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 45 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S52699N | 08 | 564-566 | S53491D | 23 | 949-950 | S56125D | 23 | 949-950 | ||
| S52699P | 08 | 564-566 | S53491S | 08 | 562-563 | S56125S | 09 | 604-605 | ||
| S52699Q | 08 | 564-566 | S53492A | 08 | 562-563 | S56126A | 08 | 564-566 | ||
| S52699R | 08 | 564-566 | S53492A | 24 | 963-965 | S56126A | 24 | 963-965 | ||
| S52699S | 08 | 559-561 | S53492D | 23 | 949-950 | S56126D | 23 | 949-950 | ||
| S5290XA | 08 | 562-563 | S53492S | 08 | 562-563 | S56126S | 09 | 604-605 | ||
| S5290XA | 24 | 963-965 | S53499A | 08 | 562-563 | S56127A | 08 | 564-566 | ||
| S5290XB | 08 | 562-563 | S53499A | 24 | 963-965 | S56127A | 24 | 963-965 | ||
| S5290XB | 24 | 963-965 | S53499D | 23 | 949-950 | S56127D | 23 | 949-950 | ||
| S5290XC | 08 | 562-563 | S53499S | 08 | 562-563 | S56127S | 09 | 604-605 | ||
| S5290XC | 24 | 963-965 | S5400XA | 01 | 073-074 | S56128A | 08 | 564-566 | ||
| S5290XD | 08 | 559-561 | S5400XA | 24 | 963-965 | S56128A | 24 | 963-965 | ||
| S5290XE | 08 | 559-561 | S5400XD | 23 | 949-950 | S56128D | 23 | 949-950 | ||
| S5290XF | 08 | 559-561 | S5400XS | 01 | 091-093 | S56128S | 09 | 604-605 | ||
| S5290XG | 08 | 559-561 | S5401XA | 01 | 073-074 | S56129A | 08 | 564-566 | ||
| S5290XH | 08 | 559-561 | S5401XA | 24 | 963-965 | S56129A | 24 | 963-965 | ||
| S5290XJ | 08 | 559-561 | S5401XD | 23 | 949-950 | S56129D | 23 | 949-950 | ||
| S5290XK | 08 | 564-566 | S5401XS | 01 | 091-093 | S56129S | 09 | 604-605 | ||
| S5290XM | 08 | 564-566 | S5402XA | 01 | 073-074 | S56191A | 21 | 913-914 | ||
| S5290XN | 08 | 564-566 | S5402XA | 24 | 963-965 | S56191A | 24 | 963-965 | ||
| S5290XP | 08 | 564-566 | S5402XD | 23 | 949-950 | S56191D | 23 | 949-950 | ||
| S5290XQ | 08 | 564-566 | S5402XS | 01 | 091-093 | S56191S | 21 | 913-914 | ||
| S5290XR | 08 | 564-566 | S5410XA | 01 | 073-074 | S56192A | 21 | 913-914 | ||
| S5290XS | 08 | 559-561 | S5410XA | 24 | 963-965 | S56192A | 24 | 963-965 | ||
| S5291XA | 08 | 562-563 | S5410XD | 23 | 949-950 | S56192D | 23 | 949-950 | ||
| S5291XA | 24 | 963-965 | S5410XS | 01 | 091-093 | S56192S | 21 | 913-914 | ||
| S5291XB | 08 | 562-563 | S5411XA | 01 | 073-074 | S56193A | 21 | 913-914 | ||
| S5291XB | 24 | 963-965 | S5411XA | 24 | 963-965 | S56193A | 24 | 963-965 | ||
| S5291XC | 08 | 562-563 | S5411XD | 23 | 949-950 | S56193D | 23 | 949-950 | ||
| S5291XC | 24 | 963-965 | S5411XS | 01 | 091-093 | S56193S | 21 | 913-914 | ||
| S5291XD | 08 | 559-561 | S5412XA | 01 | 073-074 | S56194A | 21 | 913-914 | ||
| S5291XE | 08 | 559-561 | S5412XA | 24 | 963-965 | S56194A | 24 | 963-965 | ||
| S5291XF | 08 | 559-561 | S5412XD | 23 | 949-950 | S56194D | 23 | 949-950 | ||
| S5291XG | 08 | 559-561 | S5412XS | 01 | 091-093 | S56194S | 21 | 913-914 | ||
| S5291XH | 08 | 559-561 | S5420XA | 01 | 073-074 | S56195A | 21 | 913-914 | ||
| S5291XJ | 08 | 559-561 | S5420XA | 24 | 963-965 | S56195A | 24 | 963-965 | ||
| S5291XK | 08 | 564-566 | S5420XD | 23 | 949-950 | S56195D | 23 | 949-950 | ||
| S5291XM | 08 | 564-566 | S5420XS | 01 | 091-093 | S56195S | 21 | 913-914 | ||
| S5291XN | 08 | 564-566 | S5421XA | 01 | 073-074 | S56196A | 21 | 913-914 | ||
| S5291XP | 08 | 564-566 | S5421XA | 24 | 963-965 | S56196A | 24 | 963-965 | ||
| S5291XQ | 08 | 564-566 | S5421XD | 23 | 949-950 | S56196D | 23 | 949-950 | ||
| S5291XR | 08 | 564-566 | S5421XS | 01 | 091-093 | S56196S | 21 | 913-914 | ||
| S5291XS | 08 | 559-561 | S5422XA | 01 | 073-074 | S56197A | 21 | 913-914 | ||
| S5292XA | 08 | 562-563 | S5422XA | 24 | 963-965 | S56197A | 24 | 963-965 | ||
| S5292XA | 24 | 963-965 | S5422XD | 23 | 949-950 | S56197D | 23 | 949-950 | ||
| S5292XB | 08 | 562-563 | S5422XS | 01 | 091-093 | S56197S | 21 | 913-914 | ||
| S5292XB | 24 | 963-965 | S5430XA | 01 | 073-074 | S56198A | 21 | 913-914 | ||
| S5292XC | 08 | 562-563 | S5430XA | 24 | 963-965 | S56198A | 24 | 963-965 | ||
| S5292XC | 24 | 963-965 | S5430XD | 23 | 949-950 | S56198D | 23 | 949-950 | ||
| S5292XD | 08 | 559-561 | S5430XS | 01 | 091-093 | S56198S | 21 | 913-914 | ||
| S5292XE | 08 | 559-561 | S5431XA | 01 | 073-074 | S56199A | 21 | 913-914 | ||
| S5292XF | 08 | 559-561 | S5431XA | 24 | 963-965 | S56199A | 24 | 963-965 | ||
| S5292XG | 08 | 559-561 | S5431XD | 23 | 949-950 | S56199D | 23 | 949-950 | ||
| S5292XH | 08 | 559-561 | S5431XS | 01 | 091-093 | S56199S | 21 | 913-914 | ||
| S5292XJ | 08 | 559-561 | S5432XA | 01 | 073-074 | S56201A | 21 | 913-914 | ||
| S5292XK | 08 | 564-566 | S5432XA | 24 | 963-965 | S56201A | 24 | 963-965 | ||
| S5292XM | 08 | 564-566 | S5432XD | 23 | 949-950 | S56201D | 23 | 949-950 | ||
| S5292XN | 08 | 564-566 | S5432XS | 01 | 091-093 | S56201S | 21 | 913-914 | ||
| S5292XP | 08 | 564-566 | S548X1A | 01 | 073-074 | S56202A | 21 | 913-914 | ||
| S5292XQ | 08 | 564-566 | S548X1A | 24 | 963-965 | S56202A | 24 | 963-965 | ||
| S5292XR | 08 | 564-566 | S548X1D | 23 | 949-950 | S56202D | 23 | 949-950 | ||
| S5292XS | 08 | 559-561 | S548X1S | 01 | 091-093 | S56202S | 21 | 913-914 | ||
| S53001A | 08 | 562-563 | S548X2A | 01 | 073-074 | S56209A | 21 | 913-914 | ||
| S53001A | 24 | 963-965 | S548X2A | 24 | 963-965 | S56209A | 24 | 963-965 | ||
| S53001D | 23 | 949-950 | S548X2D | 23 | 949-950 | S56209D | 23 | 949-950 | ||
| S53001S | 08 | 562-563 | S548X2S | 01 | 091-093 | S56209S | 21 | 913-914 | ||
| S53002A | 08 | 562-563 | S548X9A | 01 | 073-074 | S56211A | 08 | 562-563 | ||
| S53002A | 24 | 963-965 | S548X9A | 24 | 963-965 | S56211A | 24 | 963-965 | ||
| S53002D | 23 | 949-950 | S548X9D | 23 | 949-950 | S56211D | 23 | 949-950 | ||
| S53002S | 08 | 562-563 | S548X9S | 01 | 091-093 | S56211S | 08 | 562-563 | ||
| S53003A | 08 | 562-563 | S5490XA | 01 | 073-074 | S56212A | 08 | 562-563 | ||
| S53003A | 24 | 963-965 | S5490XA | 24 | 963-965 | S56212A | 24 | 963-965 | ||
| S53003D | 23 | 949-950 | S5490XD | 23 | 949-950 | S56212D | 23 | 949-950 | ||
| S53003S | 08 | 562-563 | S5490XS | 01 | 091-093 | S56212S | 08 | 562-563 | ||
| S53004A | 08 | 562-563 | S5491XA | 01 | 073-074 | S56219A | 08 | 562-563 | ||
| S53004A | 24 | 963-965 | S5491XA | 24 | 963-965 | S56219A | 24 | 963-965 | ||
| S53004D | 23 | 949-950 | S5491XD | 23 | 949-950 | S56219D | 23 | 949-950 | ||
| S53004S | 08 | 562-563 | S5491XS | 01 | 091-093 | S56219S | 08 | 562-563 | ||
| S53005A | 08 | 562-563 | S5492XA | 01 | 073-074 | S56221A | 08 | 564-566 | ||
| S53005A | 24 | 963-965 | S5492XA | 24 | 963-965 | S56221A | 24 | 963-965 | ||
| S53005D | 23 | 949-950 | S5492XD | 23 | 949-950 | S56221D | 23 | 949-950 | ||
| S53005S | 08 | 562-563 | S5492XS | 01 | 091-093 | S56221S | 09 | 604-605 | ||
| S53006A | 08 | 562-563 | S55001A | 21 | 913-914 | S56222A | 08 | 564-566 | ||
| S53006A | 24 | 963-965 | S55001A | 24 | 963-965 | S56222A | 24 | 963-965 | ||
| S53006D | 23 | 949-950 | S55001D | 23 | 949-950 | S56222D | 23 | 949-950 | ||
| S53006S | 08 | 562-563 | S55001S | 05 | 299-301 | S56222S | 09 | 604-605 | ||
| S53011A | 08 | 562-563 | S55002A | 21 | 913-914 | S56229A | 08 | 564-566 | ||
| S53011A | 24 | 963-965 | S55002A | 24 | 963-965 | S56229A | 24 | 963-965 | ||
| S53011D | 23 | 949-950 | S55002D | 23 | 949-950 | S56229D | 23 | 949-950 | ||
| S53011S | 08 | 562-563 | S55002S | 05 | 299-301 | S56229S | 09 | 604-605 | ||
| S53012A | 08 | 562-563 | S55009A | 21 | 913-914 | S56291A | 21 | 913-914 | ||
| S53012A | 24 | 963-965 | S55009A | 24 | 963-965 | S56291A | 24 | 963-965 | ||
| S53012D | 23 | 949-950 | S55009D | 23 | 949-950 | S56291D | 23 | 949-950 | ||
| S53012S | 08 | 562-563 | S55009S | 05 | 299-301 | S56291S | 21 | 913-914 | ||
| S53013A | 08 | 562-563 | S55011A | 21 | 913-914 | S56292A | 21 | 913-914 | ||
| S53013A | 24 | 963-965 | S55011A | 24 | 963-965 | S56292A | 24 | 963-965 | ||
| S53013D | 23 | 949-950 | S55011D | 23 | 949-950 | S56292D | 23 | 949-950 | ||
| S53013S | 08 | 562-563 | S55011S | 05 | 299-301 | S56292S | 21 | 913-914 | ||
| S53014A | 08 | 562-563 | S55012A | 21 | 913-914 | S56299A | 21 | 913-914 | ||
| S53014A | 24 | 963-965 | S55012A | 24 | 963-965 | S56299A | 24 | 963-965 | ||
| S53014D | 23 | 949-950 | S55012D | 23 | 949-950 | S56299D | 23 | 949-950 | ||
| S53014S | 08 | 562-563 | S55012S | 05 | 299-301 | S56299S | 21 | 913-914 | ||
| S53015A | 08 | 562-563 | S55019A | 21 | 913-914 | S56301A | 21 | 913-914 | ||
| S53015A | 24 | 963-965 | S55019A | 24 | 963-965 | S56301A | 24 | 963-965 | ||
| S53015D | 23 | 949-950 | S55019D | 23 | 949-950 | S56301D | 23 | 949-950 | ||
| S53015S | 08 | 562-563 | S55019S | 05 | 299-301 | S56301S | 21 | 913-914 | ||
| S53016A | 08 | 562-563 | S55091A | 21 | 913-914 | S56302A | 21 | 913-914 | ||
| S53016A | 24 | 963-965 | S55091A | 24 | 963-965 | S56302A | 24 | 963-965 | ||
| S53016D | 23 | 949-950 | S55091D | 23 | 949-950 | S56302D | 23 | 949-950 | ||
| S53016S | 08 | 562-563 | S55091S | 05 | 299-301 | S56302S | 21 | 913-914 | ||
| S53021A | 08 | 562-563 | S55092A | 21 | 913-914 | S56309A | 21 | 913-914 | ||
| S53021A | 24 | 963-965 | S55092A | 24 | 963-965 | S56309A | 24 | 963-965 | ||
| S53021D | 23 | 949-950 | S55092D | 23 | 949-950 | S56309D | 23 | 949-950 | ||
| S53021S | 08 | 562-563 | S55092S | 05 | 299-301 | S56309S | 21 | 913-914 | ||
| S53022A | 08 | 562-563 | S55099A | 21 | 913-914 | S56311A | 08 | 562-563 | ||
| S53022A | 24 | 963-965 | S55099A | 24 | 963-965 | S56311A | 24 | 963-965 | ||
| S53022D | 23 | 949-950 | S55099D | 23 | 949-950 | S56311D | 23 | 949-950 | ||
| S53022S | 08 | 562-563 | S55099S | 05 | 299-301 | S56311S | 08 | 562-563 | ||
| S53023A | 08 | 562-563 | S55101A | 21 | 913-914 | S56312A | 08 | 562-563 | ||
| S53023A | 24 | 963-965 | S55101A | 24 | 963-965 | S56312A | 24 | 963-965 | ||
| S53023D | 23 | 949-950 | S55101D | 23 | 949-950 | S56312D | 23 | 949-950 | ||
| S53023S | 08 | 562-563 | S55101S | 05 | 299-301 | S56312S | 08 | 562-563 | ||
| S53024A | 08 | 562-563 | S55102A | 21 | 913-914 | S56319A | 08 | 562-563 | ||
| S53024A | 24 | 963-965 | S55102A | 24 | 963-965 | S56319A | 24 | 963-965 | ||
| S53024D | 23 | 949-950 | S55102D | 23 | 949-950 | S56319D | 23 | 949-950 | ||
| S53024S | 08 | 562-563 | S55102S | 05 | 299-301 | S56319S | 08 | 562-563 | ||
| S53025A | 08 | 562-563 | S55109A | 21 | 913-914 | S56321A | 08 | 564-566 | ||
| S53025A | 24 | 963-965 | S55109A | 24 | 963-965 | S56321A | 24 | 963-965 | ||
| S53025D | 23 | 949-950 | S55109D | 23 | 949-950 | S56321D | 23 | 949-950 | ||
| S53025S | 08 | 562-563 | S55109S | 05 | 299-301 | S56321S | 09 | 604-605 | ||
| S53026A | 08 | 562-563 | S55111A | 21 | 913-914 | S56322A | 08 | 564-566 | ||
| S53026A | 24 | 963-965 | S55111A | 24 | 963-965 | S56322A | 24 | 963-965 | ||
| S53026D | 23 | 949-950 | S55111D | 23 | 949-950 | S56322D | 23 | 949-950 | ||
| S53026S | 08 | 562-563 | S55111S | 05 | 299-301 | S56322S | 09 | 604-605 | ||
| S53031A | 08 | 562-563 | S55112A | 21 | 913-914 | S56329A | 08 | 564-566 | ||
| S53031A | 24 | 963-965 | S55112A | 24 | 963-965 | S56329A | 24 | 963-965 | ||
| S53031D | 23 | 949-950 | S55112D | 23 | 949-950 | S56329D | 23 | 949-950 | ||
| S53031S | 08 | 562-563 | S55112S | 05 | 299-301 | S56329S | 09 | 604-605 | ||
| S53032A | 08 | 562-563 | S55119A | 21 | 913-914 | S56391A | 21 | 913-914 | ||
| S53032A | 24 | 963-965 | S55119A | 24 | 963-965 | S56391A | 24 | 963-965 | ||
| S53032D | 23 | 949-950 | S55119D | 23 | 949-950 | S56391D | 23 | 949-950 | ||
| S53032S | 08 | 562-563 | S55119S | 05 | 299-301 | S56391S | 21 | 913-914 | ||
| S53033A | 08 | 562-563 | S55191A | 21 | 913-914 | S56392A | 21 | 913-914 | ||
| S53033A | 24 | 963-965 | S55191A | 24 | 963-965 | S56392A | 24 | 963-965 | ||
| S53033D | 23 | 949-950 | S55191D | 23 | 949-950 | S56392D | 23 | 949-950 | ||
| S53033S | 08 | 562-563 | S55191S | 05 | 299-301 | S56392S | 21 | 913-914 | ||
| S53091A | 08 | 562-563 | S55192A | 21 | 913-914 | S56399A | 21 | 913-914 | ||
| S53091A | 24 | 963-965 | S55192A | 24 | 963-965 | S56399A | 24 | 963-965 | ||
| S53091D | 23 | 949-950 | S55192D | 23 | 949-950 | S56399D | 23 | 949-950 | ||
| S53091S | 08 | 562-563 | S55192S | 05 | 299-301 | S56399S | 21 | 913-914 | ||
| S53092A | 08 | 562-563 | S55199A | 21 | 913-914 | S56401A | 21 | 913-914 | ||
| S53092A | 24 | 963-965 | S55199A | 24 | 963-965 | S56401A | 24 | 963-965 | ||
| S53092D | 23 | 949-950 | S55199D | 23 | 949-950 | S56401D | 23 | 949-950 | ||
| S53092S | 08 | 562-563 | S55199S | 05 | 299-301 | S56401S | 21 | 913-914 | ||
| S53093A | 08 | 562-563 | S55201A | 21 | 913-914 | S56402A | 21 | 913-914 | ||
| S53093A | 24 | 963-965 | S55201A | 24 | 963-965 | S56402A | 24 | 963-965 | ||
| S53093D | 23 | 949-950 | S55201D | 23 | 949-950 | S56402D | 23 | 949-950 | ||
| S53093S | 08 | 562-563 | S55201S | 05 | 299-301 | S56402S | 21 | 913-914 | ||
| S53094A | 08 | 562-563 | S55202A | 21 | 913-914 | S56403A | 21 | 913-914 | ||
| S53094A | 24 | 963-965 | S55202A | 24 | 963-965 | S56403A | 24 | 963-965 | ||
| S53094D | 23 | 949-950 | S55202D | 23 | 949-950 | S56403D | 23 | 949-950 | ||
| S53094S | 08 | 562-563 | S55202S | 05 | 299-301 | S56403S | 21 | 913-914 | ||
| S53095A | 08 | 562-563 | S55209A | 21 | 913-914 | S56404A | 21 | 913-914 | ||
| S53095A | 24 | 963-965 | S55209A | 24 | 963-965 | S56404A | 24 | 963-965 | ||
| S53095D | 23 | 949-950 | S55209D | 23 | 949-950 | S56404D | 23 | 949-950 | ||
| S53095S | 08 | 562-563 | S55209S | 05 | 299-301 | S56404S | 21 | 913-914 | ||
| S53096A | 08 | 562-563 | S55211A | 21 | 913-914 | S56405A | 21 | 913-914 | ||
| S53096A | 24 | 963-965 | S55211A | 24 | 963-965 | S56405A | 24 | 963-965 | ||
| S53096D | 23 | 949-950 | S55211D | 23 | 949-950 | S56405D | 23 | 949-950 | ||
| S53096S | 08 | 562-563 | S55211S | 05 | 299-301 | S56405S | 21 | 913-914 | ||
| S53101A | 08 | 562-563 | S55212A | 21 | 913-914 | S56406A | 21 | 913-914 | ||
| S53101A | 24 | 963-965 | S55212A | 24 | 963-965 | S56406A | 24 | 963-965 | ||
| S53101D | 23 | 949-950 | S55212D | 23 | 949-950 | S56406D | 23 | 949-950 | ||
| S53101S | 08 | 562-563 | S55212S | 05 | 299-301 | S56406S | 21 | 913-914 | ||
| S53102A | 08 | 562-563 | S55219A | 21 | 913-914 | S56407A | 21 | 913-914 | ||
| S53102A | 24 | 963-965 | S55219A | 24 | 963-965 | S56407A | 24 | 963-965 | ||
| S53102D | 23 | 949-950 | S55219D | 23 | 949-950 | S56407D | 23 | 949-950 | ||
| S53102S | 08 | 562-563 | S55219S | 05 | 299-301 | S56407S | 21 | 913-914 | ||
| S53103A | 08 | 562-563 | S55291A | 21 | 913-914 | S56408A | 21 | 913-914 | ||
| S53103A | 24 | 963-965 | S55291A | 24 | 963-965 | S56408A | 24 | 963-965 | ||
| S53103D | 23 | 949-950 | S55291D | 23 | 949-950 | S56408D | 23 | 949-950 | ||
| S53103S | 08 | 562-563 | S55291S | 05 | 299-301 | S56408S | 21 | 913-914 | ||
| S53104A | 08 | 562-563 | S55292A | 21 | 913-914 | S56409A | 21 | 913-914 | ||
| S53104A | 24 | 963-965 | S55292A | 24 | 963-965 | S56409A | 24 | 963-965 | ||
| S53104D | 23 | 949-950 | S55292D | 23 | 949-950 | S56409D | 23 | 949-950 | ||
| S53104S | 08 | 562-563 | S55292S | 05 | 299-301 | S56409S | 21 | 913-914 | ||
| S53105A | 08 | 562-563 | S55299A | 21 | 913-914 | S56411A | 08 | 562-563 | ||
| S53105A | 24 | 963-965 | S55299A | 24 | 963-965 | S56411A | 24 | 963-965 | ||
| S53105D | 23 | 949-950 | S55299D | 23 | 949-950 | S56411D | 23 | 949-950 | ||
| S53105S | 08 | 562-563 | S55299S | 05 | 299-301 | S56411S | 08 | 562-563 | ||
| S53106A | 08 | 562-563 | S55801A | 21 | 913-914 | S56412A | 08 | 562-563 | ||
| S53106A | 24 | 963-965 | S55801A | 24 | 963-965 | S56412A | 24 | 963-965 | ||
| S53106D | 23 | 949-950 | S55801D | 23 | 949-950 | S56412D | 23 | 949-950 | ||
| S53106S | 08 | 562-563 | S55801S | 05 | 299-301 | S56412S | 08 | 562-563 | ||
| S53111A | 08 | 562-563 | S55802A | 21 | 913-914 | S56413A | 08 | 562-563 | ||
| S53111A | 24 | 963-965 | S55802A | 24 | 963-965 | S56413A | 24 | 963-965 | ||
| S53111D | 23 | 949-950 | S55802D | 23 | 949-950 | S56413D | 23 | 949-950 | ||
| S53111S | 08 | 562-563 | S55802S | 05 | 299-301 | S56413S | 08 | 562-563 | ||
| S53112A | 08 | 562-563 | S55809A | 21 | 913-914 | S56414A | 08 | 562-563 | ||
| S53112A | 24 | 963-965 | S55809A | 24 | 963-965 | S56414A | 24 | 963-965 | ||
| S53112D | 23 | 949-950 | S55809D | 23 | 949-950 | S56414D | 23 | 949-950 | ||
| S53112S | 08 | 562-563 | S55809S | 05 | 299-301 | S56414S | 08 | 562-563 | ||
| S53113A | 08 | 562-563 | S55811A | 21 | 913-914 | S56415A | 08 | 562-563 | ||
| S53113A | 24 | 963-965 | S55811A | 24 | 963-965 | S56415A | 24 | 963-965 | ||
| S53113D | 23 | 949-950 | S55811D | 23 | 949-950 | S56415D | 23 | 949-950 | ||
| S53113S | 08 | 562-563 | S55811S | 05 | 299-301 | S56415S | 08 | 562-563 | ||
| S53114A | 08 | 562-563 | S55812A | 21 | 913-914 | S56416A | 08 | 562-563 | ||
| S53114A | 24 | 963-965 | S55812A | 24 | 963-965 | S56416A | 24 | 963-965 | ||
| S53114D | 23 | 949-950 | S55812D | 23 | 949-950 | S56416D | 23 | 949-950 | ||
| S53114S | 08 | 562-563 | S55812S | 05 | 299-301 | S56416S | 08 | 562-563 | ||
| S53115A | 08 | 562-563 | S55819A | 21 | 913-914 | S56417A | 08 | 562-563 | ||
| S53115A | 24 | 963-965 | S55819A | 24 | 963-965 | S56417A | 24 | 963-965 | ||
| S53115D | 23 | 949-950 | S55819D | 23 | 949-950 | S56417D | 23 | 949-950 | ||
| S53115S | 08 | 562-563 | S55819S | 05 | 299-301 | S56417S | 08 | 562-563 | ||
| S53116A | 08 | 562-563 | S55891A | 21 | 913-914 | S56418A | 08 | 562-563 | ||
| S53116A | 24 | 963-965 | S55891A | 24 | 963-965 | S56418A | 24 | 963-965 | ||
| S53116D | 23 | 949-950 | S55891D | 23 | 949-950 | S56418D | 23 | 949-950 | ||
| S53116S | 08 | 562-563 | S55891S | 05 | 299-301 | S56418S | 08 | 562-563 | ||
| S53121A | 08 | 562-563 | S55892A | 21 | 913-914 | S56419A | 08 | 562-563 | ||
| S53121A | 24 | 963-965 | S55892A | 24 | 963-965 | S56419A | 24 | 963-965 | ||
| S53121D | 23 | 949-950 | S55892D | 23 | 949-950 | S56419D | 23 | 949-950 | ||
| S53121S | 08 | 562-563 | S55892S | 05 | 299-301 | S56419S | 08 | 562-563 | ||
| S53122A | 08 | 562-563 | S55899A | 21 | 913-914 | S56421A | 08 | 564-566 | ||
| S53122A | 24 | 963-965 | S55899A | 24 | 963-965 | S56421A | 24 | 963-965 | ||
| S53122D | 23 | 949-950 | S55899D | 23 | 949-950 | S56421D | 23 | 949-950 | ||
| S53122S | 08 | 562-563 | S55899S | 05 | 299-301 | S56421S | 09 | 604-605 | ||
| S53123A | 08 | 562-563 | S55901A | 21 | 913-914 | S56422A | 08 | 564-566 | ||
| S53123A | 24 | 963-965 | S55901A | 24 | 963-965 | S56422A | 24 | 963-965 | ||
| S53123D | 23 | 949-950 | S55901D | 23 | 949-950 | S56422D | 23 | 949-950 | ||
| S53123S | 08 | 562-563 | S55901S | 05 | 299-301 | S56422S | 09 | 604-605 | ||
| S53124A | 08 | 562-563 | S55902A | 21 | 913-914 | S56423A | 08 | 564-566 | ||
| S53124A | 24 | 963-965 | S55902A | 24 | 963-965 | S56423A | 24 | 963-965 | ||
| S53124D | 23 | 949-950 | S55902D | 23 | 949-950 | S56423D | 23 | 949-950 | ||
| S53124S | 08 | 562-563 | S55902S | 05 | 299-301 | S56423S | 09 | 604-605 | ||
| S53125A | 08 | 562-563 | S55909A | 21 | 913-914 | S56424A | 08 | 564-566 | ||
| S53125A | 24 | 963-965 | S55909A | 24 | 963-965 | S56424A | 24 | 963-965 | ||
| S53125D | 23 | 949-950 | S55909D | 23 | 949-950 | S56424D | 23 | 949-950 | ||
| S53125S | 08 | 562-563 | S55909S | 05 | 299-301 | S56424S | 09 | 604-605 | ||
| S53126A | 08 | 562-563 | S55911A | 21 | 913-914 | S56425A | 08 | 564-566 | ||
| S53126A | 24 | 963-965 | S55911A | 24 | 963-965 | S56425A | 24 | 963-965 | ||
| S53126D | 23 | 949-950 | S55911D | 23 | 949-950 | S56425D | 23 | 949-950 | ||
| S53126S | 08 | 562-563 | S55911S | 05 | 299-301 | S56425S | 09 | 604-605 | ||
| S53131A | 08 | 562-563 | S55912A | 21 | 913-914 | S56426A | 08 | 564-566 | ||
| S53131A | 24 | 963-965 | S55912A | 24 | 963-965 | S56426A | 24 | 963-965 | ||
| S53131D | 23 | 949-950 | S55912D | 23 | 949-950 | S56426D | 23 | 949-950 | ||
| S53131S | 08 | 562-563 | S55912S | 05 | 299-301 | S56426S | 09 | 604-605 | ||
| S53132A | 08 | 562-563 | S55919A | 21 | 913-914 | S56427A | 08 | 564-566 | ||
| S53132A | 24 | 963-965 | S55919A | 24 | 963-965 | S56427A | 24 | 963-965 | ||
| S53132D | 23 | 949-950 | S55919D | 23 | 949-950 | S56427D | 23 | 949-950 | ||
| S53132S | 08 | 562-563 | S55919S | 05 | 299-301 | S56427S | 09 | 604-605 | ||
| S53133A | 08 | 562-563 | S55991A | 21 | 913-914 | S56428A | 08 | 564-566 | ||
| S53133A | 24 | 963-965 | S55991A | 24 | 963-965 | S56428A | 24 | 963-965 | ||
| S53133D | 23 | 949-950 | S55991D | 23 | 949-950 | S56428D | 23 | 949-950 | ||
| S53133S | 08 | 562-563 | S55991S | 05 | 299-301 | S56428S | 09 | 604-605 | ||
| S53134A | 08 | 562-563 | S55992A | 21 | 913-914 | S56429A | 08 | 564-566 | ||
| S53134A | 24 | 963-965 | S55992A | 24 | 963-965 | S56429A | 24 | 963-965 | ||
| S53134D | 23 | 949-950 | S55992D | 23 | 949-950 | S56429D | 23 | 949-950 | ||
| S53134S | 08 | 562-563 | S55992S | 05 | 299-301 | S56429S | 09 | 604-605 | ||
| S53135A | 08 | 562-563 | S55999A | 21 | 913-914 | S56491A | 21 | 913-914 | ||
| S53135A | 24 | 963-965 | S55999A | 24 | 963-965 | S56491A | 24 | 963-965 | ||
| S53135D | 23 | 949-950 | S55999D | 23 | 949-950 | S56491D | 23 | 949-950 | ||
| S53135S | 08 | 562-563 | S55999S | 05 | 299-301 | S56491S | 21 | 913-914 | ||
| S53136A | 08 | 562-563 | S56001A | 21 | 913-914 | S56492A | 21 | 913-914 | ||
| S53136A | 24 | 963-965 | S56001A | 24 | 963-965 | S56492A | 24 | 963-965 | ||
| S53136D | 23 | 949-950 | S56001D | 23 | 949-950 | S56492D | 23 | 949-950 | ||
| S53136S | 08 | 562-563 | S56001S | 21 | 913-914 | S56492S | 21 | 913-914 | ||
| S53141A | 08 | 562-563 | S56002A | 21 | 913-914 | S56493A | 21 | 913-914 | ||
| S53141A | 24 | 963-965 | S56002A | 24 | 963-965 | S56493A | 24 | 963-965 | ||
| S53141D | 23 | 949-950 | S56002D | 23 | 949-950 | S56493D | 23 | 949-950 | ||
| S53141S | 08 | 562-563 | S56002S | 21 | 913-914 | S56493S | 21 | 913-914 | ||
| S53142A | 08 | 562-563 | S56009A | 21 | 913-914 | S56494A | 21 | 913-914 | ||
| S53142A | 24 | 963-965 | S56009A | 24 | 963-965 | S56494A | 24 | 963-965 | ||
| S53142D | 23 | 949-950 | S56009D | 23 | 949-950 | S56494D | 23 | 949-950 | ||
| S53142S | 08 | 562-563 | S56009S | 21 | 913-914 | S56494S | 21 | 913-914 | ||
| S53143A | 08 | 562-563 | S56011A | 08 | 562-563 | S56495A | 21 | 913-914 | ||
| S53143A | 24 | 963-965 | S56011A | 24 | 963-965 | S56495A | 24 | 963-965 | ||
| S53143D | 23 | 949-950 | S56011D | 23 | 949-950 | S56495D | 23 | 949-950 | ||
| S53143S | 08 | 562-563 | S56011S | 08 | 562-563 | S56495S | 21 | 913-914 | ||
| S53144A | 08 | 562-563 | S56012A | 08 | 562-563 | S56496A | 21 | 913-914 | ||
| S53144A | 24 | 963-965 | S56012A | 24 | 963-965 | S56496A | 24 | 963-965 | ||
| S53144D | 23 | 949-950 | S56012D | 23 | 949-950 | S56496D | 23 | 949-950 | ||
| S53144S | 08 | 562-563 | S56012S | 08 | 562-563 | S56496S | 21 | 913-914 | ||
| S53145A | 08 | 562-563 | S56019A | 08 | 562-563 | S56497A | 21 | 913-914 | ||
| S53145A | 24 | 963-965 | S56019A | 24 | 963-965 | S56497A | 24 | 963-965 | ||
| S53145D | 23 | 949-950 | S56019D | 23 | 949-950 | S56497D | 23 | 949-950 | ||
| S53145S | 08 | 562-563 | S56019S | 08 | 562-563 | S56497S | 21 | 913-914 | ||
| S53146A | 08 | 562-563 | S56021A | 08 | 564-566 | S56498A | 21 | 913-914 | ||
| S53146A | 24 | 963-965 | S56021A | 24 | 963-965 | S56498A | 24 | 963-965 | ||
| S53146D | 23 | 949-950 | S56021D | 23 | 949-950 | S56498D | 23 | 949-950 | ||
| S53146S | 08 | 562-563 | S56021S | 09 | 604-605 | S56498S | 21 | 913-914 | ||
| S53191A | 08 | 562-563 | S56022A | 08 | 564-566 | S56499A | 21 | 913-914 | ||
| S53191A | 24 | 963-965 | S56022A | 24 | 963-965 | S56499A | 24 | 963-965 | ||
| S53191D | 23 | 949-950 | S56022D | 23 | 949-950 | S56499D | 23 | 949-950 | ||
| S53191S | 08 | 562-563 | S56022S | 09 | 604-605 | S56499S | 21 | 913-914 | ||
| S53192A | 08 | 562-563 | S56029A | 08 | 564-566 | S56501A | 21 | 913-914 | ||
| S53192A | 24 | 963-965 | S56029A | 24 | 963-965 | S56501A | 24 | 963-965 | ||
| S53192D | 23 | 949-950 | S56029D | 23 | 949-950 | S56501D | 23 | 949-950 | ||
| S53192S | 08 | 562-563 | S56029S | 09 | 604-605 | S56501S | 21 | 913-914 | ||
| S53193A | 08 | 562-563 | S56091A | 21 | 913-914 | S56502A | 21 | 913-914 | ||
| S53193A | 24 | 963-965 | S56091A | 24 | 963-965 | S56502A | 24 | 963-965 | ||
| S53193D | 23 | 949-950 | S56091D | 23 | 949-950 | S56502D | 23 | 949-950 | ||
| S53193S | 08 | 562-563 | S56091S | 21 | 913-914 | S56502S | 21 | 913-914 | ||
| S53194A | 08 | 562-563 | S56092A | 21 | 913-914 | S56509A | 21 | 913-914 | ||
| S53194A | 24 | 963-965 | S56092A | 24 | 963-965 | S56509A | 24 | 963-965 | ||
| S53194D | 23 | 949-950 | S56092D | 23 | 949-950 | S56509D | 23 | 949-950 | ||
| S53194S | 08 | 562-563 | S56092S | 21 | 913-914 | S56509S | 21 | 913-914 | ||
| S53195A | 08 | 562-563 | S56099A | 21 | 913-914 | S56511A | 08 | 562-563 | ||
| S53195A | 24 | 963-965 | S56099A | 24 | 963-965 | S56511A | 24 | 963-965 | ||
| S53195D | 23 | 949-950 | S56099D | 23 | 949-950 | S56511D | 23 | 949-950 | ||
| S53195S | 08 | 562-563 | S56099S | 21 | 913-914 | S56511S | 08 | 562-563 | ||
| S53196A | 08 | 562-563 | S56101A | 21 | 913-914 | S56512A | 08 | 562-563 | ||
| S53196A | 24 | 963-965 | S56101A | 24 | 963-965 | S56512A | 24 | 963-965 | ||
| S53196D | 23 | 949-950 | S56101D | 23 | 949-950 | S56512D | 23 | 949-950 | ||
| S53196S | 08 | 562-563 | S56101S | 21 | 913-914 | S56512S | 08 | 562-563 | ||
| S5320XA | 08 | 562-563 | S56102A | 21 | 913-914 | S56519A | 08 | 562-563 | ||
| S5320XA | 24 | 963-965 | S56102A | 24 | 963-965 | S56519A | 24 | 963-965 | ||
| S5320XD | 23 | 949-950 | S56102D | 23 | 949-950 | S56519D | 23 | 949-950 | ||
| S5320XS | 08 | 562-563 | S56102S | 21 | 913-914 | S56519S | 08 | 562-563 | ||
| S5321XA | 08 | 562-563 | S56103A | 21 | 913-914 | S56521A | 08 | 564-566 | ||
| S5321XA | 24 | 963-965 | S56103A | 24 | 963-965 | S56521A | 24 | 963-965 | ||
| S5321XD | 23 | 949-950 | S56103D | 23 | 949-950 | S56521D | 23 | 949-950 | ||
| S5321XS | 08 | 562-563 | S56103S | 21 | 913-914 | S56521S | 09 | 604-605 | ||
| S5322XA | 08 | 562-563 | S56104A | 21 | 913-914 | S56522A | 08 | 564-566 | ||
| S5322XA | 24 | 963-965 | S56104A | 24 | 963-965 | S56522A | 24 | 963-965 | ||
| S5322XD | 23 | 949-950 | S56104D | 23 | 949-950 | S56522D | 23 | 949-950 | ||
| S5322XS | 08 | 562-563 | S56104S | 21 | 913-914 | S56522S | 09 | 604-605 | ||
| S5330XA | 08 | 562-563 | S56105A | 21 | 913-914 | S56529A | 08 | 564-566 | ||
| S5330XA | 24 | 963-965 | S56105A | 24 | 963-965 | S56529A | 24 | 963-965 | ||
| S5330XD | 23 | 949-950 | S56105D | 23 | 949-950 | S56529D | 23 | 949-950 | ||
| S5330XS | 08 | 562-563 | S56105S | 21 | 913-914 | S56529S | 09 | 604-605 | ||
| S5331XA | 08 | 562-563 | S56106A | 21 | 913-914 | S56591A | 21 | 913-914 | ||
| S5331XA | 24 | 963-965 | S56106A | 24 | 963-965 | S56591A | 24 | 963-965 | ||
| S5331XD | 23 | 949-950 | S56106D | 23 | 949-950 | S56591D | 23 | 949-950 | ||
| S5331XS | 08 | 562-563 | S56106S | 21 | 913-914 | S56591S | 21 | 913-914 | ||
| S5332XA | 08 | 562-563 | S56107A | 21 | 913-914 | S56592A | 21 | 913-914 | ||
| S5332XA | 24 | 963-965 | S56107A | 24 | 963-965 | S56592A | 24 | 963-965 | ||
| S5332XD | 23 | 949-950 | S56107D | 23 | 949-950 | S56592D | 23 | 949-950 | ||
| S5332XS | 08 | 562-563 | S56107S | 21 | 913-914 | S56592S | 21 | 913-914 | ||
| S53401A | 08 | 562-563 | S56108A | 21 | 913-914 | S56599A | 21 | 913-914 | ||
| S53401A | 24 | 963-965 | S56108A | 24 | 963-965 | S56599A | 24 | 963-965 | ||
| S53401D | 23 | 949-950 | S56108D | 23 | 949-950 | S56599D | 23 | 949-950 | ||
| S53401S | 08 | 562-563 | S56108S | 21 | 913-914 | S56599S | 21 | 913-914 | ||
| S53402A | 08 | 562-563 | S56109A | 21 | 913-914 | S56801A | 21 | 913-914 | ||
| S53402A | 24 | 963-965 | S56109A | 24 | 963-965 | S56801A | 24 | 963-965 | ||
| S53402D | 23 | 949-950 | S56109D | 23 | 949-950 | S56801D | 23 | 949-950 | ||
| S53402S | 08 | 562-563 | S56109S | 21 | 913-914 | S56801S | 21 | 913-914 | ||
| S53409A | 08 | 562-563 | S56111A | 08 | 562-563 | S56802A | 21 | 913-914 | ||
| S53409A | 24 | 963-965 | S56111A | 24 | 963-965 | S56802A | 24 | 963-965 | ||
| S53409D | 23 | 949-950 | S56111D | 23 | 949-950 | S56802D | 23 | 949-950 | ||
| S53409S | 08 | 562-563 | S56111S | 08 | 562-563 | S56802S | 21 | 913-914 | ||
| S53411A | 08 | 562-563 | S56112A | 08 | 562-563 | S56809A | 21 | 913-914 | ||
| S53411A | 24 | 963-965 | S56112A | 24 | 963-965 | S56809A | 24 | 963-965 | ||
| S53411D | 23 | 949-950 | S56112D | 23 | 949-950 | S56809D | 23 | 949-950 | ||
| S53411S | 08 | 562-563 | S56112S | 08 | 562-563 | S56809S | 21 | 913-914 | ||
| S53412A | 08 | 562-563 | S56113A | 08 | 562-563 | S56811A | 08 | 562-563 | ||
| S53412A | 24 | 963-965 | S56113A | 24 | 963-965 | S56811A | 24 | 963-965 | ||
| S53412D | 23 | 949-950 | S56113D | 23 | 949-950 | S56811D | 23 | 949-950 | ||
| S53412S | 08 | 562-563 | S56113S | 08 | 562-563 | S56811S | 08 | 562-563 | ||
| S53419A | 08 | 562-563 | S56114A | 08 | 562-563 | S56812A | 08 | 562-563 | ||
| S53419A | 24 | 963-965 | S56114A | 24 | 963-965 | S56812A | 24 | 963-965 | ||
| S53419D | 23 | 949-950 | S56114D | 23 | 949-950 | S56812D | 23 | 949-950 | ||
| S53419S | 08 | 562-563 | S56114S | 08 | 562-563 | S56812S | 08 | 562-563 | ||
| S53421A | 08 | 562-563 | S56115A | 08 | 562-563 | S56819A | 08 | 562-563 | ||
| S53421A | 24 | 963-965 | S56115A | 24 | 963-965 | S56819A | 24 | 963-965 | ||
| S53421D | 23 | 949-950 | S56115D | 23 | 949-950 | S56819D | 23 | 949-950 | ||
| S53421S | 08 | 562-563 | S56115S | 08 | 562-563 | S56819S | 08 | 562-563 | ||
| S53422A | 08 | 562-563 | S56116A | 08 | 562-563 | S56821A | 08 | 564-566 | ||
| S53422A | 24 | 963-965 | S56116A | 24 | 963-965 | S56821A | 24 | 963-965 | ||
| S53422D | 23 | 949-950 | S56116D | 23 | 949-950 | S56821D | 23 | 949-950 | ||
| S53422S | 08 | 562-563 | S56116S | 08 | 562-563 | S56821S | 09 | 604-605 | ||
| S53429A | 08 | 562-563 | S56117A | 08 | 562-563 | S56822A | 08 | 564-566 | ||
| S53429A | 24 | 963-965 | S56117A | 24 | 963-965 | S56822A | 24 | 963-965 | ||
| S53429D | 23 | 949-950 | S56117D | 23 | 949-950 | S56822D | 23 | 949-950 | ||
| S53429S | 08 | 562-563 | S56117S | 08 | 562-563 | S56822S | 09 | 604-605 | ||
| S53431A | 08 | 562-563 | S56118A | 08 | 562-563 | S56829A | 08 | 564-566 | ||
| S53431A | 24 | 963-965 | S56118A | 24 | 963-965 | S56829A | 24 | 963-965 | ||
| S53431D | 23 | 949-950 | S56118D | 23 | 949-950 | S56829D | 23 | 949-950 | ||
| S53431S | 08 | 562-563 | S56118S | 08 | 562-563 | S56829S | 09 | 604-605 | ||
| S53432A | 08 | 562-563 | S56119A | 08 | 562-563 | S56891A | 21 | 913-914 | ||
| S53432A | 24 | 963-965 | S56119A | 24 | 963-965 | S56891A | 24 | 963-965 | ||
| S53432D | 23 | 949-950 | S56119D | 23 | 949-950 | S56891D | 23 | 949-950 | ||
| S53432S | 08 | 562-563 | S56119S | 08 | 562-563 | S56891S | 21 | 913-914 | ||
| S53439A | 08 | 562-563 | S56121A | 08 | 564-566 | S56892A | 21 | 913-914 | ||
| S53439A | 24 | 963-965 | S56121A | 24 | 963-965 | S56892A | 24 | 963-965 | ||
| S53439D | 23 | 949-950 | S56121D | 23 | 949-950 | S56892D | 23 | 949-950 | ||
| S53439S | 08 | 562-563 | S56121S | 09 | 604-605 | S56892S | 21 | 913-914 | ||
| S53441A | 08 | 562-563 | S56122A | 08 | 564-566 | S56899A | 21 | 913-914 | ||
| S53441A | 24 | 963-965 | S56122A | 24 | 963-965 | S56899A | 24 | 963-965 | ||
| S53441D | 23 | 949-950 | S56122D | 23 | 949-950 | S56899D | 23 | 949-950 | ||
| S53441S | 08 | 562-563 | S56122S | 09 | 604-605 | S56899S | 21 | 913-914 | ||
| S53442A | 08 | 562-563 | S56123A | 08 | 564-566 | S56901A | 21 | 913-914 | ||
| S53442A | 24 | 963-965 | S56123A | 24 | 963-965 | S56901A | 24 | 963-965 | ||
| S53442D | 23 | 949-950 | S56123D | 23 | 949-950 | S56901D | 23 | 949-950 | ||
| S53442S | 08 | 562-563 | S56123S | 09 | 604-605 | S56901S | 21 | 913-914 | ||
| S53449A | 08 | 562-563 | S56124A | 08 | 564-566 | S56902A | 21 | 913-914 | ||
| S53449A | 24 | 963-965 | S56124A | 24 | 963-965 | S56902A | 24 | 963-965 | ||
| S53449D | 23 | 949-950 | S56124D | 23 | 949-950 | S56902D | 23 | 949-950 | ||
| S53449S | 08 | 562-563 | S56124S | 09 | 604-605 | S56902S | 21 | 913-914 | ||
| S53491A | 08 | 562-563 | S56125A | 08 | 564-566 | S56909A | 21 | 913-914 | ||
| S53491A | 24 | 963-965 | S56125A | 24 | 963-965 | S56909A | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |