-561 | S60022D | 23 | 949-950 | S60466D | 23 | 949-950 | ||
| S59022A | 08 | 562-563 | S60022S | 09 | 604-605 | S60466S | 09 | 604-605 | ||
| S59022A | 24 | 955-965 | S60029A | 09 | 604-605 | S60467A | 09 | 606-607 | ||
| S59022D | 08 | 559-561 | S60029A | 24 | 955-965 | S60467A | 24 | 955-965 | ||
| S59022G | 08 | 559-561 | S60029D | 23 | 949-950 | S60467D | 23 | 949-950 | ||
| S59022K | 08 | 564-566 | S60029S | 09 | 604-605 | S60467S | 09 | 604-605 | ||
| S59022P | 08 | 564-566 | S60031A | 09 | 604-605 | S60468A | 09 | 606-607 | ||
| S59022S | 08 | 559-561 | S60031A | 24 | 955-965 | S60468A | 24 | 955-965 | ||
| S59029A | 08 | 562-563 | S60031D | 23 | 949-950 | S60468D | 23 | 949-950 | ||
| S59029A | 24 | 955-965 | S60031S | 09 | 604-605 | S60468S | 09 | 604-605 | ||
| S59029D | 08 | 559-561 | S60032A | 09 | 604-605 | S60469A | 09 | 606-607 | ||
| S59029G | 08 | 559-561 | S60032A | 24 | 955-965 | S60469A | 24 | 955-965 | ||
| S59029K | 08 | 564-566 | S60032D | 23 | 949-950 | S60469D | 23 | 949-950 | ||
| S59029P | 08 | 564-566 | S60032S | 09 | 604-605 | S60469S | 09 | 604-605 | ||
| S59029S | 08 | 559-561 | S60039A | 09 | 604-605 | S60470A | 09 | 604-605 | ||
| S59031A | 08 | 562-563 | S60039A | 24 | 955-965 | S60470A | 24 | 955-965 | ||
| S59031A | 24 | 955-965 | S60039D | 23 | 949-950 | S60470D | 23 | 949-950 | ||
| S59031D | 08 | 559-561 | S60039S | 09 | 604-605 | S60470S | 09 | 604-605 | ||
| S59031G | 08 | 559-561 | S60041A | 09 | 604-605 | S60471A | 09 | 604-605 | ||
| S59031K | 08 | 564-566 | S60041A | 24 | 955-965 | S60471A | 24 | 955-965 | ||
| S59031P | 08 | 564-566 | S60041D | 23 | 949-950 | S60471D | 23 | 949-950 | ||
| S59031S | 08 | 559-561 | S60041S | 09 | 604-605 | S60471S | 09 | 604-605 | ||
| S59032A | 08 | 562-563 | S60042A | 09 | 604-605 | S60472A | 09 | 604-605 | ||
| S59032A | 24 | 955-965 | S60042A | 24 | 955-965 | S60472A | 24 | 955-965 | ||
| S59032D | 08 | 559-561 | S60042D | 23 | 949-950 | S60472D | 23 | 949-950 | ||
| S59032G | 08 | 559-561 | S60042S | 09 | 604-605 | S60472S | 09 | 604-605 | ||
| S59032K | 08 | 564-566 | S60049A | 09 | 604-605 | S60473A | 09 | 604-605 | ||
| S59032P | 08 | 564-566 | S60049A | 24 | 955-965 | S60473A | 24 | 955-965 | ||
| S59032S | 08 | 559-561 | S60049D | 23 | 949-950 | S60473D | 23 | 949-950 | ||
| S59039A | 08 | 562-563 | S60049S | 09 | 604-605 | S60473S | 09 | 604-605 | ||
| S59039A | 24 | 955-965 | S60051A | 09 | 604-605 | S60474A | 09 | 604-605 | ||
| S59039D | 08 | 559-561 | S60051A | 24 | 955-965 | S60474A | 24 | 955-965 | ||
| S59039G | 08 | 559-561 | S60051D | 23 | 949-950 | S60474D | 23 | 949-950 | ||
| S59039K | 08 | 564-566 | S60051S | 09 | 604-605 | S60474S | 09 | 604-605 | ||
| S59039P | 08 | 564-566 | S60052A | 09 | 604-605 | S60475A | 09 | 604-605 | ||
| S59039S | 08 | 559-561 | S60052A | 24 | 955-965 | S60475A | 24 | 955-965 | ||
| S59041A | 08 | 562-563 | S60052D | 23 | 949-950 | S60475D | 23 | 949-950 | ||
| S59041A | 24 | 955-965 | S60052S | 09 | 604-605 | S60475S | 09 | 604-605 | ||
| S59041D | 08 | 559-561 | S60059A | 09 | 604-605 | S60476A | 09 | 604-605 | ||
| S59041G | 08 | 559-561 | S60059A | 24 | 955-965 | S60476A | 24 | 955-965 | ||
| S59041K | 08 | 564-566 | S60059D | 23 | 949-950 | S60476D | 23 | 949-950 | ||
| S59041P | 08 | 564-566 | S60059S | 09 | 604-605 | S60476S | 09 | 604-605 | ||
| S59041S | 08 | 559-561 | S6010XA | 09 | 604-605 | S60477A | 09 | 604-605 | ||
| S59042A | 08 | 562-563 | S6010XA | 24 | 955-965 | S60477A | 24 | 955-965 | ||
| S59042A | 24 | 955-965 | S6010XD | 23 | 949-950 | S60477D | 23 | 949-950 | ||
| S59042D | 08 | 559-561 | S6010XS | 09 | 604-605 | S60477S | 09 | 604-605 | ||
| S59042G | 08 | 559-561 | S60111A | 09 | 604-605 | S60478A | 09 | 604-605 | ||
| S59042K | 08 | 564-566 | S60111A | 24 | 955-965 | S60478A | 24 | 955-965 | ||
| S59042P | 08 | 564-566 | S60111D | 23 | 949-950 | S60478D | 23 | 949-950 | ||
| S59042S | 08 | 559-561 | S60111S | 09 | 604-605 | S60478S | 09 | 604-605 | ||
| S59049A | 08 | 562-563 | S60112A | 09 | 604-605 | S60479A | 09 | 604-605 | ||
| S59049A | 24 | 955-965 | S60112A | 24 | 955-965 | S60479A | 24 | 955-965 | ||
| S59049D | 08 | 559-561 | S60112D | 23 | 949-950 | S60479D | 23 | 949-950 | ||
| S59049G | 08 | 559-561 | S60112S | 09 | 604-605 | S60479S | 09 | 604-605 | ||
| S59049K | 08 | 564-566 | S60119A | 09 | 604-605 | S60511A | 09 | 604-605 | ||
| S59049P | 08 | 564-566 | S60119A | 24 | 955-965 | S60511A | 24 | 955-965 | ||
| S59049S | 08 | 559-561 | S60119D | 23 | 949-950 | S60511D | 23 | 949-950 | ||
| S59091A | 08 | 562-563 | S60119S | 09 | 604-605 | S60511S | 09 | 604-605 | ||
| S59091A | 24 | 955-965 | S60121A | 09 | 604-605 | S60512A | 09 | 604-605 | ||
| S59091D | 08 | 559-561 | S60121A | 24 | 955-965 | S60512A | 24 | 955-965 | ||
| S59091G | 08 | 559-561 | S60121D | 23 | 949-950 | S60512D | 23 | 949-950 | ||
| S59091K | 08 | 564-566 | S60121S | 09 | 604-605 | S60512S | 09 | 604-605 | ||
| S59091P | 08 | 564-566 | S60122A | 09 | 604-605 | S60519A | 09 | 604-605 | ||
| S59091S | 08 | 559-561 | S60122A | 24 | 955-965 | S60519A | 24 | 955-965 | ||
| S59092A | 08 | 562-563 | S60122D | 23 | 949-950 | S60519D | 23 | 949-950 | ||
| S59092A | 24 | 955-965 | S60122S | 09 | 604-605 | S60519S | 09 | 604-605 | ||
| S59092D | 08 | 559-561 | S60129A | 09 | 604-605 | S60521A | 09 | 606-607 | ||
| S59092G | 08 | 559-561 | S60129A | 24 | 955-965 | S60521A | 24 | 955-965 | ||
| S59092K | 08 | 564-566 | S60129D | 23 | 949-950 | S60521D | 23 | 949-950 | ||
| S59092P | 08 | 564-566 | S60129S | 09 | 604-605 | S60521S | 09 | 604-605 | ||
| S59092S | 08 | 559-561 | S60131A | 09 | 604-605 | S60522A | 09 | 606-607 | ||
| S59099A | 08 | 562-563 | S60131A | 24 | 955-965 | S60522A | 24 | 955-965 | ||
| S59099A | 24 | 955-965 | S60131D | 23 | 949-950 | S60522D | 23 | 949-950 | ||
| S59099D | 08 | 559-561 | S60131S | 09 | 604-605 | S60522S | 09 | 604-605 | ||
| S59099G | 08 | 559-561 | S60132A | 09 | 604-605 | S60529A | 09 | 606-607 | ||
| S59099K | 08 | 564-566 | S60132A | 24 | 955-965 | S60529A | 24 | 955-965 | ||
| S59099P | 08 | 564-566 | S60132D | 23 | 949-950 | S60529D | 23 | 949-950 | ||
| S59099S | 08 | 559-561 | S60132S | 09 | 604-605 | S60529S | 09 | 604-605 | ||
| S59101A | 08 | 562-563 | S60139A | 09 | 604-605 | S60541A | 09 | 604-605 | ||
| S59101A | 24 | 955-965 | S60139A | 24 | 955-965 | S60541A | 24 | 955-965 | ||
| S59101D | 08 | 559-561 | S60139D | 23 | 949-950 | S60541D | 23 | 949-950 | ||
| S59101G | 08 | 559-561 | S60139S | 09 | 604-605 | S60541S | 09 | 604-605 | ||
| S59101K | 08 | 564-566 | S60141A | 09 | 604-605 | S60542A | 09 | 604-605 | ||
| S59101P | 08 | 564-566 | S60141A | 24 | 955-965 | S60542A | 24 | 955-965 | ||
| S59101S | 08 | 559-561 | S60141D | 23 | 949-950 | S60542D | 23 | 949-950 | ||
| S59102A | 08 | 562-563 | S60141S | 09 | 604-605 | S60542S | 09 | 604-605 | ||
| S59102A | 24 | 955-965 | S60142A | 09 | 604-605 | S60549A | 09 | 604-605 | ||
| S59102D | 08 | 559-561 | S60142A | 24 | 955-965 | S60549A | 24 | 955-965 | ||
| S59102G | 08 | 559-561 | S60142D | 23 | 949-950 | S60549D | 23 | 949-950 | ||
| S59102K | 08 | 564-566 | S60142S | 09 | 604-605 | S60549S | 09 | 604-605 | ||
| S59102P | 08 | 564-566 | S60149A | 09 | 604-605 | S60551A | 09 | 604-605 | ||
| S59102S | 08 | 559-561 | S60149A | 24 | 955-965 | S60551A | 24 | 955-965 | ||
| S59109A | 08 | 562-563 | S60149D | 23 | 949-950 | S60551D | 23 | 949-950 | ||
| S59109A | 24 | 955-965 | S60149S | 09 | 604-605 | S60551S | 09 | 604-605 | ||
| S59109D | 08 | 559-561 | S60151A | 09 | 604-605 | S60552A | 09 | 604-605 | ||
| S59109G | 08 | 559-561 | S60151A | 24 | 955-965 | S60552A | 24 | 955-965 | ||
| S59109K | 08 | 564-566 | S60151D | 23 | 949-950 | S60552D | 23 | 949-950 | ||
| S59109P | 08 | 564-566 | S60151S | 09 | 604-605 | S60552S | 09 | 604-605 | ||
| S59109S | 08 | 559-561 | S60152A | 09 | 604-605 | S60559A | 09 | 604-605 | ||
| S59111A | 08 | 562-563 | S60152A | 24 | 955-965 | S60559A | 24 | 955-965 | ||
| S59111A | 24 | 955-965 | S60152D | 23 | 949-950 | S60559D | 23 | 949-950 | ||
| S59111D | 08 | 559-561 | S60152S | 09 | 604-605 | S60559S | 09 | 604-605 | ||
| S59111G | 08 | 559-561 | S60159A | 09 | 604-605 | S60561A | 09 | 606-607 | ||
| S59111K | 08 | 564-566 | S60159A | 24 | 955-965 | S60561A | 24 | 955-965 | ||
| S59111P | 08 | 564-566 | S60159D | 23 | 949-950 | S60561D | 23 | 949-950 | ||
| S59111S | 08 | 559-561 | S60159S | 09 | 604-605 | S60561S | 09 | 604-605 | ||
| S59112A | 08 | 562-563 | S60211A | 09 | 604-605 | S60562A | 09 | 606-607 | ||
| S59112A | 24 | 955-965 | S60211A | 24 | 955-965 | S60562A | 24 | 955-965 | ||
| S59112D | 08 | 559-561 | S60211D | 23 | 949-950 | S60562D | 23 | 949-950 | ||
| S59112G | 08 | 559-561 | S60211S | 09 | 604-605 | S60562S | 09 | 604-605 | ||
| S59112K | 08 | 564-566 | S60212A | 09 | 604-605 | S60569A | 09 | 606-607 | ||
| S59112P | 08 | 564-566 | S60212A | 24 | 955-965 | S60569A | 24 | 955-965 | ||
| S59112S | 08 | 559-561 | S60212D | 23 | 949-950 | S60569D | 23 | 949-950 | ||
| S59119A | 08 | 562-563 | S60212S | 09 | 604-605 | S60569S | 09 | 604-605 | ||
| S59119A | 24 | 955-965 | S60219A | 09 | 604-605 | S60571A | 09 | 604-605 | ||
| S59119D | 08 | 559-561 | S60219A | 24 | 955-965 | S60571A | 24 | 955-965 | ||
| S59119G | 08 | 559-561 | S60219D | 23 | 949-950 | S60571D | 23 | 949-950 | ||
| S59119K | 08 | 564-566 | S60219S | 09 | 604-605 | S60571S | 09 | 604-605 | ||
| S59119P | 08 | 564-566 | S60221A | 09 | 604-605 | S60572A | 09 | 604-605 | ||
| S59119S | 08 | 559-561 | S60221A | 24 | 955-965 | S60572A | 24 | 955-965 | ||
| S59121A | 08 | 562-563 | S60221D | 23 | 949-950 | S60572D | 23 | 949-950 | ||
| S59121A | 24 | 955-965 | S60221S | 09 | 604-605 | S60572S | 09 | 604-605 | ||
| S59121D | 08 | 559-561 | S60222A | 09 | 604-605 | S60579A | 09 | 604-605 | ||
| S59121G | 08 | 559-561 | S60222A | 24 | 955-965 | S60579A | 24 | 955-965 | ||
| S59121K | 08 | 564-566 | S60222D | 23 | 949-950 | S60579D | 23 | 949-950 | ||
| S59121P | 08 | 564-566 | S60222S | 09 | 604-605 | S60579S | 09 | 604-605 | ||
| S59121S | 08 | 559-561 | S60229A | 09 | 604-605 | S60811A | 09 | 604-605 | ||
| S59122A | 08 | 562-563 | S60229A | 24 | 955-965 | S60811A | 24 | 955-965 | ||
| S59122A | 24 | 955-965 | S60229D | 23 | 949-950 | S60811D | 23 | 949-950 | ||
| S59122D | 08 | 559-561 | S60229S | 09 | 604-605 | S60811S | 09 | 604-605 | ||
| S59122G | 08 | 559-561 | S60311A | 09 | 604-605 | S60812A | 09 | 604-605 | ||
| S59122K | 08 | 564-566 | S60311A | 24 | 955-965 | S60812A | 24 | 955-965 | ||
| S59122P | 08 | 564-566 | S60311D | 23 | 949-950 | S60812D | 23 | 949-950 | ||
| S59122S | 08 | 559-561 | S60311S | 09 | 604-605 | S60812S | 09 | 604-605 | ||
| S59129A | 08 | 562-563 | S60312A | 09 | 604-605 | S60819A | 09 | 604-605 | ||
| S59129A | 24 | 955-965 | S60312A | 24 | 955-965 | S60819A | 24 | 955-965 | ||
| S59129D | 08 | 559-561 | S60312D | 23 | 949-950 | S60819D | 23 | 949-950 | ||
| S59129G | 08 | 559-561 | S60312S | 09 | 604-605 | S60819S | 09 | 604-605 | ||
| S59129K | 08 | 564-566 | S60319A | 09 | 604-605 | S60821A | 09 | 606-607 | ||
| S59129P | 08 | 564-566 | S60319A | 24 | 955-965 | S60821A | 24 | 955-965 | ||
| S59129S | 08 | 559-561 | S60319D | 23 | 949-950 | S60821D | 23 | 949-950 | ||
| S59131A | 08 | 562-563 | S60319S | 09 | 604-605 | S60821S | 09 | 604-605 | ||
| S59131A | 24 | 955-965 | S60321A | 09 | 606-607 | S60822A | 09 | 606-607 | ||
| S59131D | 08 | 559-561 | S60321A | 24 | 955-965 | S60822A | 24 | 955-965 | ||
| S59131G | 08 | 559-561 | S60321D | 23 | 949-950 | S60822D | 23 | 949-950 | ||
| S59131K | 08 | 564-566 | S60321S | 09 | 604-605 | S60822S | 09 | 604-605 | ||
| S59131P | 08 | 564-566 | S60322A | 09 | 606-607 | S60829A | 09 | 606-607 | ||
| S59131S | 08 | 559-561 | S60322A | 24 | 955-965 | S60829A | 24 | 955-965 | ||
| S59132A | 08 | 562-563 | S60322D | 23 | 949-950 | S60829D | 23 | 949-950 | ||
| S59132A | 24 | 955-965 | S60322S | 09 | 604-605 | S60829S | 09 | 604-605 | ||
| S59132D | 08 | 559-561 | S60329A | 09 | 606-607 | S60841A | 09 | 604-605 | ||
| S59132G | 08 | 559-561 | S60329A | 24 | 955-965 | S60841A | 24 | 955-965 | ||
| S59132K | 08 | 564-566 | S60329D | 23 | 949-950 | S60841D | 23 | 949-950 | ||
| S59132P | 08 | 564-566 | S60329S | 09 | 604-605 | S60841S | 09 | 604-605 | ||
| S59132S | 08 | 559-561 | S60341A | 09 | 604-605 | S60842A | 09 | 604-605 | ||
| S59139A | 08 | 562-563 | S60341A | 24 | 955-965 | S60842A | 24 | 955-965 | ||
| S59139A | 24 | 955-965 | S60341D | 23 | 949-950 | S60842D | 23 | 949-950 | ||
| S59139D | 08 | 559-561 | S60341S | 09 | 604-605 | S60842S | 09 | 604-605 | ||
| S59139G | 08 | 559-561 | S60342A | 09 | 604-605 | S60849A | 09 | 604-605 | ||
| S59139K | 08 | 564-566 | S60342A | 24 | 955-965 | S60849A | 24 | 955-965 | ||
| S59139P | 08 | 564-566 | S60342D | 23 | 949-950 | S60849D | 23 | 949-950 | ||
| S59139S | 08 | 559-561 | S60342S | 09 | 604-605 | S60849S | 09 | 604-605 | ||
| S59141A | 08 | 562-563 | S60349A | 09 | 604-605 | S60851A | 09 | 604-605 | ||
| S59141A | 24 | 955-965 | S60349A | 24 | 955-965 | S60851A | 24 | 955-965 | ||
| S59141D | 08 | 559-561 | S60349D | 23 | 949-950 | S60851D | 23 | 949-950 | ||
| S59141G | 08 | 559-561 | S60349S | 09 | 604-605 | S60851S | 09 | 604-605 | ||
| S59141K | 08 | 564-566 | S60351A | 09 | 604-605 | S60852A | 09 | 604-605 | ||
| S59141P | 08 | 564-566 | S60351A | 24 | 955-965 | S60852A | 24 | 955-965 | ||
| S59141S | 08 | 559-561 | S60351D | 23 | 949-950 | S60852D | 23 | 949-950 | ||
| S59142A | 08 | 562-563 | S60351S | 09 | 604-605 | S60852S | 09 | 604-605 | ||
| S59142A | 24 | 955-965 | S60352A | 09 | 604-605 | S60859A | 09 | 604-605 | ||
| S59142D | 08 | 559-561 | S60352A | 24 | 955-965 | S60859A | 24 | 955-965 | ||
| S59142G | 08 | 559-561 | S60352D | 23 | 949-950 | S60859D | 23 | 949-950 | ||
| S59142K | 08 | 564-566 | S60352S | 09 | 604-605 | S60859S | 09 | 604-605 | ||
| S59142P | 08 | 564-566 | S60359A | 09 | 604-605 | S60861A | 09 | 606-607 | ||
| S59142S | 08 | 559-561 | S60359A | 24 | 955-965 | S60861A | 24 | 955-965 | ||
| S59149A | 08 | 562-563 | S60359D | 23 | 949-950 | S60861D | 23 | 949-950 | ||
| S59149A | 24 | 955-965 | S60359S | 09 | 604-605 | S60861S | 09 | 604-605 | ||
| S59149D | 08 | 559-561 | S60361A | 09 | 606-607 | S60862A | 09 | 606-607 | ||
| S59149G | 08 | 559-561 | S60361A | 24 | 955-965 | S60862A | 24 | 955-965 | ||
| S59149K | 08 | 564-566 | S60361D | 23 | 949-950 | S60862D | 23 | 949-950 | ||
| S59149P | 08 | 564-566 | S60361S | 09 | 604-605 | S60862S | 09 | 604-605 | ||
| S59149S | 08 | 559-561 | S60362A | 09 | 606-607 | S60869A | 09 | 606-607 | ||
| S59191A | 08 | 562-563 | S60362A | 24 | 955-965 | S60869A | 24 | 955-965 | ||
| S59191A | 24 | 955-965 | S60362D | 23 | 949-950 | S60869D | 23 | 949-950 | ||
| S59191D | 08 | 559-561 | S60362S | 09 | 604-605 | S60869S | 09 | 604-605 | ||
| S59191G | 08 | 559-561 | S60369A | 09 | 606-607 | S60871A | 09 | 604-605 | ||
| S59191K | 08 | 564-566 | S60369A | 24 | 955-965 | S60871A | 24 | 955-965 | ||
| S59191P | 08 | 564-566 | S60369D | 23 | 949-950 | S60871D | 23 | 949-950 | ||
| S59191S | 08 | 559-561 | S60369S | 09 | 604-605 | S60871S | 09 | 604-605 | ||
| S59192A | 08 | 562-563 | S60371A | 09 | 604-605 | S60872A | 09 | 604-605 | ||
| S59192A | 24 | 955-965 | S60371A | 24 | 955-965 | S60872A | 24 | 955-965 | ||
| S59192D | 08 | 559-561 | S60371D | 23 | 949-950 | S60872D | 23 | 949-950 | ||
| S59192G | 08 | 559-561 | S60371S | 09 | 604-605 | S60872S | 09 | 604-605 | ||
| S59192K | 08 | 564-566 | S60372A | 09 | 604-605 | S60879A | 09 | 604-605 | ||
| S59192P | 08 | 564-566 | S60372A | 24 | 955-965 | S60879A | 24 | 955-965 | ||
| S59192S | 08 | 559-561 | S60372D | 23 | 949-950 | S60879D | 23 | 949-950 | ||
| S59199A | 08 | 562-563 | S60372S | 09 | 604-605 | S60879S | 09 | 604-605 | ||
| S59199A | 24 | 955-965 | S60379A | 09 | 604-605 | S60911A | 09 | 604-605 | ||
| S59199D | 08 | 559-561 | S60379A | 24 | 955-965 | S60911A | 24 | 955-965 | ||
| S59199G | 08 | 559-561 | S60379D | 23 | 949-950 | S60911D | 23 | 949-950 | ||
| S59199K | 08 | 564-566 | S60379S | 09 | 604-605 | S60911S | 09 | 604-605 | ||
| S59199P | 08 | 564-566 | S60391A | 09 | 604-605 | S60912A | 09 | 604-605 | ||
| S59199S | 08 | 559-561 | S60391A | 24 | 955-965 | S60912A | 24 | 955-965 | ||
| S59201A | 08 | 562-563 | S60391D | 23 | 949-950 | S60912D | 23 | 949-950 | ||
| S59201A | 24 | 955-965 | S60391S | 09 | 604-605 | S60912S | 09 | 604-605 | ||
| S59201D | 08 | 559-561 | S60392A | 09 | 604-605 | S60919A | 09 | 604-605 | ||
| S59201G | 08 | 559-561 | S60392A | 24 | 955-965 | S60919A | 24 | 955-965 | ||
| S59201K | 08 | 564-566 | S60392D | 23 | 949-950 | S60919D | 23 | 949-950 | ||
| S59201P | 08 | 564-566 | S60392S | 09 | 604-605 | S60919S | 09 | 604-605 | ||
| S59201S | 08 | 559-561 | S60399A | 09 | 604-605 | S60921A | 09 | 604-605 | ||
| S59202A | 08 | 562-563 | S60399A | 24 | 955-965 | S60921A | 24 | 955-965 | ||
| S59202A | 24 | 955-965 | S60399D | 23 | 949-950 | S60921D | 23 | 949-950 | ||
| S59202D | 08 | 559-561 | S60399S | 09 | 604-605 | S60921S | 09 | 604-605 | ||
| S59202G | 08 | 559-561 | S60410A | 09 | 604-605 | S60922A | 09 | 604-605 | ||
| S59202K | 08 | 564-566 | S60410A | 24 | 955-965 | S60922A | 24 | 955-965 | ||
| S59202P | 08 | 564-566 | S60410D | 23 | 949-950 | S60922D | 23 | 949-950 | ||
| S59202S | 08 | 559-561 | S60410S | 09 | 604-605 | S60922S | 09 | 604-605 | ||
| S59209A | 08 | 562-563 | S60411A | 09 | 604-605 | S60929A | 09 | 604-605 | ||
| S59209A | 24 | 955-965 | S60411A | 24 | 955-965 | S60929A | 24 | 955-965 | ||
| S59209D | 08 | 559-561 | S60411D | 23 | 949-950 | S60929D | 23 | 949-950 | ||
| S59209G | 08 | 559-561 | S60411S | 09 | 604-605 | S60929S | 09 | 604-605 | ||
| S59209K | 08 | 564-566 | S60412A | 09 | 604-605 | S60931A | 09 | 604-605 | ||
| S59209P | 08 | 564-566 | S60412A | 24 | 955-965 | S60931A | 24 | 955-965 | ||
| S59209S | 08 | 559-561 | S60412D | 23 | 949-950 | S60931D | 23 | 949-950 | ||
| S59211A | 08 | 562-563 | S60412S | 09 | 604-605 | S60931S | 09 | 604-605 | ||
| S59211A | 24 | 955-965 | S60413A | 09 | 604-605 | S60932A | 09 | 604-605 | ||
| S59211D | 08 | 559-561 | S60413A | 24 | 955-965 | S60932A | 24 | 955-965 | ||
| S59211G | 08 | 559-561 | S60413D | 23 | 949-950 | S60932D | 23 | 949-950 | ||
| S59211K | 08 | 564-566 | S60413S | 09 | 604-605 | S60932S | 09 | 604-605 | ||
| S59211P | 08 | 564-566 | S60414A | 09 | 604-605 | S60939A | 09 | 604-605 | ||
| S59211S | 08 | 559-561 | S60414A | 24 | 955-965 | S60939A | 24 | 955-965 | ||
| S59212A | 08 | 562-563 | S60414D | 23 | 949-950 | S60939D | 23 | 949-950 | ||
| S59212A | 24 | 955-965 | S60414S | 09 | 604-605 | S60939S | 09 | 604-605 | ||
| S59212D | 08 | 559-561 | S60415A | 09 | 604-605 | S60940A | 09 | 604-605 | ||
| S59212G | 08 | 559-561 | S60415A | 24 | 955-965 | S60940A | 24 | 955-965 | ||
| S59212K | 08 | 564-566 | S60415D | 23 | 949-950 | S60940D | 23 | 949-950 | ||
| S59212P | 08 | 564-566 | S60415S | 09 | 604-605 | S60940S | 09 | 604-605 | ||
| S59212S | 08 | 559-561 | S60416A | 09 | 604-605 | S60941A | 09 | 604-605 | ||
| S59219A | 08 | 562-563 | S60416A | 24 | 955-965 | S60941A | 24 | 955-965 | ||
| S59219A | 24 | 955-965 | S60416D | 23 | 949-950 | S60941D | 23 | 949-950 | ||
| S59219D | 08 | 559-561 | S60416S | 09 | 604-605 | S60941S | 09 | 604-605 | ||
| S59219G | 08 | 559-561 | S60417A | 09 | 604-605 | S60942A | 09 | 604-605 | ||
| S59219K | 08 | 564-566 | S60417A | 24 | 955-965 | S60942A | 24 | 955-965 | ||
| S59219P | 08 | 564-566 | S60417D | 23 | 949-950 | S60942D | 23 | 949-950 | ||
| S59219S | 08 | 559-561 | S60417S | 09 | 604-605 | S60942S | 09 | 604-605 | ||
| S59221A | 08 | 562-563 | S60418A | 09 | 604-605 | S60943A | 09 | 604-605 | ||
| S59221A | 24 | 955-965 | S60418A | 24 | 955-965 | S60943A | 24 | 955-965 | ||
| S59221D | 08 | 559-561 | S60418D | 23 | 949-950 | S60943D | 23 | 949-950 | ||
| S59221G | 08 | 559-561 | S60418S | 09 | 604-605 | S60943S | 09 | 604-605 | ||
| S59221K | 08 | 564-566 | S60419A | 09 | 604-605 | S60944A | 09 | 604-605 | ||
| S59221P | 08 | 564-566 | S60419A | 24 | 955-965 | S60944A | 24 | 955-965 | ||
| S59221S | 08 | 559-561 | S60419D | 23 | 949-950 | S60944D | 23 | 949-950 | ||
| S59222A | 08 | 562-563 | S60419S | 09 | 604-605 | S60944S | 09 | 604-605 | ||
| S59222A | 24 | 955-965 | S60420A | 09 | 606-607 | S60945A | 09 | 604-605 | ||
| S59222D | 08 | 559-561 | S60420A | 24 | 955-965 | S60945A | 24 | 955-965 | ||
| S59222G | 08 | 559-561 | S60420D | 23 | 949-950 | S60945D | 23 | 949-950 | ||
| S59222K | 08 | 564-566 | S60420S | 09 | 604-605 | S60945S | 09 | 604-605 | ||
| S59222P | 08 | 564-566 | S60421A | 09 | 606-607 | S60946A | 09 | 604-605 | ||
| S59222S | 08 | 559-561 | S60421A | 24 | 955-965 | S60946A | 24 | 955-965 | ||
| S59229A | 08 | 562-563 | S60421D | 23 | 949-950 | S60946D | 23 | 949-950 | ||
| S59229A | 24 | 955-965 | S60421S | 09 | 604-605 | S60946S | 09 | 604-605 | ||
| S59229D | 08 | 559-561 | S60422A | 09 | 606-607 | S60947A | 09 | 604-605 | ||
| S59229G | 08 | 559-561 | S60422A | 24 | 955-965 | S60947A | 24 | 955-965 | ||
| S59229K | 08 | 564-566 | S60422D | 23 | 949-950 | S60947D | 23 | 949-950 | ||
| S59229P | 08 | 564-566 | S60422S | 09 | 604-605 | S60947S | 09 | 604-605 | ||
| S59229S | 08 | 559-561 | S60423A | 09 | 606-607 | S60948A | 09 | 604-605 | ||
| S59231A | 08 | 562-563 | S60423A | 24 | 955-965 | S60948A | 24 | 955-965 | ||
| S59231A | 24 | 955-965 | S60423D | 23 | 949-950 | S60948D | 23 | 949-950 | ||
| S59231D | 08 | 559-561 | S60423S | 09 | 604-605 | S60948S | 09 | 604-605 | ||
| S59231G | 08 | 559-561 | S60424A | 09 | 606-607 | S60949A | 09 | 604-605 | ||
| S59231K | 08 | 564-566 | S60424A | 24 | 955-965 | S60949A | 24 | 955-965 | ||
| S59231P | 08 | 564-566 | S60424D | 23 | 949-950 | S60949D | 23 | 949-950 | ||
| S59231S | 08 | 559-561 | S60424S | 09 | 604-605 | S60949S | 09 | 604-605 | ||
| S59232A | 08 | 562-563 | S60425A | 09 | 606-607 | S61001A | 09 | 604-605 | ||
| S59232A | 24 | 955-965 | S60425A | 24 | 955-965 | S61001A | 24 | 955-965 | ||
| S59232D | 08 | 559-561 | S60425D | 23 | 949-950 | S61001D | 23 | 949-950 | ||
| S59232G | 08 | 559-561 | S60425S | 09 | 604-605 | S61001S | 09 | 604-605 | ||
| S59232K | 08 | 564-566 | S60426A | 09 | 606-607 | S61002A | 09 | 604-605 | ||
| S59232P | 08 | 564-566 | S60426A | 24 | 955-965 | S61002A | 24 | 955-965 | ||
| S59232S | 08 | 559-561 | S60426D | 23 | 949-950 | S61002D | 23 | 949-950 | ||
| S59239A | 08 | 562-563 | S60426S | 09 | 604-605 | S61002S | 09 | 604-605 | ||
| S59239A | 24 | 955-965 | S60427A | 09 | 606-607 | S61009A | 09 | 604-605 | ||
| S59239D | 08 | 559-561 | S60427A | 24 | 955-965 | S61009A | 24 | 955-965 | ||
| S59239G | 08 | 559-561 | S60427D | 23 | 949-950 | S61009D | 23 | 949-950 | ||
| S59239K | 08 | 564-566 | S60427S | 09 | 604-605 | S61009S | 09 | 604-605 | ||
| S59239P | 08 | 564-566 | S60428A | 09 | 606-607 | S61011A | 09 | 604-605 | ||
| S59239S | 08 | 559-561 | S60428A | 24 | 955-965 | S61011A | 24 | 955-965 | ||
| S59241A | 08 | 562-563 | S60428D | 23 | 949-950 | S61011D | 23 | 949-950 | ||
| S59241A | 24 | 955-965 | S60428S | 09 | 604-605 | S61011S | 09 | 604-605 | ||
| S59241D | 08 | 559-561 | S60429A | 09 | 606-607 | S61012A | 09 | 604-605 | ||
| S59241G | 08 | 559-561 | S60429A | 24 | 955-965 | S61012A | 24 | 955-965 | ||
| S59241K | 08 | 564-566 | S60429D | 23 | 949-950 | S61012D | 23 | 949-950 | ||
| S59241P | 08 | 564-566 | S60429S | 09 | 604-605 | S61012S | 09 | 604-605 | ||
| S59241S | 08 | 559-561 | S60440A | 09 | 604-605 | S61019A | 09 | 604-605 | ||
| S59242A | 08 | 562-563 | S60440A | 24 | 955-965 | S61019A | 24 | 955-965 | ||
| S59242A | 24 | 955-965 | S60440D | 23 | 949-950 | S61019D | 23 | 949-950 | ||
| S59242D | 08 | 559-561 | S60440S | 09 | 604-605 | S61019S | 09 | 604-605 | ||
| S59242G | 08 | 559-561 | S60441A | 09 | 604-605 | S61021A | 21 | 913-914 | ||
| S59242K | 08 | 564-566 | S60441A | 24 | 955-965 | S61021A | 24 | 955-965 | ||
| S59242P | 08 | 564-566 | S60441D | 23 | 949-950 | S61021D | 23 | 949-950 | ||
| S59242S | 08 | 559-561 | S60441S | 09 | 604-605 | S61021S | 09 | 604-605 | ||
| S59249A | 08 | 562-563 | S60442A | 09 | 604-605 | S61022A | 21 | 913-914 | ||
| S59249A | 24 | 955-965 | S60442A | 24 | 955-965 | S61022A | 24 | 955-965 | ||
| S59249D | 08 | 559-561 | S60442D | 23 | 949-950 | S61022D | 23 | 949-950 | ||
| S59249G | 08 | 559-561 | S60442S | 09 | 604-605 | S61022S | 09 | 604-605 | ||
| S59249K | 08 | 564-566 | S60443A | 09 | 604-605 | S61029A | 21 | 913-914 | ||
| S59249P | 08 | 564-566 | S60443A | 24 | 955-965 | S61029A | 24 | 955-965 | ||
| S59249S | 08 | 559-561 | S60443D | 23 | 949-950 | S61029D | 23 | 949-950 | ||
| S59291A | 08 | 562-563 | S60443S | 09 | 604-605 | S61029S | 09 | 604-605 | ||
| S59291A | 24 | 955-965 | S60444A | 09 | 604-605 | S61031A | 09 | 604-605 | ||
| S59291D | 08 | 559-561 | S60444A | 24 | 955-965 | S61031A | 24 | 955-965 | ||
| S59291G | 08 | 559-561 | S60444D | 23 | 949-950 | S61031D | 23 | 949-950 | ||
| S59291K | 08 | 564-566 | S60444S | 09 | 604-605 | S61031S | 09 | 604-605 | ||
| S59291P | 08 | 564-566 | S60445A | 09 | 604-605 | S61032A | 09 | 604-605 | ||
| S59291S | 08 | 559-561 | S60445A | 24 | 955-965 | S61032A | 24 | 955-965 | ||
| S59292A | 08 | 562-563 | S60445D | 23 | 949-950 | S61032D | 23 | 949-950 | ||
| S59292A | 24 | 955-965 | S60445S | 09 | 604-605 | S61032S | 09 | 604-605 | ||
| S59292D | 08 | 559-561 | S60446A | 09 | 604-605 | S61039A | 09 | 604-605 | ||
| S59292G | 08 | 559-561 | S60446A | 24 | 955-965 | S61039A | 24 | 955-965 | ||
| S59292K | 08 | 564-566 | S60446D | 23 | 949-950 | S61039D | 23 | 949-950 | ||
| S59292P | 08 | 564-566 | S60446S | 09 | 604-605 | S61039S | 09 | 604-605 | ||
| S59292S | 08 | 559-561 | S60447A | 09 | 604-605 | S61041A | 21 | 913-914 | ||
| S59299A | 08 | 562-563 | S60447A | 24 | 955-965 | S61041A | 24 | 955-965 | ||
| S59299A | 24 | 955-965 | S60447D | 23 | 949-950 | S61041D | 23 | 949-950 | ||
| S59299D | 08 | 559-561 | S60447S | 09 | 604-605 | S61041S | 09 | 604-605 | ||
| S59299G | 08 | 559-561 | S60448A | 09 | 604-605 | S61042A | 21 | 913-914 | ||
| S59299K | 08 | 564-566 | S60448A | 24 | 955-965 | S61042A | 24 | 955-965 | ||
| S59299P | 08 | 564-566 | S60448D | 23 | 949-950 | S61042D | 23 | 949-950 | ||
| S59299S | 08 | 559-561 | S60448S | 09 | 604-605 | S61042S | 09 | 604-605 | ||
| S59801A | 21 | 913-914 | S60449A | 09 | 604-605 | S61049A | 21 | 913-914 | ||
| S59801A | 24 | 955-965 | S60449A | 24 | 955-965 | S61049A | 24 | 955-965 | ||
| S59801D | 23 | 949-950 | S60449D | 23 | 949-950 | S61049D | 23 | 949-950 | ||
| S59801S | 21 | 913-914 | S60449S | 09 | 604-605 | S61049S | 09 | 604-605 | ||
| S59802A | 21 | 913-914 | S60450A | 09 | 604-605 | S61051A | 09 | 604-605 | ||
| S59802A | 24 | 955-965 | S60450A | 24 | 955-965 | S61051A | 24 | 955-965 | ||
| S59802D | 23 | 949-950 | S60450D | 23 | 949-950 | S61051D | 23 | 949-950 | ||
| S59802S | 21 | 913-914 | S60450S | 09 | 604-605 | S61051S | 09 | 604-605 | ||
| S59809A | 21 | 913-914 | S60451A | 09 | 604-605 | S61052A | 09 | 604-605 | ||
| S59809A | 24 | 955-965 | S60451A | 24 | 955-965 | S61052A | 24 | 955-965 | ||
| S59809D | 23 | 949-950 | S60451D | 23 | 949-950 | S61052D | 23 | 949-950 | ||
| S59809S | 21 | 913-914 | S60451S | 09 | 604-605 | S61052S | 09 | 604-605 | ||
| S59811A | 21 | 913-914 | S60452A | 09 | 604-605 | S61059A | 09 | 604-605 | ||
| S59811A | 24 | 955-965 | S60452A | 24 | 955-965 | S61059A | 24 | 955-965 | ||
| S59811D | 23 | 949-950 | S60452D | 23 | 949-950 | S61059D | 23 | 949-950 | ||
| S59811S | 21 | 913-914 | S60452S | 09 | 604-605 | S61059S | 09 | 604-605 |
|
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 |