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 47 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S60929A | 09 | 604-605 | S61250A | 09 | 604-605 | S61541A | 21 | 913-914 | ||
| S60929A | 24 | 963-965 | S61250A | 24 | 963-965 | S61541A | 24 | 963-965 | ||
| S60929D | 23 | 949-950 | S61250D | 23 | 949-950 | S61541D | 23 | 949-950 | ||
| S60929S | 09 | 604-605 | S61250S | 09 | 604-605 | S61541S | 09 | 604-605 | ||
| S60931A | 09 | 604-605 | S61251A | 09 | 604-605 | S61542A | 21 | 913-914 | ||
| S60931A | 24 | 963-965 | S61251A | 24 | 963-965 | S61542A | 24 | 963-965 | ||
| S60931D | 23 | 949-950 | S61251D | 23 | 949-950 | S61542D | 23 | 949-950 | ||
| S60931S | 09 | 604-605 | S61251S | 09 | 604-605 | S61542S | 09 | 604-605 | ||
| S60932A | 09 | 604-605 | S61252A | 09 | 604-605 | S61549A | 21 | 913-914 | ||
| S60932A | 24 | 963-965 | S61252A | 24 | 963-965 | S61549A | 24 | 963-965 | ||
| S60932D | 23 | 949-950 | S61252D | 23 | 949-950 | S61549D | 23 | 949-950 | ||
| S60932S | 09 | 604-605 | S61252S | 09 | 604-605 | S61549S | 09 | 604-605 | ||
| S60939A | 09 | 604-605 | S61253A | 09 | 604-605 | S61551A | 09 | 604-605 | ||
| S60939A | 24 | 963-965 | S61253A | 24 | 963-965 | S61551A | 24 | 963-965 | ||
| S60939D | 23 | 949-950 | S61253D | 23 | 949-950 | S61551D | 23 | 949-950 | ||
| S60939S | 09 | 604-605 | S61253S | 09 | 604-605 | S61551S | 09 | 604-605 | ||
| S60940A | 09 | 604-605 | S61254A | 09 | 604-605 | S61552A | 09 | 604-605 | ||
| S60940A | 24 | 963-965 | S61254A | 24 | 963-965 | S61552A | 24 | 963-965 | ||
| S60940D | 23 | 949-950 | S61254D | 23 | 949-950 | S61552D | 23 | 949-950 | ||
| S60940S | 09 | 604-605 | S61254S | 09 | 604-605 | S61552S | 09 | 604-605 | ||
| S60941A | 09 | 604-605 | S61255A | 09 | 604-605 | S61559A | 09 | 604-605 | ||
| S60941A | 24 | 963-965 | S61255A | 24 | 963-965 | S61559A | 24 | 963-965 | ||
| S60941D | 23 | 949-950 | S61255D | 23 | 949-950 | S61559D | 23 | 949-950 | ||
| S60941S | 09 | 604-605 | S61255S | 09 | 604-605 | S61559S | 09 | 604-605 | ||
| S60942A | 09 | 604-605 | S61256A | 09 | 604-605 | S62001A | 08 | 562-563 | ||
| S60942A | 24 | 963-965 | S61256A | 24 | 963-965 | S62001A | 24 | 963-965 | ||
| S60942D | 23 | 949-950 | S61256D | 23 | 949-950 | S62001B | 08 | 562-563 | ||
| S60942S | 09 | 604-605 | S61256S | 09 | 604-605 | S62001B | 24 | 963-965 | ||
| S60943A | 09 | 604-605 | S61257A | 09 | 604-605 | S62001D | 08 | 559-561 | ||
| S60943A | 24 | 963-965 | S61257A | 24 | 963-965 | S62001G | 08 | 559-561 | ||
| S60943D | 23 | 949-950 | S61257D | 23 | 949-950 | S62001K | 08 | 564-566 | ||
| S60943S | 09 | 604-605 | S61257S | 09 | 604-605 | S62001P | 08 | 564-566 | ||
| S60944A | 09 | 604-605 | S61258A | 09 | 604-605 | S62001S | 08 | 559-561 | ||
| S60944A | 24 | 963-965 | S61258A | 24 | 963-965 | S62002A | 08 | 562-563 | ||
| S60944D | 23 | 949-950 | S61258D | 23 | 949-950 | S62002A | 24 | 963-965 | ||
| S60944S | 09 | 604-605 | S61258S | 09 | 604-605 | S62002B | 08 | 562-563 | ||
| S60945A | 09 | 604-605 | S61259A | 09 | 604-605 | S62002B | 24 | 963-965 | ||
| S60945A | 24 | 963-965 | S61259A | 24 | 963-965 | S62002D | 08 | 559-561 | ||
| S60945D | 23 | 949-950 | S61259D | 23 | 949-950 | S62002G | 08 | 559-561 | ||
| S60945S | 09 | 604-605 | S61259S | 09 | 604-605 | S62002K | 08 | 564-566 | ||
| S60946A | 09 | 604-605 | S61300A | 09 | 604-605 | S62002P | 08 | 564-566 | ||
| S60946A | 24 | 963-965 | S61300A | 24 | 963-965 | S62002S | 08 | 559-561 | ||
| S60946D | 23 | 949-950 | S61300D | 23 | 949-950 | S62009A | 08 | 562-563 | ||
| S60946S | 09 | 604-605 | S61300S | 09 | 604-605 | S62009A | 24 | 963-965 | ||
| S60947A | 09 | 604-605 | S61301A | 09 | 604-605 | S62009B | 08 | 562-563 | ||
| S60947A | 24 | 963-965 | S61301A | 24 | 963-965 | S62009B | 24 | 963-965 | ||
| S60947D | 23 | 949-950 | S61301D | 23 | 949-950 | S62009D | 08 | 559-561 | ||
| S60947S | 09 | 604-605 | S61301S | 09 | 604-605 | S62009G | 08 | 559-561 | ||
| S60948A | 09 | 604-605 | S61302A | 09 | 604-605 | S62009K | 08 | 564-566 | ||
| S60948A | 24 | 963-965 | S61302A | 24 | 963-965 | S62009P | 08 | 564-566 | ||
| S60948D | 23 | 949-950 | S61302D | 23 | 949-950 | S62009S | 08 | 559-561 | ||
| S60948S | 09 | 604-605 | S61302S | 09 | 604-605 | S62011A | 08 | 562-563 | ||
| S60949A | 09 | 604-605 | S61303A | 09 | 604-605 | S62011A | 24 | 963-965 | ||
| S60949A | 24 | 963-965 | S61303A | 24 | 963-965 | S62011B | 08 | 562-563 | ||
| S60949D | 23 | 949-950 | S61303D | 23 | 949-950 | S62011B | 24 | 963-965 | ||
| S60949S | 09 | 604-605 | S61303S | 09 | 604-605 | S62011D | 08 | 559-561 | ||
| S61001A | 09 | 604-605 | S61304A | 09 | 604-605 | S62011G | 08 | 559-561 | ||
| S61001A | 24 | 963-965 | S61304A | 24 | 963-965 | S62011K | 08 | 564-566 | ||
| S61001D | 23 | 949-950 | S61304D | 23 | 949-950 | S62011P | 08 | 564-566 | ||
| S61001S | 09 | 604-605 | S61304S | 09 | 604-605 | S62011S | 08 | 559-561 | ||
| S61002A | 09 | 604-605 | S61305A | 09 | 604-605 | S62012A | 08 | 562-563 | ||
| S61002A | 24 | 963-965 | S61305A | 24 | 963-965 | S62012A | 24 | 963-965 | ||
| S61002D | 23 | 949-950 | S61305D | 23 | 949-950 | S62012B | 08 | 562-563 | ||
| S61002S | 09 | 604-605 | S61305S | 09 | 604-605 | S62012B | 24 | 963-965 | ||
| S61009A | 09 | 604-605 | S61306A | 09 | 604-605 | S62012D | 08 | 559-561 | ||
| S61009A | 24 | 963-965 | S61306A | 24 | 963-965 | S62012G | 08 | 559-561 | ||
| S61009D | 23 | 949-950 | S61306D | 23 | 949-950 | S62012K | 08 | 564-566 | ||
| S61009S | 09 | 604-605 | S61306S | 09 | 604-605 | S62012P | 08 | 564-566 | ||
| S61011A | 09 | 604-605 | S61307A | 09 | 604-605 | S62012S | 08 | 559-561 | ||
| S61011A | 24 | 963-965 | S61307A | 24 | 963-965 | S62013A | 08 | 562-563 | ||
| S61011D | 23 | 949-950 | S61307D | 23 | 949-950 | S62013A | 24 | 963-965 | ||
| S61011S | 09 | 604-605 | S61307S | 09 | 604-605 | S62013B | 08 | 562-563 | ||
| S61012A | 09 | 604-605 | S61308A | 09 | 604-605 | S62013B | 24 | 963-965 | ||
| S61012A | 24 | 963-965 | S61308A | 24 | 963-965 | S62013D | 08 | 559-561 | ||
| S61012D | 23 | 949-950 | S61308D | 23 | 949-950 | S62013G | 08 | 559-561 | ||
| S61012S | 09 | 604-605 | S61308S | 09 | 604-605 | S62013K | 08 | 564-566 | ||
| S61019A | 09 | 604-605 | S61309A | 09 | 604-605 | S62013P | 08 | 564-566 | ||
| S61019A | 24 | 963-965 | S61309A | 24 | 963-965 | S62013S | 08 | 559-561 | ||
| S61019D | 23 | 949-950 | S61309D | 23 | 949-950 | S62014A | 08 | 562-563 | ||
| S61019S | 09 | 604-605 | S61309S | 09 | 604-605 | S62014A | 24 | 963-965 | ||
| S61021A | 21 | 913-914 | S61310A | 09 | 604-605 | S62014B | 08 | 562-563 | ||
| S61021A | 24 | 963-965 | S61310A | 24 | 963-965 | S62014B | 24 | 963-965 | ||
| S61021D | 23 | 949-950 | S61310D | 23 | 949-950 | S62014D | 08 | 559-561 | ||
| S61021S | 09 | 604-605 | S61310S | 09 | 604-605 | S62014G | 08 | 559-561 | ||
| S61022A | 21 | 913-914 | S61311A | 09 | 604-605 | S62014K | 08 | 564-566 | ||
| S61022A | 24 | 963-965 | S61311A | 24 | 963-965 | S62014P | 08 | 564-566 | ||
| S61022D | 23 | 949-950 | S61311D | 23 | 949-950 | S62014S | 08 | 559-561 | ||
| S61022S | 09 | 604-605 | S61311S | 09 | 604-605 | S62015A | 08 | 562-563 | ||
| S61029A | 21 | 913-914 | S61312A | 09 | 604-605 | S62015A | 24 | 963-965 | ||
| S61029A | 24 | 963-965 | S61312A | 24 | 963-965 | S62015B | 08 | 562-563 | ||
| S61029D | 23 | 949-950 | S61312D | 23 | 949-950 | S62015B | 24 | 963-965 | ||
| S61029S | 09 | 604-605 | S61312S | 09 | 604-605 | S62015D | 08 | 559-561 | ||
| S61031A | 09 | 604-605 | S61313A | 09 | 604-605 | S62015G | 08 | 559-561 | ||
| S61031A | 24 | 963-965 | S61313A | 24 | 963-965 | S62015K | 08 | 564-566 | ||
| S61031D | 23 | 949-950 | S61313D | 23 | 949-950 | S62015P | 08 | 564-566 | ||
| S61031S | 09 | 604-605 | S61313S | 09 | 604-605 | S62015S | 08 | 559-561 | ||
| S61032A | 09 | 604-605 | S61314A | 09 | 604-605 | S62016A | 08 | 562-563 | ||
| S61032A | 24 | 963-965 | S61314A | 24 | 963-965 | S62016A | 24 | 963-965 | ||
| S61032D | 23 | 949-950 | S61314D | 23 | 949-950 | S62016B | 08 | 562-563 | ||
| S61032S | 09 | 604-605 | S61314S | 09 | 604-605 | S62016B | 24 | 963-965 | ||
| S61039A | 09 | 604-605 | S61315A | 09 | 604-605 | S62016D | 08 | 559-561 | ||
| S61039A | 24 | 963-965 | S61315A | 24 | 963-965 | S62016G | 08 | 559-561 | ||
| S61039D | 23 | 949-950 | S61315D | 23 | 949-950 | S62016K | 08 | 564-566 | ||
| S61039S | 09 | 604-605 | S61315S | 09 | 604-605 | S62016P | 08 | 564-566 | ||
| S61041A | 21 | 913-914 | S61316A | 09 | 604-605 | S62016S | 08 | 559-561 | ||
| S61041A | 24 | 963-965 | S61316A | 24 | 963-965 | S62021A | 08 | 562-563 | ||
| S61041D | 23 | 949-950 | S61316D | 23 | 949-950 | S62021A | 24 | 963-965 | ||
| S61041S | 09 | 604-605 | S61316S | 09 | 604-605 | S62021B | 08 | 562-563 | ||
| S61042A | 21 | 913-914 | S61317A | 09 | 604-605 | S62021B | 24 | 963-965 | ||
| S61042A | 24 | 963-965 | S61317A | 24 | 963-965 | S62021D | 08 | 559-561 | ||
| S61042D | 23 | 949-950 | S61317D | 23 | 949-950 | S62021G | 08 | 559-561 | ||
| S61042S | 09 | 604-605 | S61317S | 09 | 604-605 | S62021K | 08 | 564-566 | ||
| S61049A | 21 | 913-914 | S61318A | 09 | 604-605 | S62021P | 08 | 564-566 | ||
| S61049A | 24 | 963-965 | S61318A | 24 | 963-965 | S62021S | 08 | 559-561 | ||
| S61049D | 23 | 949-950 | S61318D | 23 | 949-950 | S62022A | 08 | 562-563 | ||
| S61049S | 09 | 604-605 | S61318S | 09 | 604-605 | S62022A | 24 | 963-965 | ||
| S61051A | 09 | 604-605 | S61319A | 09 | 604-605 | S62022B | 08 | 562-563 | ||
| S61051A | 24 | 963-965 | S61319A | 24 | 963-965 | S62022B | 24 | 963-965 | ||
| S61051D | 23 | 949-950 | S61319D | 23 | 949-950 | S62022D | 08 | 559-561 | ||
| S61051S | 09 | 604-605 | S61319S | 09 | 604-605 | S62022G | 08 | 559-561 | ||
| S61052A | 09 | 604-605 | S61320A | 21 | 913-914 | S62022K | 08 | 564-566 | ||
| S61052A | 24 | 963-965 | S61320A | 24 | 963-965 | S62022P | 08 | 564-566 | ||
| S61052D | 23 | 949-950 | S61320D | 23 | 949-950 | S62022S | 08 | 559-561 | ||
| S61052S | 09 | 604-605 | S61320S | 09 | 604-605 | S62023A | 08 | 562-563 | ||
| S61059A | 09 | 604-605 | S61321A | 21 | 913-914 | S62023A | 24 | 963-965 | ||
| S61059A | 24 | 963-965 | S61321A | 24 | 963-965 | S62023B | 08 | 562-563 | ||
| S61059D | 23 | 949-950 | S61321D | 23 | 949-950 | S62023B | 24 | 963-965 | ||
| S61059S | 09 | 604-605 | S61321S | 09 | 604-605 | S62023D | 08 | 559-561 | ||
| S61101A | 09 | 604-605 | S61322A | 21 | 913-914 | S62023G | 08 | 559-561 | ||
| S61101A | 24 | 963-965 | S61322A | 24 | 963-965 | S62023K | 08 | 564-566 | ||
| S61101D | 23 | 949-950 | S61322D | 23 | 949-950 | S62023P | 08 | 564-566 | ||
| S61101S | 09 | 604-605 | S61322S | 09 | 604-605 | S62023S | 08 | 559-561 | ||
| S61102A | 09 | 604-605 | S61323A | 21 | 913-914 | S62024A | 08 | 562-563 | ||
| S61102A | 24 | 963-965 | S61323A | 24 | 963-965 | S62024A | 24 | 963-965 | ||
| S61102D | 23 | 949-950 | S61323D | 23 | 949-950 | S62024B | 08 | 562-563 | ||
| S61102S | 09 | 604-605 | S61323S | 09 | 604-605 | S62024B | 24 | 963-965 | ||
| S61109A | 09 | 604-605 | S61324A | 21 | 913-914 | S62024D | 08 | 559-561 | ||
| S61109A | 24 | 963-965 | S61324A | 24 | 963-965 | S62024G | 08 | 559-561 | ||
| S61109D | 23 | 949-950 | S61324D | 23 | 949-950 | S62024K | 08 | 564-566 | ||
| S61109S | 09 | 604-605 | S61324S | 09 | 604-605 | S62024P | 08 | 564-566 | ||
| S61111A | 09 | 604-605 | S61325A | 21 | 913-914 | S62024S | 08 | 559-561 | ||
| S61111A | 24 | 963-965 | S61325A | 24 | 963-965 | S62025A | 08 | 562-563 | ||
| S61111D | 23 | 949-950 | S61325D | 23 | 949-950 | S62025A | 24 | 963-965 | ||
| S61111S | 09 | 604-605 | S61325S | 09 | 604-605 | S62025B | 08 | 562-563 | ||
| S61112A | 09 | 604-605 | S61326A | 21 | 913-914 | S62025B | 24 | 963-965 | ||
| S61112A | 24 | 963-965 | S61326A | 24 | 963-965 | S62025D | 08 | 559-561 | ||
| S61112D | 23 | 949-950 | S61326D | 23 | 949-950 | S62025G | 08 | 559-561 | ||
| S61112S | 09 | 604-605 | S61326S | 09 | 604-605 | S62025K | 08 | 564-566 | ||
| S61119A | 09 | 604-605 | S61327A | 21 | 913-914 | S62025P | 08 | 564-566 | ||
| S61119A | 24 | 963-965 | S61327A | 24 | 963-965 | S62025S | 08 | 559-561 | ||
| S61119D | 23 | 949-950 | S61327D | 23 | 949-950 | S62026A | 08 | 562-563 | ||
| S61119S | 09 | 604-605 | S61327S | 09 | 604-605 | S62026A | 24 | 963-965 | ||
| S61121A | 21 | 913-914 | S61328A | 21 | 913-914 | S62026B | 08 | 562-563 | ||
| S61121A | 24 | 963-965 | S61328A | 24 | 963-965 | S62026B | 24 | 963-965 | ||
| S61121D | 23 | 949-950 | S61328D | 23 | 949-950 | S62026D | 08 | 559-561 | ||
| S61121S | 09 | 604-605 | S61328S | 09 | 604-605 | S62026G | 08 | 559-561 | ||
| S61122A | 21 | 913-914 | S61329A | 21 | 913-914 | S62026K | 08 | 564-566 | ||
| S61122A | 24 | 963-965 | S61329A | 24 | 963-965 | S62026P | 08 | 564-566 | ||
| S61122D | 23 | 949-950 | S61329D | 23 | 949-950 | S62026S | 08 | 559-561 | ||
| S61122S | 09 | 604-605 | S61329S | 09 | 604-605 | S62031A | 08 | 562-563 | ||
| S61129A | 21 | 913-914 | S61330A | 09 | 604-605 | S62031A | 24 | 963-965 | ||
| S61129A | 24 | 963-965 | S61330A | 24 | 963-965 | S62031B | 08 | 562-563 | ||
| S61129D | 23 | 949-950 | S61330D | 23 | 949-950 | S62031B | 24 | 963-965 | ||
| S61129S | 09 | 604-605 | S61330S | 09 | 604-605 | S62031D | 08 | 559-561 | ||
| S61131A | 09 | 604-605 | S61331A | 09 | 604-605 | S62031G | 08 | 559-561 | ||
| S61131A | 24 | 963-965 | S61331A | 24 | 963-965 | S62031K | 08 | 564-566 | ||
| S61131D | 23 | 949-950 | S61331D | 23 | 949-950 | S62031P | 08 | 564-566 | ||
| S61131S | 09 | 604-605 | S61331S | 09 | 604-605 | S62031S | 08 | 559-561 | ||
| S61132A | 09 | 604-605 | S61332A | 09 | 604-605 | S62032A | 08 | 562-563 | ||
| S61132A | 24 | 963-965 | S61332A | 24 | 963-965 | S62032A | 24 | 963-965 | ||
| S61132D | 23 | 949-950 | S61332D | 23 | 949-950 | S62032B | 08 | 562-563 | ||
| S61132S | 09 | 604-605 | S61332S | 09 | 604-605 | S62032B | 24 | 963-965 | ||
| S61139A | 09 | 604-605 | S61333A | 09 | 604-605 | S62032D | 08 | 559-561 | ||
| S61139A | 24 | 963-965 | S61333A | 24 | 963-965 | S62032G | 08 | 559-561 | ||
| S61139D | 23 | 949-950 | S61333D | 23 | 949-950 | S62032K | 08 | 564-566 | ||
| S61139S | 09 | 604-605 | S61333S | 09 | 604-605 | S62032P | 08 | 564-566 | ||
| S61141A | 21 | 913-914 | S61334A | 09 | 604-605 | S62032S | 08 | 559-561 | ||
| S61141A | 24 | 963-965 | S61334A | 24 | 963-965 | S62033A | 08 | 562-563 | ||
| S61141D | 23 | 949-950 | S61334D | 23 | 949-950 | S62033A | 24 | 963-965 | ||
| S61141S | 09 | 604-605 | S61334S | 09 | 604-605 | S62033B | 08 | 562-563 | ||
| S61142A | 21 | 913-914 | S61335A | 09 | 604-605 | S62033B | 24 | 963-965 | ||
| S61142A | 24 | 963-965 | S61335A | 24 | 963-965 | S62033D | 08 | 559-561 | ||
| S61142D | 23 | 949-950 | S61335D | 23 | 949-950 | S62033G | 08 | 559-561 | ||
| S61142S | 09 | 604-605 | S61335S | 09 | 604-605 | S62033K | 08 | 564-566 | ||
| S61149A | 21 | 913-914 | S61336A | 09 | 604-605 | S62033P | 08 | 564-566 | ||
| S61149A | 24 | 963-965 | S61336A | 24 | 963-965 | S62033S | 08 | 559-561 | ||
| S61149D | 23 | 949-950 | S61336D | 23 | 949-950 | S62034A | 08 | 562-563 | ||
| S61149S | 09 | 604-605 | S61336S | 09 | 604-605 | S62034A | 24 | 963-965 | ||
| S61151A | 09 | 604-605 | S61337A | 09 | 604-605 | S62034B | 08 | 562-563 | ||
| S61151A | 24 | 963-965 | S61337A | 24 | 963-965 | S62034B | 24 | 963-965 | ||
| S61151D | 23 | 949-950 | S61337D | 23 | 949-950 | S62034D | 08 | 559-561 | ||
| S61151S | 09 | 604-605 | S61337S | 09 | 604-605 | S62034G | 08 | 559-561 | ||
| S61152A | 09 | 604-605 | S61338A | 09 | 604-605 | S62034K | 08 | 564-566 | ||
| S61152A | 24 | 963-965 | S61338A | 24 | 963-965 | S62034P | 08 | 564-566 | ||
| S61152D | 23 | 949-950 | S61338D | 23 | 949-950 | S62034S | 08 | 559-561 | ||
| S61152S | 09 | 604-605 | S61338S | 09 | 604-605 | S62035A | 08 | 562-563 | ||
| S61159A | 09 | 604-605 | S61339A | 09 | 604-605 | S62035A | 24 | 963-965 | ||
| S61159A | 24 | 963-965 | S61339A | 24 | 963-965 | S62035B | 08 | 562-563 | ||
| S61159D | 23 | 949-950 | S61339D | 23 | 949-950 | S62035B | 24 | 963-965 | ||
| S61159S | 09 | 604-605 | S61339S | 09 | 604-605 | S62035D | 08 | 559-561 | ||
| S61200A | 09 | 604-605 | S61340A | 21 | 913-914 | S62035G | 08 | 559-561 | ||
| S61200A | 24 | 963-965 | S61340A | 24 | 963-965 | S62035K | 08 | 564-566 | ||
| S61200D | 23 | 949-950 | S61340D | 23 | 949-950 | S62035P | 08 | 564-566 | ||
| S61200S | 09 | 604-605 | S61340S | 09 | 604-605 | S62035S | 08 | 559-561 | ||
| S61201A | 09 | 604-605 | S61341A | 21 | 913-914 | S62036A | 08 | 562-563 | ||
| S61201A | 24 | 963-965 | S61341A | 24 | 963-965 | S62036A | 24 | 963-965 | ||
| S61201D | 23 | 949-950 | S61341D | 23 | 949-950 | S62036B | 08 | 562-563 | ||
| S61201S | 09 | 604-605 | S61341S | 09 | 604-605 | S62036B | 24 | 963-965 | ||
| S61202A | 09 | 604-605 | S61342A | 21 | 913-914 | S62036D | 08 | 559-561 | ||
| S61202A | 24 | 963-965 | S61342A | 24 | 963-965 | S62036G | 08 | 559-561 | ||
| S61202D | 23 | 949-950 | S61342D | 23 | 949-950 | S62036K | 08 | 564-566 | ||
| S61202S | 09 | 604-605 | S61342S | 09 | 604-605 | S62036P | 08 | 564-566 | ||
| S61203A | 09 | 604-605 | S61343A | 21 | 913-914 | S62036S | 08 | 559-561 | ||
| S61203A | 24 | 963-965 | S61343A | 24 | 963-965 | S62101A | 08 | 562-563 | ||
| S61203D | 23 | 949-950 | S61343D | 23 | 949-950 | S62101A | 24 | 963-965 | ||
| S61203S | 09 | 604-605 | S61343S | 09 | 604-605 | S62101B | 08 | 562-563 | ||
| S61204A | 09 | 604-605 | S61344A | 21 | 913-914 | S62101B | 24 | 963-965 | ||
| S61204A | 24 | 963-965 | S61344A | 24 | 963-965 | S62101D | 08 | 559-561 | ||
| S61204D | 23 | 949-950 | S61344D | 23 | 949-950 | S62101G | 08 | 559-561 | ||
| S61204S | 09 | 604-605 | S61344S | 09 | 604-605 | S62101K | 08 | 564-566 | ||
| S61205A | 09 | 604-605 | S61345A | 21 | 913-914 | S62101P | 08 | 564-566 | ||
| S61205A | 24 | 963-965 | S61345A | 24 | 963-965 | S62101S | 08 | 559-561 | ||
| S61205D | 23 | 949-950 | S61345D | 23 | 949-950 | S62102A | 08 | 562-563 | ||
| S61205S | 09 | 604-605 | S61345S | 09 | 604-605 | S62102A | 24 | 963-965 | ||
| S61206A | 09 | 604-605 | S61346A | 21 | 913-914 | S62102B | 08 | 562-563 | ||
| S61206A | 24 | 963-965 | S61346A | 24 | 963-965 | S62102B | 24 | 963-965 | ||
| S61206D | 23 | 949-950 | S61346D | 23 | 949-950 | S62102D | 08 | 559-561 | ||
| S61206S | 09 | 604-605 | S61346S | 09 | 604-605 | S62102G | 08 | 559-561 | ||
| S61207A | 09 | 604-605 | S61347A | 21 | 913-914 | S62102K | 08 | 564-566 | ||
| S61207A | 24 | 963-965 | S61347A | 24 | 963-965 | S62102P | 08 | 564-566 | ||
| S61207D | 23 | 949-950 | S61347D | 23 | 949-950 | S62102S | 08 | 559-561 | ||
| S61207S | 09 | 604-605 | S61347S | 09 | 604-605 | S62109A | 08 | 562-563 | ||
| S61208A | 09 | 604-605 | S61348A | 21 | 913-914 | S62109A | 24 | 963-965 | ||
| S61208A | 24 | 963-965 | S61348A | 24 | 963-965 | S62109B | 08 | 562-563 | ||
| S61208D | 23 | 949-950 | S61348D | 23 | 949-950 | S62109B | 24 | 963-965 | ||
| S61208S | 09 | 604-605 | S61348S | 09 | 604-605 | S62109D | 08 | 559-561 | ||
| S61209A | 09 | 604-605 | S61349A | 21 | 913-914 | S62109G | 08 | 559-561 | ||
| S61209A | 24 | 963-965 | S61349A | 24 | 963-965 | S62109K | 08 | 564-566 | ||
| S61209D | 23 | 949-950 | S61349D | 23 | 949-950 | S62109P | 08 | 564-566 | ||
| S61209S | 09 | 604-605 | S61349S | 09 | 604-605 | S62109S | 08 | 559-561 | ||
| S61210A | 09 | 604-605 | S61350A | 09 | 604-605 | S62111A | 08 | 562-563 | ||
| S61210A | 24 | 963-965 | S61350A | 24 | 963-965 | S62111A | 24 | 963-965 | ||
| S61210D | 23 | 949-950 | S61350D | 23 | 949-950 | S62111B | 08 | 562-563 | ||
| S61210S | 09 | 604-605 | S61350S | 09 | 604-605 | S62111B | 24 | 963-965 | ||
| S61211A | 09 | 604-605 | S61351A | 09 | 604-605 | S62111D | 08 | 559-561 | ||
| S61211A | 24 | 963-965 | S61351A | 24 | 963-965 | S62111G | 08 | 559-561 | ||
| S61211D | 23 | 949-950 | S61351D | 23 | 949-950 | S62111K | 08 | 564-566 | ||
| S61211S | 09 | 604-605 | S61351S | 09 | 604-605 | S62111P | 08 | 564-566 | ||
| S61212A | 09 | 604-605 | S61352A | 09 | 604-605 | S62111S | 08 | 559-561 | ||
| S61212A | 24 | 963-965 | S61352A | 24 | 963-965 | S62112A | 08 | 562-563 | ||
| S61212D | 23 | 949-950 | S61352D | 23 | 949-950 | S62112A | 24 | 963-965 | ||
| S61212S | 09 | 604-605 | S61352S | 09 | 604-605 | S62112B | 08 | 562-563 | ||
| S61213A | 09 | 604-605 | S61353A | 09 | 604-605 | S62112B | 24 | 963-965 | ||
| S61213A | 24 | 963-965 | S61353A | 24 | 963-965 | S62112D | 08 | 559-561 | ||
| S61213D | 23 | 949-950 | S61353D | 23 | 949-950 | S62112G | 08 | 559-561 | ||
| S61213S | 09 | 604-605 | S61353S | 09 | 604-605 | S62112K | 08 | 564-566 | ||
| S61214A | 09 | 604-605 | S61354A | 09 | 604-605 | S62112P | 08 | 564-566 | ||
| S61214A | 24 | 963-965 | S61354A | 24 | 963-965 | S62112S | 08 | 559-561 | ||
| S61214D | 23 | 949-950 | S61354D | 23 | 949-950 | S62113A | 08 | 562-563 | ||
| S61214S | 09 | 604-605 | S61354S | 09 | 604-605 | S62113A | 24 | 963-965 | ||
| S61215A | 09 | 604-605 | S61355A | 09 | 604-605 | S62113B | 08 | 562-563 | ||
| S61215A | 24 | 963-965 | S61355A | 24 | 963-965 | S62113B | 24 | 963-965 | ||
| S61215D | 23 | 949-950 | S61355D | 23 | 949-950 | S62113D | 08 | 559-561 | ||
| S61215S | 09 | 604-605 | S61355S | 09 | 604-605 | S62113G | 08 | 559-561 | ||
| S61216A | 09 | 604-605 | S61356A | 09 | 604-605 | S62113K | 08 | 564-566 | ||
| S61216A | 24 | 963-965 | S61356A | 24 | 963-965 | S62113P | 08 | 564-566 | ||
| S61216D | 23 | 949-950 | S61356D | 23 | 949-950 | S62113S | 08 | 559-561 | ||
| S61216S | 09 | 604-605 | S61356S | 09 | 604-605 | S62114A | 08 | 562-563 | ||
| S61217A | 09 | 604-605 | S61357A | 09 | 604-605 | S62114A | 24 | 963-965 | ||
| S61217A | 24 | 963-965 | S61357A | 24 | 963-965 | S62114B | 08 | 562-563 | ||
| S61217D | 23 | 949-950 | S61357D | 23 | 949-950 | S62114B | 24 | 963-965 | ||
| S61217S | 09 | 604-605 | S61357S | 09 | 604-605 | S62114D | 08 | 559-561 | ||
| S61218A | 09 | 604-605 | S61358A | 09 | 604-605 | S62114G | 08 | 559-561 | ||
| S61218A | 24 | 963-965 | S61358A | 24 | 963-965 | S62114K | 08 | 564-566 | ||
| S61218D | 23 | 949-950 | S61358D | 23 | 949-950 | S62114P | 08 | 564-566 | ||
| S61218S | 09 | 604-605 | S61358S | 09 | 604-605 | S62114S | 08 | 559-561 | ||
| S61219A | 09 | 604-605 | S61359A | 09 | 604-605 | S62115A | 08 | 562-563 | ||
| S61219A | 24 | 963-965 | S61359A | 24 | 963-965 | S62115A | 24 | 963-965 | ||
| S61219D | 23 | 949-950 | S61359D | 23 | 949-950 | S62115B | 08 | 562-563 | ||
| S61219S | 09 | 604-605 | S61359S | 09 | 604-605 | S62115B | 24 | 963-965 | ||
| S61220A | 21 | 913-914 | S61401A | 09 | 604-605 | S62115D | 08 | 559-561 | ||
| S61220A | 24 | 963-965 | S61401A | 24 | 963-965 | S62115G | 08 | 559-561 | ||
| S61220D | 23 | 949-950 | S61401D | 23 | 949-950 | S62115K | 08 | 564-566 | ||
| S61220S | 09 | 604-605 | S61401S | 09 | 604-605 | S62115P | 08 | 564-566 | ||
| S61221A | 21 | 913-914 | S61402A | 09 | 604-605 | S62115S | 08 | 559-561 | ||
| S61221A | 24 | 963-965 | S61402A | 24 | 963-965 | S62116A | 08 | 562-563 | ||
| S61221D | 23 | 949-950 | S61402D | 23 | 949-950 | S62116A | 24 | 963-965 | ||
| S61221S | 09 | 604-605 | S61402S | 09 | 604-605 | S62116B | 08 | 562-563 | ||
| S61222A | 21 | 913-914 | S61409A | 09 | 604-605 | S62116B | 24 | 963-965 | ||
| S61222A | 24 | 963-965 | S61409A | 24 | 963-965 | S62116D | 08 | 559-561 | ||
| S61222D | 23 | 949-950 | S61409D | 23 | 949-950 | S62116G | 08 | 559-561 | ||
| S61222S | 09 | 604-605 | S61409S | 09 | 604-605 | S62116K | 08 | 564-566 | ||
| S61223A | 21 | 913-914 | S61411A | 09 | 604-605 | S62116P | 08 | 564-566 | ||
| S61223A | 24 | 963-965 | S61411A | 24 | 963-965 | S62116S | 08 | 559-561 | ||
| S61223D | 23 | 949-950 | S61411D | 23 | 949-950 | S62121A | 08 | 562-563 | ||
| S61223S | 09 | 604-605 | S61411S | 09 | 604-605 | S62121A | 24 | 963-965 | ||
| S61224A | 21 | 913-914 | S61412A | 09 | 604-605 | S62121B | 08 | 562-563 | ||
| S61224A | 24 | 963-965 | S61412A | 24 | 963-965 | S62121B | 24 | 963-965 | ||
| S61224D | 23 | 949-950 | S61412D | 23 | 949-950 | S62121D | 08 | 559-561 | ||
| S61224S | 09 | 604-605 | S61412S | 09 | 604-605 | S62121G | 08 | 559-561 | ||
| S61225A | 21 | 913-914 | S61419A | 09 | 604-605 | S62121K | 08 | 564-566 | ||
| S61225A | 24 | 963-965 | S61419A | 24 | 963-965 | S62121P | 08 | 564-566 | ||
| S61225D | 23 | 949-950 | S61419D | 23 | 949-950 | S62121S | 08 | 559-561 | ||
| S61225S | 09 | 604-605 | S61419S | 09 | 604-605 | S62122A | 08 | 562-563 | ||
| S61226A | 21 | 913-914 | S61421A | 21 | 913-914 | S62122A | 24 | 963-965 | ||
| S61226A | 24 | 963-965 | S61421A | 24 | 963-965 | S62122B | 08 | 562-563 | ||
| S61226D | 23 | 949-950 | S61421D | 23 | 949-950 | S62122B | 24 | 963-965 | ||
| S61226S | 09 | 604-605 | S61421S | 09 | 604-605 | S62122D | 08 | 559-561 | ||
| S61227A | 21 | 913-914 | S61422A | 21 | 913-914 | S62122G | 08 | 559-561 | ||
| S61227A | 24 | 963-965 | S61422A | 24 | 963-965 | S62122K | 08 | 564-566 | ||
| S61227D | 23 | 949-950 | S61422D | 23 | 949-950 | S62122P | 08 | 564-566 | ||
| S61227S | 09 | 604-605 | S61422S | 09 | 604-605 | S62122S | 08 | 559-561 | ||
| S61228A | 21 | 913-914 | S61429A | 21 | 913-914 | S62123A | 08 | 562-563 | ||
| S61228A | 24 | 963-965 | S61429A | 24 | 963-965 | S62123A | 24 | 963-965 | ||
| S61228D | 23 | 949-950 | S61429D | 23 | 949-950 | S62123B | 08 | 562-563 | ||
| S61228S | 09 | 604-605 | S61429S | 09 | 604-605 | S62123B | 24 | 963-965 | ||
| S61229A | 21 | 913-914 | S61431A | 09 | 604-605 | S62123D | 08 | 559-561 | ||
| S61229A | 24 | 963-965 | S61431A | 24 | 963-965 | S62123G | 08 | 559-561 | ||
| S61229D | 23 | 949-950 | S61431D | 23 | 949-950 | S62123K | 08 | 564-566 | ||
| S61229S | 09 | 604-605 | S61431S | 09 | 604-605 | S62123P | 08 | 564-566 | ||
| S61230A | 09 | 604-605 | S61432A | 09 | 604-605 | S62123S | 08 | 559-561 | ||
| S61230A | 24 | 963-965 | S61432A | 24 | 963-965 | S62124A | 08 | 562-563 | ||
| S61230D | 23 | 949-950 | S61432D | 23 | 949-950 | S62124A | 24 | 963-965 | ||
| S61230S | 09 | 604-605 | S61432S | 09 | 604-605 | S62124B | 08 | 562-563 | ||
| S61231A | 09 | 604-605 | S61439A | 09 | 604-605 | S62124B | 24 | 963-965 | ||
| S61231A | 24 | 963-965 | S61439A | 24 | 963-965 | S62124D | 08 | 559-561 | ||
| S61231D | 23 | 949-950 | S61439D | 23 | 949-950 | S62124G | 08 | 559-561 | ||
| S61231S | 09 | 604-605 | S61439S | 09 | 604-605 | S62124K | 08 | 564-566 | ||
| S61232A | 09 | 604-605 | S61441A | 21 | 913-914 | S62124P | 08 | 564-566 | ||
| S61232A | 24 | 963-965 | S61441A | 24 | 963-965 | S62124S | 08 | 559-561 | ||
| S61232D | 23 | 949-950 | S61441D | 23 | 949-950 | S62125A | 08 | 562-563 | ||
| S61232S | 09 | 604-605 | S61441S | 09 | 604-605 | S62125A | 24 | 963-965 | ||
| S61233A | 09 | 604-605 | S61442A | 21 | 913-914 | S62125B | 08 | 562-563 | ||
| S61233A | 24 | 963-965 | S61442A | 24 | 963-965 | S62125B | 24 | 963-965 | ||
| S61233D | 23 | 949-950 | S61442D | 23 | 949-950 | S62125D | 08 | 559-561 | ||
| S61233S | 09 | 604-605 | S61442S | 09 | 604-605 | S62125G | 08 | 559-561 | ||
| S61234A | 09 | 604-605 | S61449A | 21 | 913-914 | S62125K | 08 | 564-566 | ||
| S61234A | 24 | 963-965 | S61449A | 24 | 963-965 | S62125P | 08 | 564-566 | ||
| S61234D | 23 | 949-950 | S61449D | 23 | 949-950 | S62125S | 08 | 559-561 | ||
| S61234S | 09 | 604-605 | S61449S | 09 | 604-605 | S62126A | 08 | 562-563 | ||
| S61235A | 09 | 604-605 | S61451A | 09 | 604-605 | S62126A | 24 | 963-965 | ||
| S61235A | 24 | 963-965 | S61451A | 24 | 963-965 | S62126B | 08 | 562-563 | ||
| S61235D | 23 | 949-950 | S61451D | 23 | 949-950 | S62126B | 24 | 963-965 | ||
| S61235S | 09 | 604-605 | S61451S | 09 | 604-605 | S62126D | 08 | 559-561 | ||
| S61236A | 09 | 604-605 | S61452A | 09 | 604-605 | S62126G | 08 | 559-561 | ||
| S61236A | 24 | 963-965 | S61452A | 24 | 963-965 | S62126K | 08 | 564-566 | ||
| S61236D | 23 | 949-950 | S61452D | 23 | 949-950 | S62126P | 08 | 564-566 | ||
| S61236S | 09 | 604-605 | S61452S | 09 | 604-605 | S62126S | 08 | 559-561 | ||
| S61237A | 09 | 604-605 | S61459A | 09 | 604-605 | S62131A | 08 | 562-563 | ||
| S61237A | 24 | 963-965 | S61459A | 24 | 963-965 | S62131A | 24 | 963-965 | ||
| S61237D | 23 | 949-950 | S61459D | 23 | 949-950 | S62131B | 08 | 562-563 | ||
| S61237S | 09 | 604-605 | S61459S | 09 | 604-605 | S62131B | 24 | 963-965 | ||
| S61238A | 09 | 604-605 | S61501A | 09 | 604-605 | S62131D | 08 | 559-561 | ||
| S61238A | 24 | 963-965 | S61501A | 24 | 963-965 | S62131G | 08 | 559-561 | ||
| S61238D | 23 | 949-950 | S61501D | 23 | 949-950 | S62131K | 08 | 564-566 | ||
| S61238S | 09 | 604-605 | S61501S | 09 | 604-605 | S62131P | 08 | 564-566 | ||
| S61239A | 09 | 604-605 | S61502A | 09 | 604-605 | S62131S | 08 | 559-561 | ||
| S61239A | 24 | 963-965 | S61502A | 24 | 963-965 | S62132A | 08 | 562-563 | ||
| S61239D | 23 | 949-950 | S61502D | 23 | 949-950 | S62132A | 24 | 963-965 | ||
| S61239S | 09 | 604-605 | S61502S | 09 | 604-605 | S62132B | 08 | 562-563 | ||
| S61240A | 21 | 913-914 | S61509A | 09 | 604-605 | S62132B | 24 | 963-965 | ||
| S61240A | 24 | 963-965 | S61509A | 24 | 963-965 | S62132D | 08 | 559-561 | ||
| S61240D | 23 | 949-950 | S61509D | 23 | 949-950 | S62132G | 08 | 559-561 | ||
| S61240S | 09 | 604-605 | S61509S | 09 | 604-605 | S62132K | 08 | 564-566 | ||
| S61241A | 21 | 913-914 | S61511A | 09 | 604-605 | S62132P | 08 | 564-566 | ||
| S61241A | 24 | 963-965 | S61511A | 24 | 963-965 | S62132S | 08 | 559-561 | ||
| S61241D | 23 | 949-950 | S61511D | 23 | 949-950 | S62133A | 08 | 562-563 | ||
| S61241S | 09 | 604-605 | S61511S | 09 | 604-605 | S62133A | 24 | 963-965 | ||
| S61242A | 21 | 913-914 | S61512A | 09 | 604-605 | S62133B | 08 | 562-563 | ||
| S61242A | 24 | 963-965 | S61512A | 24 | 963-965 | S62133B | 24 | 963-965 | ||
| S61242D | 23 | 949-950 | S61512D | 23 | 949-950 | S62133D | 08 | 559-561 | ||
| S61242S | 09 | 604-605 | S61512S | 09 | 604-605 | S62133G | 08 | 559-561 | ||
| S61243A | 21 | 913-914 | S61519A | 09 | 604-605 | S62133K | 08 | 564-566 | ||
| S61243A | 24 | 963-965 | S61519A | 24 | 963-965 | S62133P | 08 | 564-566 | ||
| S61243D | 23 | 949-950 | S61519D | 23 | 949-950 | S62133S | 08 | 559-561 | ||
| S61243S | 09 | 604-605 | S61519S | 09 | 604-605 | S62134A | 08 | 562-563 | ||
| S61244A | 21 | 913-914 | S61521A | 21 | 913-914 | S62134A | 24 | 963-965 | ||
| S61244A | 24 | 963-965 | S61521A | 24 | 963-965 | S62134B | 08 | 562-563 | ||
| S61244D | 23 | 949-950 | S61521D | 23 | 949-950 | S62134B | 24 | 963-965 | ||
| S61244S | 09 | 604-605 | S61521S | 09 | 604-605 | S62134D | 08 | 559-561 | ||
| S61245A | 21 | 913-914 | S61522A | 21 | 913-914 | S62134G | 08 | 559-561 | ||
| S61245A | 24 | 963-965 | S61522A | 24 | 963-965 | S62134K | 08 | 564-566 | ||
| S61245D | 23 | 949-950 | S61522D | 23 | 949-950 | S62134P | 08 | 564-566 | ||
| S61245S | 09 | 604-605 | S61522S | 09 | 604-605 | S62134S | 08 | 559-561 | ||
| S61246A | 21 | 913-914 | S61529A | 21 | 913-914 | S62135A | 08 | 562-563 | ||
| S61246A | 24 | 963-965 | S61529A | 24 | 963-965 | S62135A | 24 | 963-965 | ||
| S61246D | 23 | 949-950 | S61529D | 23 | 949-950 | S62135B | 08 | 562-563 | ||
| S61246S | 09 | 604-605 | S61529S | 09 | 604-605 | S62135B | 24 | 963-965 | ||
| S61247A | 21 | 913-914 | S61531A | 09 | 604-605 | S62135D | 08 | 559-561 | ||
| S61247A | 24 | 963-965 | S61531A | 24 | 963-965 | S62135G | 08 | 559-561 | ||
| S61247D | 23 | 949-950 | S61531D | 23 | 949-950 | S62135K | 08 | 564-566 | ||
| S61247S | 09 | 604-605 | S61531S | 09 | 604-605 | S62135P | 08 | 564-566 | ||
| S61248A | 21 | 913-914 | S61532A | 09 | 604-605 | S62135S | 08 | 559-561 | ||
| S61248A | 24 | 963-965 | S61532A | 24 | 963-965 | S62136A | 08 | 562-563 | ||
| S61248D | 23 | 949-950 | S61532D | 23 | 949-950 | S62136A | 24 | 963-965 | ||
| S61248S | 09 | 604-605 | S61532S | 09 | 604-605 | S62136B | 08 | 562-563 | ||
| S61249A | 21 | 913-914 | S61539A | 09 | 604-605 | S62136B | 24 | 963-965 | ||
| S61249A | 24 | 963-965 | S61539A | 24 | 963-965 | S62136D | 08 | 559-561 | ||
| S61249D | 23 | 949-950 | S61539D | 23 | 949-950 | S62136G | 08 | 559-561 | ||
| S61249S | 09 | 604-605 | S61539S | 09 | 604-605 | S62136K | 08 | 564-566 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |