ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 41 of 75 |
| A000 B302 C577 C8442 D309 E093393 E1344 F19280 G9761 H21341 H52203 I369 I70221 J682 K7031 L89200 M06812 M23203 M4841XS M71811 M84529D M87842 N468 O1214 O336XX3 O368234 O714 P913 R062 S0092XA S0303XA S069X2A S14106D S21312S S25809S S31811D S32499S S37012A S42123D S42449D S46329S S52045R S52291A S52552B S56112S S60359A S61509A S62321G S62660D S63637S S66529S S72024G S72114B S72326D S72451B S7711XD S82045J S82251P S8261XA S83521A S89309D S92044S S92426G S96802A T20219S T23229S T25739S T391X5S T444X2S T498X3S T602X4S T7805XS T83728S Z315 Z96641 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S46329S | 09 | 604-605 | S49139P | 08 | 564-566 | S51859D | 23 | 949-950 | ||
| S46391A | 21 | 913-914 | S49139S | 08 | 559-561 | S51859S | 09 | 604-605 | ||
| S46391A | 24 | 963-965 | S49141A | 08 | 562-563 | S52001A | 08 | 562-563 | ||
| S46391D | 23 | 949-950 | S49141A | 24 | 963-965 | S52001A | 24 | 963-965 | ||
| S46391S | 21 | 913-914 | S49141D | 08 | 559-561 | S52001B | 08 | 562-563 | ||
| S46392A | 21 | 913-914 | S49141G | 08 | 559-561 | S52001B | 24 | 963-965 | ||
| S46392A | 24 | 963-965 | S49141K | 08 | 564-566 | S52001C | 08 | 562-563 | ||
| S46392D | 23 | 949-950 | S49141P | 08 | 564-566 | S52001C | 24 | 963-965 | ||
| S46392S | 21 | 913-914 | S49141S | 08 | 559-561 | S52001D | 08 | 559-561 | ||
| S46399A | 21 | 913-914 | S49142A | 08 | 562-563 | S52001E | 08 | 559-561 | ||
| S46399A | 24 | 963-965 | S49142A | 24 | 963-965 | S52001F | 08 | 559-561 | ||
| S46399D | 23 | 949-950 | S49142D | 08 | 559-561 | S52001G | 08 | 559-561 | ||
| S46399S | 21 | 913-914 | S49142G | 08 | 559-561 | S52001H | 08 | 559-561 | ||
| S46801A | 21 | 913-914 | S49142K | 08 | 564-566 | S52001J | 08 | 559-561 | ||
| S46801A | 24 | 963-965 | S49142P | 08 | 564-566 | S52001K | 08 | 564-566 | ||
| S46801D | 23 | 949-950 | S49142S | 08 | 559-561 | S52001M | 08 | 564-566 | ||
| S46801S | 21 | 913-914 | S49149A | 08 | 562-563 | S52001N | 08 | 564-566 | ||
| S46802A | 21 | 913-914 | S49149A | 24 | 963-965 | S52001P | 08 | 564-566 | ||
| S46802A | 24 | 963-965 | S49149D | 08 | 559-561 | S52001Q | 08 | 564-566 | ||
| S46802D | 23 | 949-950 | S49149G | 08 | 559-561 | S52001R | 08 | 564-566 | ||
| S46802S | 21 | 913-914 | S49149K | 08 | 564-566 | S52001S | 08 | 559-561 | ||
| S46809A | 21 | 913-914 | S49149P | 08 | 564-566 | S52002A | 08 | 562-563 | ||
| S46809A | 24 | 963-965 | S49149S | 08 | 559-561 | S52002A | 24 | 963-965 | ||
| S46809D | 23 | 949-950 | S49191A | 08 | 562-563 | S52002B | 08 | 562-563 | ||
| S46809S | 21 | 913-914 | S49191A | 24 | 963-965 | S52002B | 24 | 963-965 | ||
| S46811A | 08 | 562-563 | S49191D | 08 | 559-561 | S52002C | 08 | 562-563 | ||
| S46811A | 24 | 963-965 | S49191G | 08 | 559-561 | S52002C | 24 | 963-965 | ||
| S46811D | 23 | 949-950 | S49191K | 08 | 564-566 | S52002D | 08 | 559-561 | ||
| S46811S | 08 | 562-563 | S49191P | 08 | 564-566 | S52002E | 08 | 559-561 | ||
| S46812A | 08 | 562-563 | S49191S | 08 | 559-561 | S52002F | 08 | 559-561 | ||
| S46812A | 24 | 963-965 | S49192A | 08 | 562-563 | S52002G | 08 | 559-561 | ||
| S46812D | 23 | 949-950 | S49192A | 24 | 963-965 | S52002H | 08 | 559-561 | ||
| S46812S | 08 | 562-563 | S49192D | 08 | 559-561 | S52002J | 08 | 559-561 | ||
| S46819A | 08 | 562-563 | S49192G | 08 | 559-561 | S52002K | 08 | 564-566 | ||
| S46819A | 24 | 963-965 | S49192K | 08 | 564-566 | S52002M | 08 | 564-566 | ||
| S46819D | 23 | 949-950 | S49192P | 08 | 564-566 | S52002N | 08 | 564-566 | ||
| S46819S | 08 | 562-563 | S49192S | 08 | 559-561 | S52002P | 08 | 564-566 | ||
| S46821A | 08 | 564-566 | S49199A | 08 | 562-563 | S52002Q | 08 | 564-566 | ||
| S46821A | 24 | 963-965 | S49199A | 24 | 963-965 | S52002R | 08 | 564-566 | ||
| S46821D | 23 | 949-950 | S49199D | 08 | 559-561 | S52002S | 08 | 559-561 | ||
| S46821S | 09 | 604-605 | S49199G | 08 | 559-561 | S52009A | 08 | 562-563 | ||
| S46822A | 08 | 564-566 | S49199K | 08 | 564-566 | S52009A | 24 | 963-965 | ||
| S46822A | 24 | 963-965 | S49199P | 08 | 564-566 | S52009B | 08 | 562-563 | ||
| S46822D | 23 | 949-950 | S49199S | 08 | 559-561 | S52009B | 24 | 963-965 | ||
| S46822S | 09 | 604-605 | S4980XA | 21 | 913-914 | S52009C | 08 | 562-563 | ||
| S46829A | 08 | 564-566 | S4980XA | 24 | 963-965 | S52009C | 24 | 963-965 | ||
| S46829A | 24 | 963-965 | S4980XD | 23 | 949-950 | S52009D | 08 | 559-561 | ||
| S46829D | 23 | 949-950 | S4980XS | 21 | 913-914 | S52009E | 08 | 559-561 | ||
| S46829S | 09 | 604-605 | S4981XA | 21 | 913-914 | S52009F | 08 | 559-561 | ||
| S46891A | 21 | 913-914 | S4981XA | 24 | 963-965 | S52009G | 08 | 559-561 | ||
| S46891A | 24 | 963-965 | S4981XD | 23 | 949-950 | S52009H | 08 | 559-561 | ||
| S46891D | 23 | 949-950 | S4981XS | 21 | 913-914 | S52009J | 08 | 559-561 | ||
| S46891S | 21 | 913-914 | S4982XA | 21 | 913-914 | S52009K | 08 | 564-566 | ||
| S46892A | 21 | 913-914 | S4982XA | 24 | 963-965 | S52009M | 08 | 564-566 | ||
| S46892A | 24 | 963-965 | S4982XD | 23 | 949-950 | S52009N | 08 | 564-566 | ||
| S46892D | 23 | 949-950 | S4982XS | 21 | 913-914 | S52009P | 08 | 564-566 | ||
| S46892S | 21 | 913-914 | S4990XA | 21 | 913-914 | S52009Q | 08 | 564-566 | ||
| S46899A | 21 | 913-914 | S4990XA | 24 | 963-965 | S52009R | 08 | 564-566 | ||
| S46899A | 24 | 963-965 | S4990XD | 23 | 949-950 | S52009S | 08 | 559-561 | ||
| S46899D | 23 | 949-950 | S4990XS | 21 | 913-914 | S52011A | 08 | 562-563 | ||
| S46899S | 21 | 913-914 | S4991XA | 21 | 913-914 | S52011A | 24 | 963-965 | ||
| S46901A | 21 | 913-914 | S4991XA | 24 | 963-965 | S52011D | 08 | 559-561 | ||
| S46901A | 24 | 963-965 | S4991XD | 23 | 949-950 | S52011G | 08 | 559-561 | ||
| S46901D | 23 | 949-950 | S4991XS | 21 | 913-914 | S52011K | 08 | 564-566 | ||
| S46901S | 21 | 913-914 | S4992XA | 21 | 913-914 | S52011P | 08 | 564-566 | ||
| S46902A | 21 | 913-914 | S4992XA | 24 | 963-965 | S52011S | 08 | 559-561 | ||
| S46902A | 24 | 963-965 | S4992XD | 23 | 949-950 | S52012A | 08 | 562-563 | ||
| S46902D | 23 | 949-950 | S4992XS | 21 | 913-914 | S52012A | 24 | 963-965 | ||
| S46902S | 21 | 913-914 | S5000XA | 09 | 604-605 | S52012D | 08 | 559-561 | ||
| S46909A | 21 | 913-914 | S5000XA | 24 | 963-965 | S52012G | 08 | 559-561 | ||
| S46909A | 24 | 963-965 | S5000XD | 23 | 949-950 | S52012K | 08 | 564-566 | ||
| S46909D | 23 | 949-950 | S5000XS | 09 | 604-605 | S52012P | 08 | 564-566 | ||
| S46909S | 21 | 913-914 | S5001XA | 09 | 604-605 | S52012S | 08 | 559-561 | ||
| S46911A | 08 | 562-563 | S5001XA | 24 | 963-965 | S52019A | 08 | 562-563 | ||
| S46911A | 24 | 963-965 | S5001XD | 23 | 949-950 | S52019A | 24 | 963-965 | ||
| S46911D | 23 | 949-950 | S5001XS | 09 | 604-605 | S52019D | 08 | 559-561 | ||
| S46911S | 08 | 562-563 | S5002XA | 09 | 604-605 | S52019G | 08 | 559-561 | ||
| S46912A | 08 | 562-563 | S5002XA | 24 | 963-965 | S52019K | 08 | 564-566 | ||
| S46912A | 24 | 963-965 | S5002XD | 23 | 949-950 | S52019P | 08 | 564-566 | ||
| S46912D | 23 | 949-950 | S5002XS | 09 | 604-605 | S52019S | 08 | 559-561 | ||
| S46912S | 08 | 562-563 | S5010XA | 09 | 604-605 | S52021A | 08 | 562-563 | ||
| S46919A | 08 | 562-563 | S5010XA | 24 | 963-965 | S52021A | 24 | 963-965 | ||
| S46919A | 24 | 963-965 | S5010XD | 23 | 949-950 | S52021B | 08 | 562-563 | ||
| S46919D | 23 | 949-950 | S5010XS | 09 | 604-605 | S52021B | 24 | 963-965 | ||
| S46919S | 08 | 562-563 | S5011XA | 09 | 604-605 | S52021C | 08 | 562-563 | ||
| S46921A | 08 | 564-566 | S5011XA | 24 | 963-965 | S52021C | 24 | 963-965 | ||
| S46921A | 24 | 963-965 | S5011XD | 23 | 949-950 | S52021D | 08 | 559-561 | ||
| S46921D | 23 | 949-950 | S5011XS | 09 | 604-605 | S52021E | 08 | 559-561 | ||
| S46921S | 09 | 604-605 | S5012XA | 09 | 604-605 | S52021F | 08 | 559-561 | ||
| S46922A | 08 | 564-566 | S5012XA | 24 | 963-965 | S52021G | 08 | 559-561 | ||
| S46922A | 24 | 963-965 | S5012XD | 23 | 949-950 | S52021H | 08 | 559-561 | ||
| S46922D | 23 | 949-950 | S5012XS | 09 | 604-605 | S52021J | 08 | 559-561 | ||
| S46922S | 09 | 604-605 | S50311A | 09 | 604-605 | S52021K | 08 | 564-566 | ||
| S46929A | 08 | 564-566 | S50311A | 24 | 963-965 | S52021M | 08 | 564-566 | ||
| S46929A | 24 | 963-965 | S50311D | 23 | 949-950 | S52021N | 08 | 564-566 | ||
| S46929D | 23 | 949-950 | S50311S | 09 | 604-605 | S52021P | 08 | 564-566 | ||
| S46929S | 09 | 604-605 | S50312A | 09 | 604-605 | S52021Q | 08 | 564-566 | ||
| S46991A | 21 | 913-914 | S50312A | 24 | 963-965 | S52021R | 08 | 564-566 | ||
| S46991A | 24 | 963-965 | S50312D | 23 | 949-950 | S52021S | 08 | 559-561 | ||
| S46991D | 23 | 949-950 | S50312S | 09 | 604-605 | S52022A | 08 | 562-563 | ||
| S46991S | 21 | 913-914 | S50319A | 09 | 604-605 | S52022A | 24 | 963-965 | ||
| S46992A | 21 | 913-914 | S50319A | 24 | 963-965 | S52022B | 08 | 562-563 | ||
| S46992A | 24 | 963-965 | S50319D | 23 | 949-950 | S52022B | 24 | 963-965 | ||
| S46992D | 23 | 949-950 | S50319S | 09 | 604-605 | S52022C | 08 | 562-563 | ||
| S46992S | 21 | 913-914 | S50321A | 09 | 606-607 | S52022C | 24 | 963-965 | ||
| S46999A | 21 | 913-914 | S50321A | 24 | 963-965 | S52022D | 08 | 559-561 | ||
| S46999A | 24 | 963-965 | S50321D | 23 | 949-950 | S52022E | 08 | 559-561 | ||
| S46999D | 23 | 949-950 | S50321S | 09 | 604-605 | S52022F | 08 | 559-561 | ||
| S46999S | 21 | 913-914 | S50322A | 09 | 606-607 | S52022G | 08 | 559-561 | ||
| S471XXA | 21 | 913-914 | S50322A | 24 | 963-965 | S52022H | 08 | 559-561 | ||
| S471XXA | 24 | 963-965 | S50322D | 23 | 949-950 | S52022J | 08 | 559-561 | ||
| S471XXD | 23 | 949-950 | S50322S | 09 | 604-605 | S52022K | 08 | 564-566 | ||
| S471XXS | 09 | 604-605 | S50329A | 09 | 606-607 | S52022M | 08 | 564-566 | ||
| S472XXA | 21 | 913-914 | S50329A | 24 | 963-965 | S52022N | 08 | 564-566 | ||
| S472XXA | 24 | 963-965 | S50329D | 23 | 949-950 | S52022P | 08 | 564-566 | ||
| S472XXD | 23 | 949-950 | S50329S | 09 | 604-605 | S52022Q | 08 | 564-566 | ||
| S472XXS | 09 | 604-605 | S50341A | 09 | 604-605 | S52022R | 08 | 564-566 | ||
| S479XXA | 21 | 913-914 | S50341A | 24 | 963-965 | S52022S | 08 | 559-561 | ||
| S479XXA | 24 | 963-965 | S50341D | 23 | 949-950 | S52023A | 08 | 562-563 | ||
| S479XXD | 23 | 949-950 | S50341S | 09 | 604-605 | S52023A | 24 | 963-965 | ||
| S479XXS | 09 | 604-605 | S50342A | 09 | 604-605 | S52023B | 08 | 562-563 | ||
| S48011A | 21 | 913-914 | S50342A | 24 | 963-965 | S52023B | 24 | 963-965 | ||
| S48011A | 24 | 963-965 | S50342D | 23 | 949-950 | S52023C | 08 | 562-563 | ||
| S48011D | 23 | 949-950 | S50342S | 09 | 604-605 | S52023C | 24 | 963-965 | ||
| S48011S | 08 | 559-561 | S50349A | 09 | 604-605 | S52023D | 08 | 559-561 | ||
| S48012A | 21 | 913-914 | S50349A | 24 | 963-965 | S52023E | 08 | 559-561 | ||
| S48012A | 24 | 963-965 | S50349D | 23 | 949-950 | S52023F | 08 | 559-561 | ||
| S48012D | 23 | 949-950 | S50349S | 09 | 604-605 | S52023G | 08 | 559-561 | ||
| S48012S | 08 | 559-561 | S50351A | 09 | 604-605 | S52023H | 08 | 559-561 | ||
| S48019A | 21 | 913-914 | S50351A | 24 | 963-965 | S52023J | 08 | 559-561 | ||
| S48019A | 24 | 963-965 | S50351D | 23 | 949-950 | S52023K | 08 | 564-566 | ||
| S48019D | 23 | 949-950 | S50351S | 09 | 604-605 | S52023M | 08 | 564-566 | ||
| S48019S | 08 | 559-561 | S50352A | 09 | 604-605 | S52023N | 08 | 564-566 | ||
| S48021A | 21 | 913-914 | S50352A | 24 | 963-965 | S52023P | 08 | 564-566 | ||
| S48021A | 24 | 963-965 | S50352D | 23 | 949-950 | S52023Q | 08 | 564-566 | ||
| S48021D | 23 | 949-950 | S50352S | 09 | 604-605 | S52023R | 08 | 564-566 | ||
| S48021S | 08 | 559-561 | S50359A | 09 | 604-605 | S52023S | 08 | 559-561 | ||
| S48022A | 21 | 913-914 | S50359A | 24 | 963-965 | S52024A | 08 | 562-563 | ||
| S48022A | 24 | 963-965 | S50359D | 23 | 949-950 | S52024A | 24 | 963-965 | ||
| S48022D | 23 | 949-950 | S50359S | 09 | 604-605 | S52024B | 08 | 562-563 | ||
| S48022S | 08 | 559-561 | S50361A | 09 | 606-607 | S52024B | 24 | 963-965 | ||
| S48029A | 21 | 913-914 | S50361A | 24 | 963-965 | S52024C | 08 | 562-563 | ||
| S48029A | 24 | 963-965 | S50361D | 23 | 949-950 | S52024C | 24 | 963-965 | ||
| S48029D | 23 | 949-950 | S50361S | 09 | 604-605 | S52024D | 08 | 559-561 | ||
| S48029S | 08 | 559-561 | S50362A | 09 | 606-607 | S52024E | 08 | 559-561 | ||
| S48111A | 21 | 913-914 | S50362A | 24 | 963-965 | S52024F | 08 | 559-561 | ||
| S48111A | 24 | 963-965 | S50362D | 23 | 949-950 | S52024G | 08 | 559-561 | ||
| S48111D | 23 | 949-950 | S50362S | 09 | 604-605 | S52024H | 08 | 559-561 | ||
| S48111S | 08 | 559-561 | S50369A | 09 | 606-607 | S52024J | 08 | 559-561 | ||
| S48112A | 21 | 913-914 | S50369A | 24 | 963-965 | S52024K | 08 | 564-566 | ||
| S48112A | 24 | 963-965 | S50369D | 23 | 949-950 | S52024M | 08 | 564-566 | ||
| S48112D | 23 | 949-950 | S50369S | 09 | 604-605 | S52024N | 08 | 564-566 | ||
| S48112S | 08 | 559-561 | S50371A | 09 | 604-605 | S52024P | 08 | 564-566 | ||
| S48119A | 21 | 913-914 | S50371A | 24 | 963-965 | S52024Q | 08 | 564-566 | ||
| S48119A | 24 | 963-965 | S50371D | 23 | 949-950 | S52024R | 08 | 564-566 | ||
| S48119D | 23 | 949-950 | S50371S | 09 | 604-605 | S52024S | 08 | 559-561 | ||
| S48119S | 08 | 559-561 | S50372A | 09 | 604-605 | S52025A | 08 | 562-563 | ||
| S48121A | 21 | 913-914 | S50372A | 24 | 963-965 | S52025A | 24 | 963-965 | ||
| S48121A | 24 | 963-965 | S50372D | 23 | 949-950 | S52025B | 08 | 562-563 | ||
| S48121D | 23 | 949-950 | S50372S | 09 | 604-605 | S52025B | 24 | 963-965 | ||
| S48121S | 08 | 559-561 | S50379A | 09 | 604-605 | S52025C | 08 | 562-563 | ||
| S48122A | 21 | 913-914 | S50379A | 24 | 963-965 | S52025C | 24 | 963-965 | ||
| S48122A | 24 | 963-965 | S50379D | 23 | 949-950 | S52025D | 08 | 559-561 | ||
| S48122D | 23 | 949-950 | S50379S | 09 | 604-605 | S52025E | 08 | 559-561 | ||
| S48122S | 08 | 559-561 | S50811A | 09 | 604-605 | S52025F | 08 | 559-561 | ||
| S48129A | 21 | 913-914 | S50811A | 24 | 963-965 | S52025G | 08 | 559-561 | ||
| S48129A | 24 | 963-965 | S50811D | 23 | 949-950 | S52025H | 08 | 559-561 | ||
| S48129D | 23 | 949-950 | S50811S | 09 | 604-605 | S52025J | 08 | 559-561 | ||
| S48129S | 08 | 559-561 | S50812A | 09 | 604-605 | S52025K | 08 | 564-566 | ||
| S48911A | 21 | 913-914 | S50812A | 24 | 963-965 | S52025M | 08 | 564-566 | ||
| S48911A | 24 | 963-965 | S50812D | 23 | 949-950 | S52025N | 08 | 564-566 | ||
| S48911D | 23 | 949-950 | S50812S | 09 | 604-605 | S52025P | 08 | 564-566 | ||
| S48911S | 08 | 559-561 | S50819A | 09 | 604-605 | S52025Q | 08 | 564-566 | ||
| S48912A | 21 | 913-914 | S50819A | 24 | 963-965 | S52025R | 08 | 564-566 | ||
| S48912A | 24 | 963-965 | S50819D | 23 | 949-950 | S52025S | 08 | 559-561 | ||
| S48912D | 23 | 949-950 | S50819S | 09 | 604-605 | S52026A | 08 | 562-563 | ||
| S48912S | 08 | 559-561 | S50821A | 09 | 606-607 | S52026A | 24 | 963-965 | ||
| S48919A | 21 | 913-914 | S50821A | 24 | 963-965 | S52026B | 08 | 562-563 | ||
| S48919A | 24 | 963-965 | S50821D | 23 | 949-950 | S52026B | 24 | 963-965 | ||
| S48919D | 23 | 949-950 | S50821S | 09 | 604-605 | S52026C | 08 | 562-563 | ||
| S48919S | 08 | 559-561 | S50822A | 09 | 606-607 | S52026C | 24 | 963-965 | ||
| S48921A | 21 | 913-914 | S50822A | 24 | 963-965 | S52026D | 08 | 559-561 | ||
| S48921A | 24 | 963-965 | S50822D | 23 | 949-950 | S52026E | 08 | 559-561 | ||
| S48921D | 23 | 949-950 | S50822S | 09 | 604-605 | S52026F | 08 | 559-561 | ||
| S48921S | 08 | 559-561 | S50829A | 09 | 606-607 | S52026G | 08 | 559-561 | ||
| S48922A | 21 | 913-914 | S50829A | 24 | 963-965 | S52026H | 08 | 559-561 | ||
| S48922A | 24 | 963-965 | S50829D | 23 | 949-950 | S52026J | 08 | 559-561 | ||
| S48922D | 23 | 949-950 | S50829S | 09 | 604-605 | S52026K | 08 | 564-566 | ||
| S48922S | 08 | 559-561 | S50841A | 09 | 604-605 | S52026M | 08 | 564-566 | ||
| S48929A | 21 | 913-914 | S50841A | 24 | 963-965 | S52026N | 08 | 564-566 | ||
| S48929A | 24 | 963-965 | S50841D | 23 | 949-950 | S52026P | 08 | 564-566 | ||
| S48929D | 23 | 949-950 | S50841S | 09 | 604-605 | S52026Q | 08 | 564-566 | ||
| S48929S | 08 | 559-561 | S50842A | 09 | 604-605 | S52026R | 08 | 564-566 | ||
| S49001A | 08 | 562-563 | S50842A | 24 | 963-965 | S52026S | 08 | 559-561 | ||
| S49001A | 24 | 963-965 | S50842D | 23 | 949-950 | S52031A | 08 | 562-563 | ||
| S49001D | 08 | 559-561 | S50842S | 09 | 604-605 | S52031A | 24 | 963-965 | ||
| S49001G | 08 | 559-561 | S50849A | 09 | 604-605 | S52031B | 08 | 562-563 | ||
| S49001K | 08 | 564-566 | S50849A | 24 | 963-965 | S52031B | 24 | 963-965 | ||
| S49001P | 08 | 564-566 | S50849D | 23 | 949-950 | S52031C | 08 | 562-563 | ||
| S49001S | 08 | 559-561 | S50849S | 09 | 604-605 | S52031C | 24 | 963-965 | ||
| S49002A | 08 | 562-563 | S50851A | 09 | 604-605 | S52031D | 08 | 559-561 | ||
| S49002A | 24 | 963-965 | S50851A | 24 | 963-965 | S52031E | 08 | 559-561 | ||
| S49002D | 08 | 559-561 | S50851D | 23 | 949-950 | S52031F | 08 | 559-561 | ||
| S49002G | 08 | 559-561 | S50851S | 09 | 604-605 | S52031G | 08 | 559-561 | ||
| S49002K | 08 | 564-566 | S50852A | 09 | 604-605 | S52031H | 08 | 559-561 | ||
| S49002P | 08 | 564-566 | S50852A | 24 | 963-965 | S52031J | 08 | 559-561 | ||
| S49002S | 08 | 559-561 | S50852D | 23 | 949-950 | S52031K | 08 | 564-566 | ||
| S49009A | 08 | 562-563 | S50852S | 09 | 604-605 | S52031M | 08 | 564-566 | ||
| S49009A | 24 | 963-965 | S50859A | 09 | 604-605 | S52031N | 08 | 564-566 | ||
| S49009D | 08 | 559-561 | S50859A | 24 | 963-965 | S52031P | 08 | 564-566 | ||
| S49009G | 08 | 559-561 | S50859D | 23 | 949-950 | S52031Q | 08 | 564-566 | ||
| S49009K | 08 | 564-566 | S50859S | 09 | 604-605 | S52031R | 08 | 564-566 | ||
| S49009P | 08 | 564-566 | S50861A | 09 | 606-607 | S52031S | 08 | 559-561 | ||
| S49009S | 08 | 559-561 | S50861A | 24 | 963-965 | S52032A | 08 | 562-563 | ||
| S49011A | 08 | 562-563 | S50861D | 23 | 949-950 | S52032A | 24 | 963-965 | ||
| S49011A | 24 | 963-965 | S50861S | 09 | 604-605 | S52032B | 08 | 562-563 | ||
| S49011D | 08 | 559-561 | S50862A | 09 | 606-607 | S52032B | 24 | 963-965 | ||
| S49011G | 08 | 559-561 | S50862A | 24 | 963-965 | S52032C | 08 | 562-563 | ||
| S49011K | 08 | 564-566 | S50862D | 23 | 949-950 | S52032C | 24 | 963-965 | ||
| S49011P | 08 | 564-566 | S50862S | 09 | 604-605 | S52032D | 08 | 559-561 | ||
| S49011S | 08 | 559-561 | S50869A | 09 | 606-607 | S52032E | 08 | 559-561 | ||
| S49012A | 08 | 562-563 | S50869A | 24 | 963-965 | S52032F | 08 | 559-561 | ||
| S49012A | 24 | 963-965 | S50869D | 23 | 949-950 | S52032G | 08 | 559-561 | ||
| S49012D | 08 | 559-561 | S50869S | 09 | 604-605 | S52032H | 08 | 559-561 | ||
| S49012G | 08 | 559-561 | S50871A | 09 | 604-605 | S52032J | 08 | 559-561 | ||
| S49012K | 08 | 564-566 | S50871A | 24 | 963-965 | S52032K | 08 | 564-566 | ||
| S49012P | 08 | 564-566 | S50871D | 23 | 949-950 | S52032M | 08 | 564-566 | ||
| S49012S | 08 | 559-561 | S50871S | 09 | 604-605 | S52032N | 08 | 564-566 | ||
| S49019A | 08 | 562-563 | S50872A | 09 | 604-605 | S52032P | 08 | 564-566 | ||
| S49019A | 24 | 963-965 | S50872A | 24 | 963-965 | S52032Q | 08 | 564-566 | ||
| S49019D | 08 | 559-561 | S50872D | 23 | 949-950 | S52032R | 08 | 564-566 | ||
| S49019G | 08 | 559-561 | S50872S | 09 | 604-605 | S52032S | 08 | 559-561 | ||
| S49019K | 08 | 564-566 | S50879A | 09 | 604-605 | S52033A | 08 | 562-563 | ||
| S49019P | 08 | 564-566 | S50879A | 24 | 963-965 | S52033A | 24 | 963-965 | ||
| S49019S | 08 | 559-561 | S50879D | 23 | 949-950 | S52033B | 08 | 562-563 | ||
| S49021A | 08 | 562-563 | S50879S | 09 | 604-605 | S52033B | 24 | 963-965 | ||
| S49021A | 24 | 963-965 | S50901A | 09 | 604-605 | S52033C | 08 | 562-563 | ||
| S49021D | 08 | 559-561 | S50901A | 24 | 963-965 | S52033C | 24 | 963-965 | ||
| S49021G | 08 | 559-561 | S50901D | 23 | 949-950 | S52033D | 08 | 559-561 | ||
| S49021K | 08 | 564-566 | S50901S | 09 | 604-605 | S52033E | 08 | 559-561 | ||
| S49021P | 08 | 564-566 | S50902A | 09 | 604-605 | S52033F | 08 | 559-561 | ||
| S49021S | 08 | 559-561 | S50902A | 24 | 963-965 | S52033G | 08 | 559-561 | ||
| S49022A | 08 | 562-563 | S50902D | 23 | 949-950 | S52033H | 08 | 559-561 | ||
| S49022A | 24 | 963-965 | S50902S | 09 | 604-605 | S52033J | 08 | 559-561 | ||
| S49022D | 08 | 559-561 | S50909A | 09 | 604-605 | S52033K | 08 | 564-566 | ||
| S49022G | 08 | 559-561 | S50909A | 24 | 963-965 | S52033M | 08 | 564-566 | ||
| S49022K | 08 | 564-566 | S50909D | 23 | 949-950 | S52033N | 08 | 564-566 | ||
| S49022P | 08 | 564-566 | S50909S | 09 | 604-605 | S52033P | 08 | 564-566 | ||
| S49022S | 08 | 559-561 | S50911A | 09 | 604-605 | S52033Q | 08 | 564-566 | ||
| S49029A | 08 | 562-563 | S50911A | 24 | 963-965 | S52033R | 08 | 564-566 | ||
| S49029A | 24 | 963-965 | S50911D | 23 | 949-950 | S52033S | 08 | 559-561 | ||
| S49029D | 08 | 559-561 | S50911S | 09 | 604-605 | S52034A | 08 | 562-563 | ||
| S49029G | 08 | 559-561 | S50912A | 09 | 604-605 | S52034A | 24 | 963-965 | ||
| S49029K | 08 | 564-566 | S50912A | 24 | 963-965 | S52034B | 08 | 562-563 | ||
| S49029P | 08 | 564-566 | S50912D | 23 | 949-950 | S52034B | 24 | 963-965 | ||
| S49029S | 08 | 559-561 | S50912S | 09 | 604-605 | S52034C | 08 | 562-563 | ||
| S49031A | 08 | 562-563 | S50919A | 09 | 604-605 | S52034C | 24 | 963-965 | ||
| S49031A | 24 | 963-965 | S50919A | 24 | 963-965 | S52034D | 08 | 559-561 | ||
| S49031D | 08 | 559-561 | S50919D | 23 | 949-950 | S52034E | 08 | 559-561 | ||
| S49031G | 08 | 559-561 | S50919S | 09 | 604-605 | S52034F | 08 | 559-561 | ||
| S49031K | 08 | 564-566 | S51001A | 09 | 604-605 | S52034G | 08 | 559-561 | ||
| S49031P | 08 | 564-566 | S51001A | 24 | 963-965 | S52034H | 08 | 559-561 | ||
| S49031S | 08 | 559-561 | S51001D | 23 | 949-950 | S52034J | 08 | 559-561 | ||
| S49032A | 08 | 562-563 | S51001S | 09 | 604-605 | S52034K | 08 | 564-566 | ||
| S49032A | 24 | 963-965 | S51002A | 09 | 604-605 | S52034M | 08 | 564-566 | ||
| S49032D | 08 | 559-561 | S51002A | 24 | 963-965 | S52034N | 08 | 564-566 | ||
| S49032G | 08 | 559-561 | S51002D | 23 | 949-950 | S52034P | 08 | 564-566 | ||
| S49032K | 08 | 564-566 | S51002S | 09 | 604-605 | S52034Q | 08 | 564-566 | ||
| S49032P | 08 | 564-566 | S51009A | 09 | 604-605 | S52034R | 08 | 564-566 | ||
| S49032S | 08 | 559-561 | S51009A | 24 | 963-965 | S52034S | 08 | 559-561 | ||
| S49039A | 08 | 562-563 | S51009D | 23 | 949-950 | S52035A | 08 | 562-563 | ||
| S49039A | 24 | 963-965 | S51009S | 09 | 604-605 | S52035A | 24 | 963-965 | ||
| S49039D | 08 | 559-561 | S51011A | 09 | 604-605 | S52035B | 08 | 562-563 | ||
| S49039G | 08 | 559-561 | S51011A | 24 | 963-965 | S52035B | 24 | 963-965 | ||
| S49039K | 08 | 564-566 | S51011D | 23 | 949-950 | S52035C | 08 | 562-563 | ||
| S49039P | 08 | 564-566 | S51011S | 09 | 604-605 | S52035C | 24 | 963-965 | ||
| S49039S | 08 | 559-561 | S51012A | 09 | 604-605 | S52035D | 08 | 559-561 | ||
| S49041A | 08 | 562-563 | S51012A | 24 | 963-965 | S52035E | 08 | 559-561 | ||
| S49041A | 24 | 963-965 | S51012D | 23 | 949-950 | S52035F | 08 | 559-561 | ||
| S49041D | 08 | 559-561 | S51012S | 09 | 604-605 | S52035G | 08 | 559-561 | ||
| S49041G | 08 | 559-561 | S51019A | 09 | 604-605 | S52035H | 08 | 559-561 | ||
| S49041K | 08 | 564-566 | S51019A | 24 | 963-965 | S52035J | 08 | 559-561 | ||
| S49041P | 08 | 564-566 | S51019D | 23 | 949-950 | S52035K | 08 | 564-566 | ||
| S49041S | 08 | 559-561 | S51019S | 09 | 604-605 | S52035M | 08 | 564-566 | ||
| S49042A | 08 | 562-563 | S51021A | 21 | 913-914 | S52035N | 08 | 564-566 | ||
| S49042A | 24 | 963-965 | S51021A | 24 | 963-965 | S52035P | 08 | 564-566 | ||
| S49042D | 08 | 559-561 | S51021D | 23 | 949-950 | S52035Q | 08 | 564-566 | ||
| S49042G | 08 | 559-561 | S51021S | 09 | 604-605 | S52035R | 08 | 564-566 | ||
| S49042K | 08 | 564-566 | S51022A | 21 | 913-914 | S52035S | 08 | 559-561 | ||
| S49042P | 08 | 564-566 | S51022A | 24 | 963-965 | S52036A | 08 | 562-563 | ||
| S49042S | 08 | 559-561 | S51022D | 23 | 949-950 | S52036A | 24 | 963-965 | ||
| S49049A | 08 | 562-563 | S51022S | 09 | 604-605 | S52036B | 08 | 562-563 | ||
| S49049A | 24 | 963-965 | S51029A | 21 | 913-914 | S52036B | 24 | 963-965 | ||
| S49049D | 08 | 559-561 | S51029A | 24 | 963-965 | S52036C | 08 | 562-563 | ||
| S49049G | 08 | 559-561 | S51029D | 23 | 949-950 | S52036C | 24 | 963-965 | ||
| S49049K | 08 | 564-566 | S51029S | 09 | 604-605 | S52036D | 08 | 559-561 | ||
| S49049P | 08 | 564-566 | S51031A | 09 | 604-605 | S52036E | 08 | 559-561 | ||
| S49049S | 08 | 559-561 | S51031A | 24 | 963-965 | S52036F | 08 | 559-561 | ||
| S49091A | 08 | 562-563 | S51031D | 23 | 949-950 | S52036G | 08 | 559-561 | ||
| S49091A | 24 | 963-965 | S51031S | 09 | 604-605 | S52036H | 08 | 559-561 | ||
| S49091D | 08 | 559-561 | S51032A | 09 | 604-605 | S52036J | 08 | 559-561 | ||
| S49091G | 08 | 559-561 | S51032A | 24 | 963-965 | S52036K | 08 | 564-566 | ||
| S49091K | 08 | 564-566 | S51032D | 23 | 949-950 | S52036M | 08 | 564-566 | ||
| S49091P | 08 | 564-566 | S51032S | 09 | 604-605 | S52036N | 08 | 564-566 | ||
| S49091S | 08 | 559-561 | S51039A | 09 | 604-605 | S52036P | 08 | 564-566 | ||
| S49092A | 08 | 562-563 | S51039A | 24 | 963-965 | S52036Q | 08 | 564-566 | ||
| S49092A | 24 | 963-965 | S51039D | 23 | 949-950 | S52036R | 08 | 564-566 | ||
| S49092D | 08 | 559-561 | S51039S | 09 | 604-605 | S52036S | 08 | 559-561 | ||
| S49092G | 08 | 559-561 | S51041A | 21 | 913-914 | S52041A | 08 | 562-563 | ||
| S49092K | 08 | 564-566 | S51041A | 24 | 963-965 | S52041A | 24 | 963-965 | ||
| S49092P | 08 | 564-566 | S51041D | 23 | 949-950 | S52041B | 08 | 562-563 | ||
| S49092S | 08 | 559-561 | S51041S | 09 | 604-605 | S52041B | 24 | 963-965 | ||
| S49099A | 08 | 562-563 | S51042A | 21 | 913-914 | S52041C | 08 | 562-563 | ||
| S49099A | 24 | 963-965 | S51042A | 24 | 963-965 | S52041C | 24 | 963-965 | ||
| S49099D | 08 | 559-561 | S51042D | 23 | 949-950 | S52041D | 08 | 559-561 | ||
| S49099G | 08 | 559-561 | S51042S | 09 | 604-605 | S52041E | 08 | 559-561 | ||
| S49099K | 08 | 564-566 | S51049A | 21 | 913-914 | S52041F | 08 | 559-561 | ||
| S49099P | 08 | 564-566 | S51049A | 24 | 963-965 | S52041G | 08 | 559-561 | ||
| S49099S | 08 | 559-561 | S51049D | 23 | 949-950 | S52041H | 08 | 559-561 | ||
| S49101A | 08 | 562-563 | S51049S | 09 | 604-605 | S52041J | 08 | 559-561 | ||
| S49101A | 24 | 963-965 | S51051A | 09 | 604-605 | S52041K | 08 | 564-566 | ||
| S49101D | 08 | 559-561 | S51051A | 24 | 963-965 | S52041M | 08 | 564-566 | ||
| S49101G | 08 | 559-561 | S51051D | 23 | 949-950 | S52041N | 08 | 564-566 | ||
| S49101K | 08 | 564-566 | S51051S | 09 | 604-605 | S52041P | 08 | 564-566 | ||
| S49101P | 08 | 564-566 | S51052A | 09 | 604-605 | S52041Q | 08 | 564-566 | ||
| S49101S | 08 | 559-561 | S51052A | 24 | 963-965 | S52041R | 08 | 564-566 | ||
| S49102A | 08 | 562-563 | S51052D | 23 | 949-950 | S52041S | 08 | 559-561 | ||
| S49102A | 24 | 963-965 | S51052S | 09 | 604-605 | S52042A | 08 | 562-563 | ||
| S49102D | 08 | 559-561 | S51059A | 09 | 604-605 | S52042A | 24 | 963-965 | ||
| S49102G | 08 | 559-561 | S51059A | 24 | 963-965 | S52042B | 08 | 562-563 | ||
| S49102K | 08 | 564-566 | S51059D | 23 | 949-950 | S52042B | 24 | 963-965 | ||
| S49102P | 08 | 564-566 | S51059S | 09 | 604-605 | S52042C | 08 | 562-563 | ||
| S49102S | 08 | 559-561 | S51801A | 09 | 604-605 | S52042C | 24 | 963-965 | ||
| S49109A | 08 | 562-563 | S51801A | 24 | 963-965 | S52042D | 08 | 559-561 | ||
| S49109A | 24 | 963-965 | S51801D | 23 | 949-950 | S52042E | 08 | 559-561 | ||
| S49109D | 08 | 559-561 | S51801S | 09 | 604-605 | S52042F | 08 | 559-561 | ||
| S49109G | 08 | 559-561 | S51802A | 09 | 604-605 | S52042G | 08 | 559-561 | ||
| S49109K | 08 | 564-566 | S51802A | 24 | 963-965 | S52042H | 08 | 559-561 | ||
| S49109P | 08 | 564-566 | S51802D | 23 | 949-950 | S52042J | 08 | 559-561 | ||
| S49109S | 08 | 559-561 | S51802S | 09 | 604-605 | S52042K | 08 | 564-566 | ||
| S49111A | 08 | 562-563 | S51809A | 09 | 604-605 | S52042M | 08 | 564-566 | ||
| S49111A | 24 | 963-965 | S51809A | 24 | 963-965 | S52042N | 08 | 564-566 | ||
| S49111D | 08 | 559-561 | S51809D | 23 | 949-950 | S52042P | 08 | 564-566 | ||
| S49111G | 08 | 559-561 | S51809S | 09 | 604-605 | S52042Q | 08 | 564-566 | ||
| S49111K | 08 | 564-566 | S51811A | 09 | 604-605 | S52042R | 08 | 564-566 | ||
| S49111P | 08 | 564-566 | S51811A | 24 | 963-965 | S52042S | 08 | 559-561 | ||
| S49111S | 08 | 559-561 | S51811D | 23 | 949-950 | S52043A | 08 | 562-563 | ||
| S49112A | 08 | 562-563 | S51811S | 09 | 604-605 | S52043A | 24 | 963-965 | ||
| S49112A | 24 | 963-965 | S51812A | 09 | 604-605 | S52043B | 08 | 562-563 | ||
| S49112D | 08 | 559-561 | S51812A | 24 | 963-965 | S52043B | 24 | 963-965 | ||
| S49112G | 08 | 559-561 | S51812D | 23 | 949-950 | S52043C | 08 | 562-563 | ||
| S49112K | 08 | 564-566 | S51812S | 09 | 604-605 | S52043C | 24 | 963-965 | ||
| S49112P | 08 | 564-566 | S51819A | 09 | 604-605 | S52043D | 08 | 559-561 | ||
| S49112S | 08 | 559-561 | S51819A | 24 | 963-965 | S52043E | 08 | 559-561 | ||
| S49119A | 08 | 562-563 | S51819D | 23 | 949-950 | S52043F | 08 | 559-561 | ||
| S49119A | 24 | 963-965 | S51819S | 09 | 604-605 | S52043G | 08 | 559-561 | ||
| S49119D | 08 | 559-561 | S51821A | 21 | 913-914 | S52043H | 08 | 559-561 | ||
| S49119G | 08 | 559-561 | S51821A | 24 | 963-965 | S52043J | 08 | 559-561 | ||
| S49119K | 08 | 564-566 | S51821D | 23 | 949-950 | S52043K | 08 | 564-566 | ||
| S49119P | 08 | 564-566 | S51821S | 09 | 604-605 | S52043M | 08 | 564-566 | ||
| S49119S | 08 | 559-561 | S51822A | 21 | 913-914 | S52043N | 08 | 564-566 | ||
| S49121A | 08 | 562-563 | S51822A | 24 | 963-965 | S52043P | 08 | 564-566 | ||
| S49121A | 24 | 963-965 | S51822D | 23 | 949-950 | S52043Q | 08 | 564-566 | ||
| S49121D | 08 | 559-561 | S51822S | 09 | 604-605 | S52043R | 08 | 564-566 | ||
| S49121G | 08 | 559-561 | S51829A | 21 | 913-914 | S52043S | 08 | 559-561 | ||
| S49121K | 08 | 564-566 | S51829A | 24 | 963-965 | S52044A | 08 | 562-563 | ||
| S49121P | 08 | 564-566 | S51829D | 23 | 949-950 | S52044A | 24 | 963-965 | ||
| S49121S | 08 | 559-561 | S51829S | 09 | 604-605 | S52044B | 08 | 562-563 | ||
| S49122A | 08 | 562-563 | S51831A | 09 | 604-605 | S52044B | 24 | 963-965 | ||
| S49122A | 24 | 963-965 | S51831A | 24 | 963-965 | S52044C | 08 | 562-563 | ||
| S49122D | 08 | 559-561 | S51831D | 23 | 949-950 | S52044C | 24 | 963-965 | ||
| S49122G | 08 | 559-561 | S51831S | 09 | 604-605 | S52044D | 08 | 559-561 | ||
| S49122K | 08 | 564-566 | S51832A | 09 | 604-605 | S52044E | 08 | 559-561 | ||
| S49122P | 08 | 564-566 | S51832A | 24 | 963-965 | S52044F | 08 | 559-561 | ||
| S49122S | 08 | 559-561 | S51832D | 23 | 949-950 | S52044G | 08 | 559-561 | ||
| S49129A | 08 | 562-563 | S51832S | 09 | 604-605 | S52044H | 08 | 559-561 | ||
| S49129A | 24 | 963-965 | S51839A | 09 | 604-605 | S52044J | 08 | 559-561 | ||
| S49129D | 08 | 559-561 | S51839A | 24 | 963-965 | S52044K | 08 | 564-566 | ||
| S49129G | 08 | 559-561 | S51839D | 23 | 949-950 | S52044M | 08 | 564-566 | ||
| S49129K | 08 | 564-566 | S51839S | 09 | 604-605 | S52044N | 08 | 564-566 | ||
| S49129P | 08 | 564-566 | S51841A | 21 | 913-914 | S52044P | 08 | 564-566 | ||
| S49129S | 08 | 559-561 | S51841A | 24 | 963-965 | S52044Q | 08 | 564-566 | ||
| S49131A | 08 | 562-563 | S51841D | 23 | 949-950 | S52044R | 08 | 564-566 | ||
| S49131A | 24 | 963-965 | S51841S | 09 | 604-605 | S52044S | 08 | 559-561 | ||
| S49131D | 08 | 559-561 | S51842A | 21 | 913-914 | S52045A | 08 | 562-563 | ||
| S49131G | 08 | 559-561 | S51842A | 24 | 963-965 | S52045A | 24 | 963-965 | ||
| S49131K | 08 | 564-566 | S51842D | 23 | 949-950 | S52045B | 08 | 562-563 | ||
| S49131P | 08 | 564-566 | S51842S | 09 | 604-605 | S52045B | 24 | 963-965 | ||
| S49131S | 08 | 559-561 | S51849A | 21 | 913-914 | S52045C | 08 | 562-563 | ||
| S49132A | 08 | 562-563 | S51849A | 24 | 963-965 | S52045C | 24 | 963-965 | ||
| S49132A | 24 | 963-965 | S51849D | 23 | 949-950 | S52045D | 08 | 559-561 | ||
| S49132D | 08 | 559-561 | S51849S | 09 | 604-605 | S52045E | 08 | 559-561 | ||
| S49132G | 08 | 559-561 | S51851A | 09 | 604-605 | S52045F | 08 | 559-561 | ||
| S49132K | 08 | 564-566 | S51851A | 24 | 963-965 | S52045G | 08 | 559-561 | ||
| S49132P | 08 | 564-566 | S51851D | 23 | 949-950 | S52045H | 08 | 559-561 | ||
| S49132S | 08 | 559-561 | S51851S | 09 | 604-605 | S52045J | 08 | 559-561 | ||
| S49139A | 08 | 562-563 | S51852A | 09 | 604-605 | S52045K | 08 | 564-566 | ||
| S49139A | 24 | 963-965 | S51852A | 24 | 963-965 | S52045M | 08 | 564-566 | ||
| S49139D | 08 | 559-561 | S51852D | 23 | 949-950 | S52045N | 08 | 564-566 | ||
| S49139G | 08 | 559-561 | S51852S | 09 | 604-605 | S52045P | 08 | 564-566 | ||
| S49139K | 08 | 564-566 | S51859A | 09 | 604-605 | S52045Q | 08 | 564-566 | ||
| S51859A | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Aug 2022 07:55:53 CMS, code-revision=335, description-revision=1339 |