ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 41 of 75 |
| A000 B2781 C5712 C8395 D107 E083542 E1301 F13259 G543 H16041 H4303 H8393 I63541 I97610 K4020 L0882 M00239 M19072 M314 M6519 M84311S M84759P M96830 N8501 O2990 O35GXX1 O4192X9 O99845 Q51818 R502 S02118D S06319D S1192XA S15399D S22082B S30823D S32309A S35221D S39002D S42261D S43202A S4991XA S52201Q S52345P S52699N S56909D S60929A S62136P S62390B S63208D S65500D S68619D S72043S S72133F S72355A S7291XC S80211S S82132R S82399Q S82854P S85801A S90821D S92153B S93103D S99032A T2161XA T23661D T3371XA T40903A T457X5D T50B15D T632X3D T8112XD T8454XD Z4801 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S43202A | 04 | 183-185 | S45119A | 21 | 913-914 | S46901A | 21 | 913-914 | ||
| S43202A | 24 | 963-965 | S45119A | 24 | 963-965 | S46901A | 24 | 963-965 | ||
| S43202D | 23 | 949-950 | S45119D | 23 | 949-950 | S46901D | 23 | 949-950 | ||
| S43202S | 08 | 562-563 | S45119S | 05 | 299-301 | S46901S | 21 | 913-914 | ||
| S43203A | 04 | 183-185 | S45191A | 21 | 913-914 | S46902A | 21 | 913-914 | ||
| S43203A | 24 | 963-965 | S45191A | 24 | 963-965 | S46902A | 24 | 963-965 | ||
| S43203D | 23 | 949-950 | S45191D | 23 | 949-950 | S46902D | 23 | 949-950 | ||
| S43203S | 08 | 562-563 | S45191S | 05 | 299-301 | S46902S | 21 | 913-914 | ||
| S43204A | 04 | 183-185 | S45192A | 21 | 913-914 | S46909A | 21 | 913-914 | ||
| S43204A | 24 | 963-965 | S45192A | 24 | 963-965 | S46909A | 24 | 963-965 | ||
| S43204D | 23 | 949-950 | S45192D | 23 | 949-950 | S46909D | 23 | 949-950 | ||
| S43204S | 08 | 562-563 | S45192S | 05 | 299-301 | S46909S | 21 | 913-914 | ||
| S43205A | 04 | 183-185 | S45199A | 21 | 913-914 | S46911A | 08 | 562-563 | ||
| S43205A | 24 | 963-965 | S45199A | 24 | 963-965 | S46911A | 24 | 963-965 | ||
| S43205D | 23 | 949-950 | S45199D | 23 | 949-950 | S46911D | 23 | 949-950 | ||
| S43205S | 08 | 562-563 | S45199S | 05 | 299-301 | S46911S | 08 | 562-563 | ||
| S43206A | 04 | 183-185 | S45201A | 21 | 913-914 | S46912A | 08 | 562-563 | ||
| S43206A | 24 | 963-965 | S45201A | 24 | 963-965 | S46912A | 24 | 963-965 | ||
| S43206D | 23 | 949-950 | S45201D | 23 | 949-950 | S46912D | 23 | 949-950 | ||
| S43206S | 08 | 562-563 | S45201S | 05 | 299-301 | S46912S | 08 | 562-563 | ||
| S43211A | 04 | 183-185 | S45202A | 21 | 913-914 | S46919A | 08 | 562-563 | ||
| S43211A | 24 | 963-965 | S45202A | 24 | 963-965 | S46919A | 24 | 963-965 | ||
| S43211D | 23 | 949-950 | S45202D | 23 | 949-950 | S46919D | 23 | 949-950 | ||
| S43211S | 08 | 562-563 | S45202S | 05 | 299-301 | S46919S | 08 | 562-563 | ||
| S43212A | 04 | 183-185 | S45209A | 21 | 913-914 | S46921A | 08 | 564-566 | ||
| S43212A | 24 | 963-965 | S45209A | 24 | 963-965 | S46921A | 24 | 963-965 | ||
| S43212D | 23 | 949-950 | S45209D | 23 | 949-950 | S46921D | 23 | 949-950 | ||
| S43212S | 08 | 562-563 | S45209S | 05 | 299-301 | S46921S | 09 | 604-605 | ||
| S43213A | 04 | 183-185 | S45211A | 21 | 913-914 | S46922A | 08 | 564-566 | ||
| S43213A | 24 | 963-965 | S45211A | 24 | 963-965 | S46922A | 24 | 963-965 | ||
| S43213D | 23 | 949-950 | S45211D | 23 | 949-950 | S46922D | 23 | 949-950 | ||
| S43213S | 08 | 562-563 | S45211S | 05 | 299-301 | S46922S | 09 | 604-605 | ||
| S43214A | 04 | 183-185 | S45212A | 21 | 913-914 | S46929A | 08 | 564-566 | ||
| S43214A | 24 | 963-965 | S45212A | 24 | 963-965 | S46929A | 24 | 963-965 | ||
| S43214D | 23 | 949-950 | S45212D | 23 | 949-950 | S46929D | 23 | 949-950 | ||
| S43214S | 08 | 562-563 | S45212S | 05 | 299-301 | S46929S | 09 | 604-605 | ||
| S43215A | 04 | 183-185 | S45219A | 21 | 913-914 | S46991A | 21 | 913-914 | ||
| S43215A | 24 | 963-965 | S45219A | 24 | 963-965 | S46991A | 24 | 963-965 | ||
| S43215D | 23 | 949-950 | S45219D | 23 | 949-950 | S46991D | 23 | 949-950 | ||
| S43215S | 08 | 562-563 | S45219S | 05 | 299-301 | S46991S | 21 | 913-914 | ||
| S43216A | 04 | 183-185 | S45291A | 21 | 913-914 | S46992A | 21 | 913-914 | ||
| S43216A | 24 | 963-965 | S45291A | 24 | 963-965 | S46992A | 24 | 963-965 | ||
| S43216D | 23 | 949-950 | S45291D | 23 | 949-950 | S46992D | 23 | 949-950 | ||
| S43216S | 08 | 562-563 | S45291S | 05 | 299-301 | S46992S | 21 | 913-914 | ||
| S43221A | 04 | 183-185 | S45292A | 21 | 913-914 | S46999A | 21 | 913-914 | ||
| S43221A | 24 | 963-965 | S45292A | 24 | 963-965 | S46999A | 24 | 963-965 | ||
| S43221D | 23 | 949-950 | S45292D | 23 | 949-950 | S46999D | 23 | 949-950 | ||
| S43221S | 08 | 562-563 | S45292S | 05 | 299-301 | S46999S | 21 | 913-914 | ||
| S43222A | 04 | 183-185 | S45299A | 21 | 913-914 | S471XXA | 21 | 913-914 | ||
| S43222A | 24 | 963-965 | S45299A | 24 | 963-965 | S471XXA | 24 | 963-965 | ||
| S43222D | 23 | 949-950 | S45299D | 23 | 949-950 | S471XXD | 23 | 949-950 | ||
| S43222S | 08 | 562-563 | S45299S | 05 | 299-301 | S471XXS | 09 | 604-605 | ||
| S43223A | 04 | 183-185 | S45301A | 21 | 913-914 | S472XXA | 21 | 913-914 | ||
| S43223A | 24 | 963-965 | S45301A | 24 | 963-965 | S472XXA | 24 | 963-965 | ||
| S43223D | 23 | 949-950 | S45301D | 23 | 949-950 | S472XXD | 23 | 949-950 | ||
| S43223S | 08 | 562-563 | S45301S | 05 | 299-301 | S472XXS | 09 | 604-605 | ||
| S43224A | 04 | 183-185 | S45302A | 21 | 913-914 | S479XXA | 21 | 913-914 | ||
| S43224A | 24 | 963-965 | S45302A | 24 | 963-965 | S479XXA | 24 | 963-965 | ||
| S43224D | 23 | 949-950 | S45302D | 23 | 949-950 | S479XXD | 23 | 949-950 | ||
| S43224S | 08 | 562-563 | S45302S | 05 | 299-301 | S479XXS | 09 | 604-605 | ||
| S43225A | 04 | 183-185 | S45309A | 21 | 913-914 | S48011A | 21 | 913-914 | ||
| S43225A | 24 | 963-965 | S45309A | 24 | 963-965 | S48011A | 24 | 963-965 | ||
| S43225D | 23 | 949-950 | S45309D | 23 | 949-950 | S48011D | 23 | 949-950 | ||
| S43225S | 08 | 562-563 | S45309S | 05 | 299-301 | S48011S | 08 | 559-561 | ||
| S43226A | 04 | 183-185 | S45311A | 21 | 913-914 | S48012A | 21 | 913-914 | ||
| S43226A | 24 | 963-965 | S45311A | 24 | 963-965 | S48012A | 24 | 963-965 | ||
| S43226D | 23 | 949-950 | S45311D | 23 | 949-950 | S48012D | 23 | 949-950 | ||
| S43226S | 08 | 562-563 | S45311S | 05 | 299-301 | S48012S | 08 | 559-561 | ||
| S43301A | 08 | 562-563 | S45312A | 21 | 913-914 | S48019A | 21 | 913-914 | ||
| S43301A | 24 | 963-965 | S45312A | 24 | 963-965 | S48019A | 24 | 963-965 | ||
| S43301D | 23 | 949-950 | S45312D | 23 | 949-950 | S48019D | 23 | 949-950 | ||
| S43301S | 08 | 562-563 | S45312S | 05 | 299-301 | S48019S | 08 | 559-561 | ||
| S43302A | 08 | 562-563 | S45319A | 21 | 913-914 | S48021A | 21 | 913-914 | ||
| S43302A | 24 | 963-965 | S45319A | 24 | 963-965 | S48021A | 24 | 963-965 | ||
| S43302D | 23 | 949-950 | S45319D | 23 | 949-950 | S48021D | 23 | 949-950 | ||
| S43302S | 08 | 562-563 | S45319S | 05 | 299-301 | S48021S | 08 | 559-561 | ||
| S43303A | 08 | 562-563 | S45391A | 21 | 913-914 | S48022A | 21 | 913-914 | ||
| S43303A | 24 | 963-965 | S45391A | 24 | 963-965 | S48022A | 24 | 963-965 | ||
| S43303D | 23 | 949-950 | S45391D | 23 | 949-950 | S48022D | 23 | 949-950 | ||
| S43303S | 08 | 562-563 | S45391S | 05 | 299-301 | S48022S | 08 | 559-561 | ||
| S43304A | 08 | 562-563 | S45392A | 21 | 913-914 | S48029A | 21 | 913-914 | ||
| S43304A | 24 | 963-965 | S45392A | 24 | 963-965 | S48029A | 24 | 963-965 | ||
| S43304D | 23 | 949-950 | S45392D | 23 | 949-950 | S48029D | 23 | 949-950 | ||
| S43304S | 08 | 562-563 | S45392S | 05 | 299-301 | S48029S | 08 | 559-561 | ||
| S43305A | 08 | 562-563 | S45399A | 21 | 913-914 | S48111A | 21 | 913-914 | ||
| S43305A | 24 | 963-965 | S45399A | 24 | 963-965 | S48111A | 24 | 963-965 | ||
| S43305D | 23 | 949-950 | S45399D | 23 | 949-950 | S48111D | 23 | 949-950 | ||
| S43305S | 08 | 562-563 | S45399S | 05 | 299-301 | S48111S | 08 | 559-561 | ||
| S43306A | 08 | 562-563 | S45801A | 21 | 913-914 | S48112A | 21 | 913-914 | ||
| S43306A | 24 | 963-965 | S45801A | 24 | 963-965 | S48112A | 24 | 963-965 | ||
| S43306D | 23 | 949-950 | S45801D | 23 | 949-950 | S48112D | 23 | 949-950 | ||
| S43306S | 08 | 562-563 | S45801S | 05 | 299-301 | S48112S | 08 | 559-561 | ||
| S43311A | 08 | 562-563 | S45802A | 21 | 913-914 | S48119A | 21 | 913-914 | ||
| S43311A | 24 | 963-965 | S45802A | 24 | 963-965 | S48119A | 24 | 963-965 | ||
| S43311D | 23 | 949-950 | S45802D | 23 | 949-950 | S48119D | 23 | 949-950 | ||
| S43311S | 08 | 562-563 | S45802S | 05 | 299-301 | S48119S | 08 | 559-561 | ||
| S43312A | 08 | 562-563 | S45809A | 21 | 913-914 | S48121A | 21 | 913-914 | ||
| S43312A | 24 | 963-965 | S45809A | 24 | 963-965 | S48121A | 24 | 963-965 | ||
| S43312D | 23 | 949-950 | S45809D | 23 | 949-950 | S48121D | 23 | 949-950 | ||
| S43312S | 08 | 562-563 | S45809S | 05 | 299-301 | S48121S | 08 | 559-561 | ||
| S43313A | 08 | 562-563 | S45811A | 21 | 913-914 | S48122A | 21 | 913-914 | ||
| S43313A | 24 | 963-965 | S45811A | 24 | 963-965 | S48122A | 24 | 963-965 | ||
| S43313D | 23 | 949-950 | S45811D | 23 | 949-950 | S48122D | 23 | 949-950 | ||
| S43313S | 08 | 562-563 | S45811S | 05 | 299-301 | S48122S | 08 | 559-561 | ||
| S43314A | 08 | 562-563 | S45812A | 21 | 913-914 | S48129A | 21 | 913-914 | ||
| S43314A | 24 | 963-965 | S45812A | 24 | 963-965 | S48129A | 24 | 963-965 | ||
| S43314D | 23 | 949-950 | S45812D | 23 | 949-950 | S48129D | 23 | 949-950 | ||
| S43314S | 08 | 562-563 | S45812S | 05 | 299-301 | S48129S | 08 | 559-561 | ||
| S43315A | 08 | 562-563 | S45819A | 21 | 913-914 | S48911A | 21 | 913-914 | ||
| S43315A | 24 | 963-965 | S45819A | 24 | 963-965 | S48911A | 24 | 963-965 | ||
| S43315D | 23 | 949-950 | S45819D | 23 | 949-950 | S48911D | 23 | 949-950 | ||
| S43315S | 08 | 562-563 | S45819S | 05 | 299-301 | S48911S | 08 | 559-561 | ||
| S43316A | 08 | 562-563 | S45891A | 21 | 913-914 | S48912A | 21 | 913-914 | ||
| S43316A | 24 | 963-965 | S45891A | 24 | 963-965 | S48912A | 24 | 963-965 | ||
| S43316D | 23 | 949-950 | S45891D | 23 | 949-950 | S48912D | 23 | 949-950 | ||
| S43316S | 08 | 562-563 | S45891S | 05 | 299-301 | S48912S | 08 | 559-561 | ||
| S43391A | 08 | 562-563 | S45892A | 21 | 913-914 | S48919A | 21 | 913-914 | ||
| S43391A | 24 | 963-965 | S45892A | 24 | 963-965 | S48919A | 24 | 963-965 | ||
| S43391D | 23 | 949-950 | S45892D | 23 | 949-950 | S48919D | 23 | 949-950 | ||
| S43391S | 08 | 562-563 | S45892S | 05 | 299-301 | S48919S | 08 | 559-561 | ||
| S43392A | 08 | 562-563 | S45899A | 21 | 913-914 | S48921A | 21 | 913-914 | ||
| S43392A | 24 | 963-965 | S45899A | 24 | 963-965 | S48921A | 24 | 963-965 | ||
| S43392D | 23 | 949-950 | S45899D | 23 | 949-950 | S48921D | 23 | 949-950 | ||
| S43392S | 08 | 562-563 | S45899S | 05 | 299-301 | S48921S | 08 | 559-561 | ||
| S43393A | 08 | 562-563 | S45901A | 21 | 913-914 | S48922A | 21 | 913-914 | ||
| S43393A | 24 | 963-965 | S45901A | 24 | 963-965 | S48922A | 24 | 963-965 | ||
| S43393D | 23 | 949-950 | S45901D | 23 | 949-950 | S48922D | 23 | 949-950 | ||
| S43393S | 08 | 562-563 | S45901S | 05 | 299-301 | S48922S | 08 | 559-561 | ||
| S43394A | 08 | 562-563 | S45902A | 21 | 913-914 | S48929A | 21 | 913-914 | ||
| S43394A | 24 | 963-965 | S45902A | 24 | 963-965 | S48929A | 24 | 963-965 | ||
| S43394D | 23 | 949-950 | S45902D | 23 | 949-950 | S48929D | 23 | 949-950 | ||
| S43394S | 08 | 562-563 | S45902S | 05 | 299-301 | S48929S | 08 | 559-561 | ||
| S43395A | 08 | 562-563 | S45909A | 21 | 913-914 | S49001A | 08 | 562-563 | ||
| S43395A | 24 | 963-965 | S45909A | 24 | 963-965 | S49001A | 24 | 963-965 | ||
| S43395D | 23 | 949-950 | S45909D | 23 | 949-950 | S49001D | 08 | 559-561 | ||
| S43395S | 08 | 562-563 | S45909S | 05 | 299-301 | S49001G | 08 | 559-561 | ||
| S43396A | 08 | 562-563 | S45911A | 21 | 913-914 | S49001K | 08 | 564-566 | ||
| S43396A | 24 | 963-965 | S45911A | 24 | 963-965 | S49001P | 08 | 564-566 | ||
| S43396D | 23 | 949-950 | S45911D | 23 | 949-950 | S49001S | 08 | 559-561 | ||
| S43396S | 08 | 562-563 | S45911S | 05 | 299-301 | S49002A | 08 | 562-563 | ||
| S43401A | 08 | 562-563 | S45912A | 21 | 913-914 | S49002A | 24 | 963-965 | ||
| S43401A | 24 | 963-965 | S45912A | 24 | 963-965 | S49002D | 08 | 559-561 | ||
| S43401D | 23 | 949-950 | S45912D | 23 | 949-950 | S49002G | 08 | 559-561 | ||
| S43401S | 08 | 562-563 | S45912S | 05 | 299-301 | S49002K | 08 | 564-566 | ||
| S43402A | 08 | 562-563 | S45919A | 21 | 913-914 | S49002P | 08 | 564-566 | ||
| S43402A | 24 | 963-965 | S45919A | 24 | 963-965 | S49002S | 08 | 559-561 | ||
| S43402D | 23 | 949-950 | S45919D | 23 | 949-950 | S49009A | 08 | 562-563 | ||
| S43402S | 08 | 562-563 | S45919S | 05 | 299-301 | S49009A | 24 | 963-965 | ||
| S43409A | 08 | 562-563 | S45991A | 21 | 913-914 | S49009D | 08 | 559-561 | ||
| S43409A | 24 | 963-965 | S45991A | 24 | 963-965 | S49009G | 08 | 559-561 | ||
| S43409D | 23 | 949-950 | S45991D | 23 | 949-950 | S49009K | 08 | 564-566 | ||
| S43409S | 08 | 562-563 | S45991S | 05 | 299-301 | S49009P | 08 | 564-566 | ||
| S43411A | 08 | 562-563 | S45992A | 21 | 913-914 | S49009S | 08 | 559-561 | ||
| S43411A | 24 | 963-965 | S45992A | 24 | 963-965 | S49011A | 08 | 562-563 | ||
| S43411D | 23 | 949-950 | S45992D | 23 | 949-950 | S49011A | 24 | 963-965 | ||
| S43411S | 08 | 562-563 | S45992S | 05 | 299-301 | S49011D | 08 | 559-561 | ||
| S43412A | 08 | 562-563 | S45999A | 21 | 913-914 | S49011G | 08 | 559-561 | ||
| S43412A | 24 | 963-965 | S45999A | 24 | 963-965 | S49011K | 08 | 564-566 | ||
| S43412D | 23 | 949-950 | S45999D | 23 | 949-950 | S49011P | 08 | 564-566 | ||
| S43412S | 08 | 562-563 | S45999S | 05 | 299-301 | S49011S | 08 | 559-561 | ||
| S43419A | 08 | 562-563 | S46001A | 21 | 913-914 | S49012A | 08 | 562-563 | ||
| S43419A | 24 | 963-965 | S46001A | 24 | 963-965 | S49012A | 24 | 963-965 | ||
| S43419D | 23 | 949-950 | S46001D | 23 | 949-950 | S49012D | 08 | 559-561 | ||
| S43419S | 08 | 562-563 | S46001S | 21 | 913-914 | S49012G | 08 | 559-561 | ||
| S43421A | 08 | 562-563 | S46002A | 21 | 913-914 | S49012K | 08 | 564-566 | ||
| S43421A | 24 | 963-965 | S46002A | 24 | 963-965 | S49012P | 08 | 564-566 | ||
| S43421D | 23 | 949-950 | S46002D | 23 | 949-950 | S49012S | 08 | 559-561 | ||
| S43421S | 08 | 562-563 | S46002S | 21 | 913-914 | S49019A | 08 | 562-563 | ||
| S43422A | 08 | 562-563 | S46009A | 21 | 913-914 | S49019A | 24 | 963-965 | ||
| S43422A | 24 | 963-965 | S46009A | 24 | 963-965 | S49019D | 08 | 559-561 | ||
| S43422D | 23 | 949-950 | S46009D | 23 | 949-950 | S49019G | 08 | 559-561 | ||
| S43422S | 08 | 562-563 | S46009S | 21 | 913-914 | S49019K | 08 | 564-566 | ||
| S43429A | 08 | 562-563 | S46011A | 08 | 562-563 | S49019P | 08 | 564-566 | ||
| S43429A | 24 | 963-965 | S46011A | 24 | 963-965 | S49019S | 08 | 559-561 | ||
| S43429D | 23 | 949-950 | S46011D | 23 | 949-950 | S49021A | 08 | 562-563 | ||
| S43429S | 08 | 562-563 | S46011S | 08 | 562-563 | S49021A | 24 | 963-965 | ||
| S43431A | 08 | 562-563 | S46012A | 08 | 562-563 | S49021D | 08 | 559-561 | ||
| S43431A | 24 | 963-965 | S46012A | 24 | 963-965 | S49021G | 08 | 559-561 | ||
| S43431D | 23 | 949-950 | S46012D | 23 | 949-950 | S49021K | 08 | 564-566 | ||
| S43431S | 08 | 562-563 | S46012S | 08 | 562-563 | S49021P | 08 | 564-566 | ||
| S43432A | 08 | 562-563 | S46019A | 08 | 562-563 | S49021S | 08 | 559-561 | ||
| S43432A | 24 | 963-965 | S46019A | 24 | 963-965 | S49022A | 08 | 562-563 | ||
| S43432D | 23 | 949-950 | S46019D | 23 | 949-950 | S49022A | 24 | 963-965 | ||
| S43432S | 08 | 562-563 | S46019S | 08 | 562-563 | S49022D | 08 | 559-561 | ||
| S43439A | 08 | 562-563 | S46021A | 08 | 564-566 | S49022G | 08 | 559-561 | ||
| S43439A | 24 | 963-965 | S46021A | 24 | 963-965 | S49022K | 08 | 564-566 | ||
| S43439D | 23 | 949-950 | S46021D | 23 | 949-950 | S49022P | 08 | 564-566 | ||
| S43439S | 08 | 562-563 | S46021S | 09 | 604-605 | S49022S | 08 | 559-561 | ||
| S43491A | 08 | 562-563 | S46022A | 08 | 564-566 | S49029A | 08 | 562-563 | ||
| S43491A | 24 | 963-965 | S46022A | 24 | 963-965 | S49029A | 24 | 963-965 | ||
| S43491D | 23 | 949-950 | S46022D | 23 | 949-950 | S49029D | 08 | 559-561 | ||
| S43491S | 08 | 562-563 | S46022S | 09 | 604-605 | S49029G | 08 | 559-561 | ||
| S43492A | 08 | 562-563 | S46029A | 08 | 564-566 | S49029K | 08 | 564-566 | ||
| S43492A | 24 | 963-965 | S46029A | 24 | 963-965 | S49029P | 08 | 564-566 | ||
| S43492D | 23 | 949-950 | S46029D | 23 | 949-950 | S49029S | 08 | 559-561 | ||
| S43492S | 08 | 562-563 | S46029S | 09 | 604-605 | S49031A | 08 | 562-563 | ||
| S43499A | 08 | 562-563 | S46091A | 21 | 913-914 | S49031A | 24 | 963-965 | ||
| S43499A | 24 | 963-965 | S46091A | 24 | 963-965 | S49031D | 08 | 559-561 | ||
| S43499D | 23 | 949-950 | S46091D | 23 | 949-950 | S49031G | 08 | 559-561 | ||
| S43499S | 08 | 562-563 | S46091S | 21 | 913-914 | S49031K | 08 | 564-566 | ||
| S4350XA | 08 | 562-563 | S46092A | 21 | 913-914 | S49031P | 08 | 564-566 | ||
| S4350XA | 24 | 963-965 | S46092A | 24 | 963-965 | S49031S | 08 | 559-561 | ||
| S4350XD | 23 | 949-950 | S46092D | 23 | 949-950 | S49032A | 08 | 562-563 | ||
| S4350XS | 08 | 562-563 | S46092S | 21 | 913-914 | S49032A | 24 | 963-965 | ||
| S4351XA | 08 | 562-563 | S46099A | 21 | 913-914 | S49032D | 08 | 559-561 | ||
| S4351XA | 24 | 963-965 | S46099A | 24 | 963-965 | S49032G | 08 | 559-561 | ||
| S4351XD | 23 | 949-950 | S46099D | 23 | 949-950 | S49032K | 08 | 564-566 | ||
| S4351XS | 08 | 562-563 | S46099S | 21 | 913-914 | S49032P | 08 | 564-566 | ||
| S4352XA | 08 | 562-563 | S46101A | 21 | 913-914 | S49032S | 08 | 559-561 | ||
| S4352XA | 24 | 963-965 | S46101A | 24 | 963-965 | S49039A | 08 | 562-563 | ||
| S4352XD | 23 | 949-950 | S46101D | 23 | 949-950 | S49039A | 24 | 963-965 | ||
| S4352XS | 08 | 562-563 | S46101S | 21 | 913-914 | S49039D | 08 | 559-561 | ||
| S4360XA | 08 | 562-563 | S46102A | 21 | 913-914 | S49039G | 08 | 559-561 | ||
| S4360XA | 24 | 963-965 | S46102A | 24 | 963-965 | S49039K | 08 | 564-566 | ||
| S4360XD | 23 | 949-950 | S46102D | 23 | 949-950 | S49039P | 08 | 564-566 | ||
| S4360XS | 08 | 562-563 | S46102S | 21 | 913-914 | S49039S | 08 | 559-561 | ||
| S4361XA | 08 | 562-563 | S46109A | 21 | 913-914 | S49041A | 08 | 562-563 | ||
| S4361XA | 24 | 963-965 | S46109A | 24 | 963-965 | S49041A | 24 | 963-965 | ||
| S4361XD | 23 | 949-950 | S46109D | 23 | 949-950 | S49041D | 08 | 559-561 | ||
| S4361XS | 08 | 562-563 | S46109S | 21 | 913-914 | S49041G | 08 | 559-561 | ||
| S4362XA | 08 | 562-563 | S46111A | 08 | 562-563 | S49041K | 08 | 564-566 | ||
| S4362XA | 24 | 963-965 | S46111A | 24 | 963-965 | S49041P | 08 | 564-566 | ||
| S4362XD | 23 | 949-950 | S46111D | 23 | 949-950 | S49041S | 08 | 559-561 | ||
| S4362XS | 08 | 562-563 | S46111S | 08 | 562-563 | S49042A | 08 | 562-563 | ||
| S4380XA | 08 | 562-563 | S46112A | 08 | 562-563 | S49042A | 24 | 963-965 | ||
| S4380XA | 24 | 963-965 | S46112A | 24 | 963-965 | S49042D | 08 | 559-561 | ||
| S4380XD | 23 | 949-950 | S46112D | 23 | 949-950 | S49042G | 08 | 559-561 | ||
| S4380XS | 08 | 562-563 | S46112S | 08 | 562-563 | S49042K | 08 | 564-566 | ||
| S4381XA | 08 | 562-563 | S46119A | 08 | 562-563 | S49042P | 08 | 564-566 | ||
| S4381XA | 24 | 963-965 | S46119A | 24 | 963-965 | S49042S | 08 | 559-561 | ||
| S4381XD | 23 | 949-950 | S46119D | 23 | 949-950 | S49049A | 08 | 562-563 | ||
| S4381XS | 08 | 562-563 | S46119S | 08 | 562-563 | S49049A | 24 | 963-965 | ||
| S4382XA | 08 | 562-563 | S46121A | 08 | 564-566 | S49049D | 08 | 559-561 | ||
| S4382XA | 24 | 963-965 | S46121A | 24 | 963-965 | S49049G | 08 | 559-561 | ||
| S4382XD | 23 | 949-950 | S46121D | 23 | 949-950 | S49049K | 08 | 564-566 | ||
| S4382XS | 08 | 562-563 | S46121S | 09 | 604-605 | S49049P | 08 | 564-566 | ||
| S4390XA | 08 | 562-563 | S46122A | 08 | 564-566 | S49049S | 08 | 559-561 | ||
| S4390XA | 24 | 963-965 | S46122A | 24 | 963-965 | S49091A | 08 | 562-563 | ||
| S4390XD | 23 | 949-950 | S46122D | 23 | 949-950 | S49091A | 24 | 963-965 | ||
| S4390XS | 08 | 562-563 | S46122S | 09 | 604-605 | S49091D | 08 | 559-561 | ||
| S4391XA | 08 | 562-563 | S46129A | 08 | 564-566 | S49091G | 08 | 559-561 | ||
| S4391XA | 24 | 963-965 | S46129A | 24 | 963-965 | S49091K | 08 | 564-566 | ||
| S4391XD | 23 | 949-950 | S46129D | 23 | 949-950 | S49091P | 08 | 564-566 | ||
| S4391XS | 08 | 562-563 | S46129S | 09 | 604-605 | S49091S | 08 | 559-561 | ||
| S4392XA | 08 | 562-563 | S46191A | 21 | 913-914 | S49092A | 08 | 562-563 | ||
| S4392XA | 24 | 963-965 | S46191A | 24 | 963-965 | S49092A | 24 | 963-965 | ||
| S4392XD | 23 | 949-950 | S46191D | 23 | 949-950 | S49092D | 08 | 559-561 | ||
| S4392XS | 08 | 562-563 | S46191S | 21 | 913-914 | S49092G | 08 | 559-561 | ||
| S4400XA | 01 | 073-074 | S46192A | 21 | 913-914 | S49092K | 08 | 564-566 | ||
| S4400XA | 24 | 963-965 | S46192A | 24 | 963-965 | S49092P | 08 | 564-566 | ||
| S4400XD | 23 | 949-950 | S46192D | 23 | 949-950 | S49092S | 08 | 559-561 | ||
| S4400XS | 01 | 091-093 | S46192S | 21 | 913-914 | S49099A | 08 | 562-563 | ||
| S4401XA | 01 | 073-074 | S46199A | 21 | 913-914 | S49099A | 24 | 963-965 | ||
| S4401XA | 24 | 963-965 | S46199A | 24 | 963-965 | S49099D | 08 | 559-561 | ||
| S4401XD | 23 | 949-950 | S46199D | 23 | 949-950 | S49099G | 08 | 559-561 | ||
| S4401XS | 01 | 091-093 | S46199S | 21 | 913-914 | S49099K | 08 | 564-566 | ||
| S4402XA | 01 | 073-074 | S46201A | 21 | 913-914 | S49099P | 08 | 564-566 | ||
| S4402XA | 24 | 963-965 | S46201A | 24 | 963-965 | S49099S | 08 | 559-561 | ||
| S4402XD | 23 | 949-950 | S46201D | 23 | 949-950 | S49101A | 08 | 562-563 | ||
| S4402XS | 01 | 091-093 | S46201S | 21 | 913-914 | S49101A | 24 | 963-965 | ||
| S4410XA | 01 | 073-074 | S46202A | 21 | 913-914 | S49101D | 08 | 559-561 | ||
| S4410XA | 24 | 963-965 | S46202A | 24 | 963-965 | S49101G | 08 | 559-561 | ||
| S4410XD | 23 | 949-950 | S46202D | 23 | 949-950 | S49101K | 08 | 564-566 | ||
| S4410XS | 01 | 091-093 | S46202S | 21 | 913-914 | S49101P | 08 | 564-566 | ||
| S4411XA | 01 | 073-074 | S46209A | 21 | 913-914 | S49101S | 08 | 559-561 | ||
| S4411XA | 24 | 963-965 | S46209A | 24 | 963-965 | S49102A | 08 | 562-563 | ||
| S4411XD | 23 | 949-950 | S46209D | 23 | 949-950 | S49102A | 24 | 963-965 | ||
| S4411XS | 01 | 091-093 | S46209S | 21 | 913-914 | S49102D | 08 | 559-561 | ||
| S4412XA | 01 | 073-074 | S46211A | 08 | 562-563 | S49102G | 08 | 559-561 | ||
| S4412XA | 24 | 963-965 | S46211A | 24 | 963-965 | S49102K | 08 | 564-566 | ||
| S4412XD | 23 | 949-950 | S46211D | 23 | 949-950 | S49102P | 08 | 564-566 | ||
| S4412XS | 01 | 091-093 | S46211S | 08 | 562-563 | S49102S | 08 | 559-561 | ||
| S4420XA | 01 | 073-074 | S46212A | 08 | 562-563 | S49109A | 08 | 562-563 | ||
| S4420XA | 24 | 963-965 | S46212A | 24 | 963-965 | S49109A | 24 | 963-965 | ||
| S4420XD | 23 | 949-950 | S46212D | 23 | 949-950 | S49109D | 08 | 559-561 | ||
| S4420XS | 01 | 091-093 | S46212S | 08 | 562-563 | S49109G | 08 | 559-561 | ||
| S4421XA | 01 | 073-074 | S46219A | 08 | 562-563 | S49109K | 08 | 564-566 | ||
| S4421XA | 24 | 963-965 | S46219A | 24 | 963-965 | S49109P | 08 | 564-566 | ||
| S4421XD | 23 | 949-950 | S46219D | 23 | 949-950 | S49109S | 08 | 559-561 | ||
| S4421XS | 01 | 091-093 | S46219S | 08 | 562-563 | S49111A | 08 | 562-563 | ||
| S4422XA | 01 | 073-074 | S46221A | 08 | 564-566 | S49111A | 24 | 963-965 | ||
| S4422XA | 24 | 963-965 | S46221A | 24 | 963-965 | S49111D | 08 | 559-561 | ||
| S4422XD | 23 | 949-950 | S46221D | 23 | 949-950 | S49111G | 08 | 559-561 | ||
| S4422XS | 01 | 091-093 | S46221S | 09 | 604-605 | S49111K | 08 | 564-566 | ||
| S4430XA | 01 | 073-074 | S46222A | 08 | 564-566 | S49111P | 08 | 564-566 | ||
| S4430XA | 24 | 963-965 | S46222A | 24 | 963-965 | S49111S | 08 | 559-561 | ||
| S4430XD | 23 | 949-950 | S46222D | 23 | 949-950 | S49112A | 08 | 562-563 | ||
| S4430XS | 01 | 091-093 | S46222S | 09 | 604-605 | S49112A | 24 | 963-965 | ||
| S4431XA | 01 | 073-074 | S46229A | 08 | 564-566 | S49112D | 08 | 559-561 | ||
| S4431XA | 24 | 963-965 | S46229A | 24 | 963-965 | S49112G | 08 | 559-561 | ||
| S4431XD | 23 | 949-950 | S46229D | 23 | 949-950 | S49112K | 08 | 564-566 | ||
| S4431XS | 01 | 091-093 | S46229S | 09 | 604-605 | S49112P | 08 | 564-566 | ||
| S4432XA | 01 | 073-074 | S46291A | 21 | 913-914 | S49112S | 08 | 559-561 | ||
| S4432XA | 24 | 963-965 | S46291A | 24 | 963-965 | S49119A | 08 | 562-563 | ||
| S4432XD | 23 | 949-950 | S46291D | 23 | 949-950 | S49119A | 24 | 963-965 | ||
| S4432XS | 01 | 091-093 | S46291S | 21 | 913-914 | S49119D | 08 | 559-561 | ||
| S4440XA | 01 | 073-074 | S46292A | 21 | 913-914 | S49119G | 08 | 559-561 | ||
| S4440XA | 24 | 963-965 | S46292A | 24 | 963-965 | S49119K | 08 | 564-566 | ||
| S4440XD | 23 | 949-950 | S46292D | 23 | 949-950 | S49119P | 08 | 564-566 | ||
| S4440XS | 01 | 091-093 | S46292S | 21 | 913-914 | S49119S | 08 | 559-561 | ||
| S4441XA | 01 | 073-074 | S46299A | 21 | 913-914 | S49121A | 08 | 562-563 | ||
| S4441XA | 24 | 963-965 | S46299A | 24 | 963-965 | S49121A | 24 | 963-965 | ||
| S4441XD | 23 | 949-950 | S46299D | 23 | 949-950 | S49121D | 08 | 559-561 | ||
| S4441XS | 01 | 091-093 | S46299S | 21 | 913-914 | S49121G | 08 | 559-561 | ||
| S4442XA | 01 | 073-074 | S46301A | 21 | 913-914 | S49121K | 08 | 564-566 | ||
| S4442XA | 24 | 963-965 | S46301A | 24 | 963-965 | S49121P | 08 | 564-566 | ||
| S4442XD | 23 | 949-950 | S46301D | 23 | 949-950 | S49121S | 08 | 559-561 | ||
| S4442XS | 01 | 091-093 | S46301S | 21 | 913-914 | S49122A | 08 | 562-563 | ||
| S4450XA | 01 | 073-074 | S46302A | 21 | 913-914 | S49122A | 24 | 963-965 | ||
| S4450XA | 24 | 963-965 | S46302A | 24 | 963-965 | S49122D | 08 | 559-561 | ||
| S4450XD | 23 | 949-950 | S46302D | 23 | 949-950 | S49122G | 08 | 559-561 | ||
| S4450XS | 01 | 091-093 | S46302S | 21 | 913-914 | S49122K | 08 | 564-566 | ||
| S4451XA | 01 | 073-074 | S46309A | 21 | 913-914 | S49122P | 08 | 564-566 | ||
| S4451XA | 24 | 963-965 | S46309A | 24 | 963-965 | S49122S | 08 | 559-561 | ||
| S4451XD | 23 | 949-950 | S46309D | 23 | 949-950 | S49129A | 08 | 562-563 | ||
| S4451XS | 01 | 091-093 | S46309S | 21 | 913-914 | S49129A | 24 | 963-965 | ||
| S4452XA | 01 | 073-074 | S46311A | 08 | 562-563 | S49129D | 08 | 559-561 | ||
| S4452XA | 24 | 963-965 | S46311A | 24 | 963-965 | S49129G | 08 | 559-561 | ||
| S4452XD | 23 | 949-950 | S46311D | 23 | 949-950 | S49129K | 08 | 564-566 | ||
| S4452XS | 01 | 091-093 | S46311S | 08 | 562-563 | S49129P | 08 | 564-566 | ||
| S448X1A | 01 | 073-074 | S46312A | 08 | 562-563 | S49129S | 08 | 559-561 | ||
| S448X1A | 24 | 963-965 | S46312A | 24 | 963-965 | S49131A | 08 | 562-563 | ||
| S448X1D | 23 | 949-950 | S46312D | 23 | 949-950 | S49131A | 24 | 963-965 | ||
| S448X1S | 01 | 091-093 | S46312S | 08 | 562-563 | S49131D | 08 | 559-561 | ||
| S448X2A | 01 | 073-074 | S46319A | 08 | 562-563 | S49131G | 08 | 559-561 | ||
| S448X2A | 24 | 963-965 | S46319A | 24 | 963-965 | S49131K | 08 | 564-566 | ||
| S448X2D | 23 | 949-950 | S46319D | 23 | 949-950 | S49131P | 08 | 564-566 | ||
| S448X2S | 01 | 091-093 | S46319S | 08 | 562-563 | S49131S | 08 | 559-561 | ||
| S448X9A | 01 | 073-074 | S46321A | 08 | 564-566 | S49132A | 08 | 562-563 | ||
| S448X9A | 24 | 963-965 | S46321A | 24 | 963-965 | S49132A | 24 | 963-965 | ||
| S448X9D | 23 | 949-950 | S46321D | 23 | 949-950 | S49132D | 08 | 559-561 | ||
| S448X9S | 01 | 091-093 | S46321S | 09 | 604-605 | S49132G | 08 | 559-561 | ||
| S4490XA | 01 | 073-074 | S46322A | 08 | 564-566 | S49132K | 08 | 564-566 | ||
| S4490XA | 24 | 963-965 | S46322A | 24 | 963-965 | S49132P | 08 | 564-566 | ||
| S4490XD | 23 | 949-950 | S46322D | 23 | 949-950 | S49132S | 08 | 559-561 | ||
| S4490XS | 01 | 091-093 | S46322S | 09 | 604-605 | S49139A | 08 | 562-563 | ||
| S4491XA | 01 | 073-074 | S46329A | 08 | 564-566 | S49139A | 24 | 963-965 | ||
| S4491XA | 24 | 963-965 | S46329A | 24 | 963-965 | S49139D | 08 | 559-561 | ||
| S4491XD | 23 | 949-950 | S46329D | 23 | 949-950 | S49139G | 08 | 559-561 | ||
| S4491XS | 01 | 091-093 | S46329S | 09 | 604-605 | S49139K | 08 | 564-566 | ||
| S4492XA | 01 | 073-074 | S46391A | 21 | 913-914 | S49139P | 08 | 564-566 | ||
| S4492XA | 24 | 963-965 | S46391A | 24 | 963-965 | S49139S | 08 | 559-561 | ||
| S4492XD | 23 | 949-950 | S46391D | 23 | 949-950 | S49141A | 08 | 562-563 | ||
| S4492XS | 01 | 091-093 | S46391S | 21 | 913-914 | S49141A | 24 | 963-965 | ||
| S45001A | 21 | 913-914 | S46392A | 21 | 913-914 | S49141D | 08 | 559-561 | ||
| S45001A | 24 | 963-965 | S46392A | 24 | 963-965 | S49141G | 08 | 559-561 | ||
| S45001D | 23 | 949-950 | S46392D | 23 | 949-950 | S49141K | 08 | 564-566 | ||
| S45001S | 05 | 299-301 | S46392S | 21 | 913-914 | S49141P | 08 | 564-566 | ||
| S45002A | 21 | 913-914 | S46399A | 21 | 913-914 | S49141S | 08 | 559-561 | ||
| S45002A | 24 | 963-965 | S46399A | 24 | 963-965 | S49142A | 08 | 562-563 | ||
| S45002D | 23 | 949-950 | S46399D | 23 | 949-950 | S49142A | 24 | 963-965 | ||
| S45002S | 05 | 299-301 | S46399S | 21 | 913-914 | S49142D | 08 | 559-561 | ||
| S45009A | 21 | 913-914 | S46801A | 21 | 913-914 | S49142G | 08 | 559-561 | ||
| S45009A | 24 | 963-965 | S46801A | 24 | 963-965 | S49142K | 08 | 564-566 | ||
| S45009D | 23 | 949-950 | S46801D | 23 | 949-950 | S49142P | 08 | 564-566 | ||
| S45009S | 05 | 299-301 | S46801S | 21 | 913-914 | S49142S | 08 | 559-561 | ||
| S45011A | 21 | 913-914 | S46802A | 21 | 913-914 | S49149A | 08 | 562-563 | ||
| S45011A | 24 | 963-965 | S46802A | 24 | 963-965 | S49149A | 24 | 963-965 | ||
| S45011D | 23 | 949-950 | S46802D | 23 | 949-950 | S49149D | 08 | 559-561 | ||
| S45011S | 05 | 299-301 | S46802S | 21 | 913-914 | S49149G | 08 | 559-561 | ||
| S45012A | 21 | 913-914 | S46809A | 21 | 913-914 | S49149K | 08 | 564-566 | ||
| S45012A | 24 | 963-965 | S46809A | 24 | 963-965 | S49149P | 08 | 564-566 | ||
| S45012D | 23 | 949-950 | S46809D | 23 | 949-950 | S49149S | 08 | 559-561 | ||
| S45012S | 05 | 299-301 | S46809S | 21 | 913-914 | S49191A | 08 | 562-563 | ||
| S45019A | 21 | 913-914 | S46811A | 08 | 562-563 | S49191A | 24 | 963-965 | ||
| S45019A | 24 | 963-965 | S46811A | 24 | 963-965 | S49191D | 08 | 559-561 | ||
| S45019D | 23 | 949-950 | S46811D | 23 | 949-950 | S49191G | 08 | 559-561 | ||
| S45019S | 05 | 299-301 | S46811S | 08 | 562-563 | S49191K | 08 | 564-566 | ||
| S45091A | 21 | 913-914 | S46812A | 08 | 562-563 | S49191P | 08 | 564-566 | ||
| S45091A | 24 | 963-965 | S46812A | 24 | 963-965 | S49191S | 08 | 559-561 | ||
| S45091D | 23 | 949-950 | S46812D | 23 | 949-950 | S49192A | 08 | 562-563 | ||
| S45091S | 05 | 299-301 | S46812S | 08 | 562-563 | S49192A | 24 | 963-965 | ||
| S45092A | 21 | 913-914 | S46819A | 08 | 562-563 | S49192D | 08 | 559-561 | ||
| S45092A | 24 | 963-965 | S46819A | 24 | 963-965 | S49192G | 08 | 559-561 | ||
| S45092D | 23 | 949-950 | S46819D | 23 | 949-950 | S49192K | 08 | 564-566 | ||
| S45092S | 05 | 299-301 | S46819S | 08 | 562-563 | S49192P | 08 | 564-566 | ||
| S45099A | 21 | 913-914 | S46821A | 08 | 564-566 | S49192S | 08 | 559-561 | ||
| S45099A | 24 | 963-965 | S46821A | 24 | 963-965 | S49199A | 08 | 562-563 | ||
| S45099D | 23 | 949-950 | S46821D | 23 | 949-950 | S49199A | 24 | 963-965 | ||
| S45099S | 05 | 299-301 | S46821S | 09 | 604-605 | S49199D | 08 | 559-561 | ||
| S45101A | 21 | 913-914 | S46822A | 08 | 564-566 | S49199G | 08 | 559-561 | ||
| S45101A | 24 | 963-965 | S46822A | 24 | 963-965 | S49199K | 08 | 564-566 | ||
| S45101D | 23 | 949-950 | S46822D | 23 | 949-950 | S49199P | 08 | 564-566 | ||
| S45101S | 05 | 299-301 | S46822S | 09 | 604-605 | S49199S | 08 | 559-561 | ||
| S45102A | 21 | 913-914 | S46829A | 08 | 564-566 | S4980XA | 21 | 913-914 | ||
| S45102A | 24 | 963-965 | S46829A | 24 | 963-965 | S4980XA | 24 | 963-965 | ||
| S45102D | 23 | 949-950 | S46829D | 23 | 949-950 | S4980XD | 23 | 949-950 | ||
| S45102S | 05 | 299-301 | S46829S | 09 | 604-605 | S4980XS | 21 | 913-914 | ||
| S45109A | 21 | 913-914 | S46891A | 21 | 913-914 | S4981XA | 21 | 913-914 | ||
| S45109A | 24 | 963-965 | S46891A | 24 | 963-965 | S4981XA | 24 | 963-965 | ||
| S45109D | 23 | 949-950 | S46891D | 23 | 949-950 | S4981XD | 23 | 949-950 | ||
| S45109S | 05 | 299-301 | S46891S | 21 | 913-914 | S4981XS | 21 | 913-914 | ||
| S45111A | 21 | 913-914 | S46892A | 21 | 913-914 | S4982XA | 21 | 913-914 | ||
| S45111A | 24 | 963-965 | S46892A | 24 | 963-965 | S4982XA | 24 | 963-965 | ||
| S45111D | 23 | 949-950 | S46892D | 23 | 949-950 | S4982XD | 23 | 949-950 | ||
| S45111S | 05 | 299-301 | S46892S | 21 | 913-914 | S4982XS | 21 | 913-914 | ||
| S45112A | 21 | 913-914 | S46899A | 21 | 913-914 | S4990XA | 21 | 913-914 | ||
| S45112A | 24 | 963-965 | S46899A | 24 | 963-965 | S4990XA | 24 | 963-965 | ||
| S45112D | 23 | 949-950 | S46899D | 23 | 949-950 | S4990XD | 23 | 949-950 | ||
| S45112S | 05 | 299-301 | S46899S | 21 | 913-914 | S4990XS | 21 | 913-914 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |