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 50 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S63208D | 23 | 949-950 | S63329D | 23 | 949-950 | S63652D | 23 | 949-950 | ||
| S63208S | 08 | 562-563 | S63329S | 08 | 562-563 | S63652S | 08 | 562-563 | ||
| S63209A | 08 | 562-563 | S63331A | 08 | 562-563 | S63653A | 08 | 562-563 | ||
| S63209A | 24 | 963-965 | S63331A | 24 | 963-965 | S63653A | 24 | 963-965 | ||
| S63209D | 23 | 949-950 | S63331D | 23 | 949-950 | S63653D | 23 | 949-950 | ||
| S63209S | 08 | 562-563 | S63331S | 08 | 562-563 | S63653S | 08 | 562-563 | ||
| S63210A | 08 | 562-563 | S63332A | 08 | 562-563 | S63654A | 08 | 562-563 | ||
| S63210A | 24 | 963-965 | S63332A | 24 | 963-965 | S63654A | 24 | 963-965 | ||
| S63210D | 23 | 949-950 | S63332D | 23 | 949-950 | S63654D | 23 | 949-950 | ||
| S63210S | 08 | 562-563 | S63332S | 08 | 562-563 | S63654S | 08 | 562-563 | ||
| S63211A | 08 | 562-563 | S63339A | 08 | 562-563 | S63655A | 08 | 562-563 | ||
| S63211A | 24 | 963-965 | S63339A | 24 | 963-965 | S63655A | 24 | 963-965 | ||
| S63211D | 23 | 949-950 | S63339D | 23 | 949-950 | S63655D | 23 | 949-950 | ||
| S63211S | 08 | 562-563 | S63339S | 08 | 562-563 | S63655S | 08 | 562-563 | ||
| S63212A | 08 | 562-563 | S63391A | 08 | 562-563 | S63656A | 08 | 562-563 | ||
| S63212A | 24 | 963-965 | S63391A | 24 | 963-965 | S63656A | 24 | 963-965 | ||
| S63212D | 23 | 949-950 | S63391D | 23 | 949-950 | S63656D | 23 | 949-950 | ||
| S63212S | 08 | 562-563 | S63391S | 08 | 562-563 | S63656S | 08 | 562-563 | ||
| S63213A | 08 | 562-563 | S63392A | 08 | 562-563 | S63657A | 08 | 562-563 | ||
| S63213A | 24 | 963-965 | S63392A | 24 | 963-965 | S63657A | 24 | 963-965 | ||
| S63213D | 23 | 949-950 | S63392D | 23 | 949-950 | S63657D | 23 | 949-950 | ||
| S63213S | 08 | 562-563 | S63392S | 08 | 562-563 | S63657S | 08 | 562-563 | ||
| S63214A | 08 | 562-563 | S63399A | 08 | 562-563 | S63658A | 08 | 562-563 | ||
| S63214A | 24 | 963-965 | S63399A | 24 | 963-965 | S63658A | 24 | 963-965 | ||
| S63214D | 23 | 949-950 | S63399D | 23 | 949-950 | S63658D | 23 | 949-950 | ||
| S63214S | 08 | 562-563 | S63399S | 08 | 562-563 | S63658S | 08 | 562-563 | ||
| S63215A | 08 | 562-563 | S63400A | 08 | 562-563 | S63659A | 08 | 562-563 | ||
| S63215A | 24 | 963-965 | S63400A | 24 | 963-965 | S63659A | 24 | 963-965 | ||
| S63215D | 23 | 949-950 | S63400D | 23 | 949-950 | S63659D | 23 | 949-950 | ||
| S63215S | 08 | 562-563 | S63400S | 08 | 562-563 | S63659S | 08 | 562-563 | ||
| S63216A | 08 | 562-563 | S63401A | 08 | 562-563 | S63681A | 08 | 562-563 | ||
| S63216A | 24 | 963-965 | S63401A | 24 | 963-965 | S63681A | 24 | 963-965 | ||
| S63216D | 23 | 949-950 | S63401D | 23 | 949-950 | S63681D | 23 | 949-950 | ||
| S63216S | 08 | 562-563 | S63401S | 08 | 562-563 | S63681S | 08 | 562-563 | ||
| S63217A | 08 | 562-563 | S63402A | 08 | 562-563 | S63682A | 08 | 562-563 | ||
| S63217A | 24 | 963-965 | S63402A | 24 | 963-965 | S63682A | 24 | 963-965 | ||
| S63217D | 23 | 949-950 | S63402D | 23 | 949-950 | S63682D | 23 | 949-950 | ||
| S63217S | 08 | 562-563 | S63402S | 08 | 562-563 | S63682S | 08 | 562-563 | ||
| S63218A | 08 | 562-563 | S63403A | 08 | 562-563 | S63689A | 08 | 562-563 | ||
| S63218A | 24 | 963-965 | S63403A | 24 | 963-965 | S63689A | 24 | 963-965 | ||
| S63218D | 23 | 949-950 | S63403D | 23 | 949-950 | S63689D | 23 | 949-950 | ||
| S63218S | 08 | 562-563 | S63403S | 08 | 562-563 | S63689S | 08 | 562-563 | ||
| S63219A | 08 | 562-563 | S63404A | 08 | 562-563 | S63690A | 08 | 562-563 | ||
| S63219A | 24 | 963-965 | S63404A | 24 | 963-965 | S63690A | 24 | 963-965 | ||
| S63219D | 23 | 949-950 | S63404D | 23 | 949-950 | S63690D | 23 | 949-950 | ||
| S63219S | 08 | 562-563 | S63404S | 08 | 562-563 | S63690S | 08 | 562-563 | ||
| S63220A | 08 | 562-563 | S63405A | 08 | 562-563 | S63691A | 08 | 562-563 | ||
| S63220A | 24 | 963-965 | S63405A | 24 | 963-965 | S63691A | 24 | 963-965 | ||
| S63220D | 23 | 949-950 | S63405D | 23 | 949-950 | S63691D | 23 | 949-950 | ||
| S63220S | 08 | 562-563 | S63405S | 08 | 562-563 | S63691S | 08 | 562-563 | ||
| S63221A | 08 | 562-563 | S63406A | 08 | 562-563 | S63692A | 08 | 562-563 | ||
| S63221A | 24 | 963-965 | S63406A | 24 | 963-965 | S63692A | 24 | 963-965 | ||
| S63221D | 23 | 949-950 | S63406D | 23 | 949-950 | S63692D | 23 | 949-950 | ||
| S63221S | 08 | 562-563 | S63406S | 08 | 562-563 | S63692S | 08 | 562-563 | ||
| S63222A | 08 | 562-563 | S63407A | 08 | 562-563 | S63693A | 08 | 562-563 | ||
| S63222A | 24 | 963-965 | S63407A | 24 | 963-965 | S63693A | 24 | 963-965 | ||
| S63222D | 23 | 949-950 | S63407D | 23 | 949-950 | S63693D | 23 | 949-950 | ||
| S63222S | 08 | 562-563 | S63407S | 08 | 562-563 | S63693S | 08 | 562-563 | ||
| S63223A | 08 | 562-563 | S63408A | 08 | 562-563 | S63694A | 08 | 562-563 | ||
| S63223A | 24 | 963-965 | S63408A | 24 | 963-965 | S63694A | 24 | 963-965 | ||
| S63223D | 23 | 949-950 | S63408D | 23 | 949-950 | S63694D | 23 | 949-950 | ||
| S63223S | 08 | 562-563 | S63408S | 08 | 562-563 | S63694S | 08 | 562-563 | ||
| S63224A | 08 | 562-563 | S63409A | 08 | 562-563 | S63695A | 08 | 562-563 | ||
| S63224A | 24 | 963-965 | S63409A | 24 | 963-965 | S63695A | 24 | 963-965 | ||
| S63224D | 23 | 949-950 | S63409D | 23 | 949-950 | S63695D | 23 | 949-950 | ||
| S63224S | 08 | 562-563 | S63409S | 08 | 562-563 | S63695S | 08 | 562-563 | ||
| S63225A | 08 | 562-563 | S63410A | 08 | 562-563 | S63696A | 08 | 562-563 | ||
| S63225A | 24 | 963-965 | S63410A | 24 | 963-965 | S63696A | 24 | 963-965 | ||
| S63225D | 23 | 949-950 | S63410D | 23 | 949-950 | S63696D | 23 | 949-950 | ||
| S63225S | 08 | 562-563 | S63410S | 08 | 562-563 | S63696S | 08 | 562-563 | ||
| S63226A | 08 | 562-563 | S63411A | 08 | 562-563 | S63697A | 08 | 562-563 | ||
| S63226A | 24 | 963-965 | S63411A | 24 | 963-965 | S63697A | 24 | 963-965 | ||
| S63226D | 23 | 949-950 | S63411D | 23 | 949-950 | S63697D | 23 | 949-950 | ||
| S63226S | 08 | 562-563 | S63411S | 08 | 562-563 | S63697S | 08 | 562-563 | ||
| S63227A | 08 | 562-563 | S63412A | 08 | 562-563 | S63698A | 08 | 562-563 | ||
| S63227A | 24 | 963-965 | S63412A | 24 | 963-965 | S63698A | 24 | 963-965 | ||
| S63227D | 23 | 949-950 | S63412D | 23 | 949-950 | S63698D | 23 | 949-950 | ||
| S63227S | 08 | 562-563 | S63412S | 08 | 562-563 | S63698S | 08 | 562-563 | ||
| S63228A | 08 | 562-563 | S63413A | 08 | 562-563 | S63699A | 08 | 562-563 | ||
| S63228A | 24 | 963-965 | S63413A | 24 | 963-965 | S63699A | 24 | 963-965 | ||
| S63228D | 23 | 949-950 | S63413D | 23 | 949-950 | S63699D | 23 | 949-950 | ||
| S63228S | 08 | 562-563 | S63413S | 08 | 562-563 | S63699S | 08 | 562-563 | ||
| S63229A | 08 | 562-563 | S63414A | 08 | 562-563 | S638X1A | 08 | 562-563 | ||
| S63229A | 24 | 963-965 | S63414A | 24 | 963-965 | S638X1A | 24 | 963-965 | ||
| S63229D | 23 | 949-950 | S63414D | 23 | 949-950 | S638X1D | 23 | 949-950 | ||
| S63229S | 08 | 562-563 | S63414S | 08 | 562-563 | S638X1S | 08 | 562-563 | ||
| S63230A | 08 | 562-563 | S63415A | 08 | 562-563 | S638X2A | 08 | 562-563 | ||
| S63230A | 24 | 963-965 | S63415A | 24 | 963-965 | S638X2A | 24 | 963-965 | ||
| S63230D | 23 | 949-950 | S63415D | 23 | 949-950 | S638X2D | 23 | 949-950 | ||
| S63230S | 08 | 562-563 | S63415S | 08 | 562-563 | S638X2S | 08 | 562-563 | ||
| S63231A | 08 | 562-563 | S63416A | 08 | 562-563 | S638X9A | 08 | 562-563 | ||
| S63231A | 24 | 963-965 | S63416A | 24 | 963-965 | S638X9A | 24 | 963-965 | ||
| S63231D | 23 | 949-950 | S63416D | 23 | 949-950 | S638X9D | 23 | 949-950 | ||
| S63231S | 08 | 562-563 | S63416S | 08 | 562-563 | S638X9S | 08 | 562-563 | ||
| S63232A | 08 | 562-563 | S63417A | 08 | 562-563 | S6390XA | 08 | 562-563 | ||
| S63232A | 24 | 963-965 | S63417A | 24 | 963-965 | S6390XA | 24 | 963-965 | ||
| S63232D | 23 | 949-950 | S63417D | 23 | 949-950 | S6390XD | 23 | 949-950 | ||
| S63232S | 08 | 562-563 | S63417S | 08 | 562-563 | S6390XS | 08 | 562-563 | ||
| S63233A | 08 | 562-563 | S63418A | 08 | 562-563 | S6391XA | 08 | 562-563 | ||
| S63233A | 24 | 963-965 | S63418A | 24 | 963-965 | S6391XA | 24 | 963-965 | ||
| S63233D | 23 | 949-950 | S63418D | 23 | 949-950 | S6391XD | 23 | 949-950 | ||
| S63233S | 08 | 562-563 | S63418S | 08 | 562-563 | S6391XS | 08 | 562-563 | ||
| S63234A | 08 | 562-563 | S63419A | 08 | 562-563 | S6392XA | 08 | 562-563 | ||
| S63234A | 24 | 963-965 | S63419A | 24 | 963-965 | S6392XA | 24 | 963-965 | ||
| S63234D | 23 | 949-950 | S63419D | 23 | 949-950 | S6392XD | 23 | 949-950 | ||
| S63234S | 08 | 562-563 | S63419S | 08 | 562-563 | S6392XS | 08 | 562-563 | ||
| S63235A | 08 | 562-563 | S63420A | 08 | 562-563 | S6400XA | 01 | 073-074 | ||
| S63235A | 24 | 963-965 | S63420A | 24 | 963-965 | S6400XA | 24 | 963-965 | ||
| S63235D | 23 | 949-950 | S63420D | 23 | 949-950 | S6400XD | 23 | 949-950 | ||
| S63235S | 08 | 562-563 | S63420S | 08 | 562-563 | S6400XS | 01 | 091-093 | ||
| S63236A | 08 | 562-563 | S63421A | 08 | 562-563 | S6401XA | 01 | 073-074 | ||
| S63236A | 24 | 963-965 | S63421A | 24 | 963-965 | S6401XA | 24 | 963-965 | ||
| S63236D | 23 | 949-950 | S63421D | 23 | 949-950 | S6401XD | 23 | 949-950 | ||
| S63236S | 08 | 562-563 | S63421S | 08 | 562-563 | S6401XS | 01 | 091-093 | ||
| S63237A | 08 | 562-563 | S63422A | 08 | 562-563 | S6402XA | 01 | 073-074 | ||
| S63237A | 24 | 963-965 | S63422A | 24 | 963-965 | S6402XA | 24 | 963-965 | ||
| S63237D | 23 | 949-950 | S63422D | 23 | 949-950 | S6402XD | 23 | 949-950 | ||
| S63237S | 08 | 562-563 | S63422S | 08 | 562-563 | S6402XS | 01 | 091-093 | ||
| S63238A | 08 | 562-563 | S63423A | 08 | 562-563 | S6410XA | 01 | 073-074 | ||
| S63238A | 24 | 963-965 | S63423A | 24 | 963-965 | S6410XA | 24 | 963-965 | ||
| S63238D | 23 | 949-950 | S63423D | 23 | 949-950 | S6410XD | 23 | 949-950 | ||
| S63238S | 08 | 562-563 | S63423S | 08 | 562-563 | S6410XS | 01 | 091-093 | ||
| S63239A | 08 | 562-563 | S63424A | 08 | 562-563 | S6411XA | 01 | 073-074 | ||
| S63239A | 24 | 963-965 | S63424A | 24 | 963-965 | S6411XA | 24 | 963-965 | ||
| S63239D | 23 | 949-950 | S63424D | 23 | 949-950 | S6411XD | 23 | 949-950 | ||
| S63239S | 08 | 562-563 | S63424S | 08 | 562-563 | S6411XS | 01 | 091-093 | ||
| S63240A | 08 | 562-563 | S63425A | 08 | 562-563 | S6412XA | 01 | 073-074 | ||
| S63240A | 24 | 963-965 | S63425A | 24 | 963-965 | S6412XA | 24 | 963-965 | ||
| S63240D | 23 | 949-950 | S63425D | 23 | 949-950 | S6412XD | 23 | 949-950 | ||
| S63240S | 08 | 562-563 | S63425S | 08 | 562-563 | S6412XS | 01 | 091-093 | ||
| S63241A | 08 | 562-563 | S63426A | 08 | 562-563 | S6420XA | 01 | 073-074 | ||
| S63241A | 24 | 963-965 | S63426A | 24 | 963-965 | S6420XA | 24 | 963-965 | ||
| S63241D | 23 | 949-950 | S63426D | 23 | 949-950 | S6420XD | 23 | 949-950 | ||
| S63241S | 08 | 562-563 | S63426S | 08 | 562-563 | S6420XS | 01 | 091-093 | ||
| S63242A | 08 | 562-563 | S63427A | 08 | 562-563 | S6421XA | 01 | 073-074 | ||
| S63242A | 24 | 963-965 | S63427A | 24 | 963-965 | S6421XA | 24 | 963-965 | ||
| S63242D | 23 | 949-950 | S63427D | 23 | 949-950 | S6421XD | 23 | 949-950 | ||
| S63242S | 08 | 562-563 | S63427S | 08 | 562-563 | S6421XS | 01 | 091-093 | ||
| S63243A | 08 | 562-563 | S63428A | 08 | 562-563 | S6422XA | 01 | 073-074 | ||
| S63243A | 24 | 963-965 | S63428A | 24 | 963-965 | S6422XA | 24 | 963-965 | ||
| S63243D | 23 | 949-950 | S63428D | 23 | 949-950 | S6422XD | 23 | 949-950 | ||
| S63243S | 08 | 562-563 | S63428S | 08 | 562-563 | S6422XS | 01 | 091-093 | ||
| S63244A | 08 | 562-563 | S63429A | 08 | 562-563 | S6430XA | 01 | 073-074 | ||
| S63244A | 24 | 963-965 | S63429A | 24 | 963-965 | S6430XA | 24 | 963-965 | ||
| S63244D | 23 | 949-950 | S63429D | 23 | 949-950 | S6430XD | 23 | 949-950 | ||
| S63244S | 08 | 562-563 | S63429S | 08 | 562-563 | S6430XS | 01 | 091-093 | ||
| S63245A | 08 | 562-563 | S63430A | 08 | 562-563 | S6431XA | 01 | 073-074 | ||
| S63245A | 24 | 963-965 | S63430A | 24 | 963-965 | S6431XA | 24 | 963-965 | ||
| S63245D | 23 | 949-950 | S63430D | 23 | 949-950 | S6431XD | 23 | 949-950 | ||
| S63245S | 08 | 562-563 | S63430S | 08 | 562-563 | S6431XS | 01 | 091-093 | ||
| S63246A | 08 | 562-563 | S63431A | 08 | 562-563 | S6432XA | 01 | 073-074 | ||
| S63246A | 24 | 963-965 | S63431A | 24 | 963-965 | S6432XA | 24 | 963-965 | ||
| S63246D | 23 | 949-950 | S63431D | 23 | 949-950 | S6432XD | 23 | 949-950 | ||
| S63246S | 08 | 562-563 | S63431S | 08 | 562-563 | S6432XS | 01 | 091-093 | ||
| S63247A | 08 | 562-563 | S63432A | 08 | 562-563 | S6440XA | 01 | 073-074 | ||
| S63247A | 24 | 963-965 | S63432A | 24 | 963-965 | S6440XA | 24 | 963-965 | ||
| S63247D | 23 | 949-950 | S63432D | 23 | 949-950 | S6440XD | 23 | 949-950 | ||
| S63247S | 08 | 562-563 | S63432S | 08 | 562-563 | S6440XS | 01 | 091-093 | ||
| S63248A | 08 | 562-563 | S63433A | 08 | 562-563 | S64490A | 01 | 073-074 | ||
| S63248A | 24 | 963-965 | S63433A | 24 | 963-965 | S64490A | 24 | 963-965 | ||
| S63248D | 23 | 949-950 | S63433D | 23 | 949-950 | S64490D | 23 | 949-950 | ||
| S63248S | 08 | 562-563 | S63433S | 08 | 562-563 | S64490S | 01 | 091-093 | ||
| S63249A | 08 | 562-563 | S63434A | 08 | 562-563 | S64491A | 01 | 073-074 | ||
| S63249A | 24 | 963-965 | S63434A | 24 | 963-965 | S64491A | 24 | 963-965 | ||
| S63249D | 23 | 949-950 | S63434D | 23 | 949-950 | S64491D | 23 | 949-950 | ||
| S63249S | 08 | 562-563 | S63434S | 08 | 562-563 | S64491S | 01 | 091-093 | ||
| S63250A | 08 | 562-563 | S63435A | 08 | 562-563 | S64492A | 01 | 073-074 | ||
| S63250A | 24 | 963-965 | S63435A | 24 | 963-965 | S64492A | 24 | 963-965 | ||
| S63250D | 23 | 949-950 | S63435D | 23 | 949-950 | S64492D | 23 | 949-950 | ||
| S63250S | 08 | 562-563 | S63435S | 08 | 562-563 | S64492S | 01 | 091-093 | ||
| S63251A | 08 | 562-563 | S63436A | 08 | 562-563 | S64493A | 01 | 073-074 | ||
| S63251A | 24 | 963-965 | S63436A | 24 | 963-965 | S64493A | 24 | 963-965 | ||
| S63251D | 23 | 949-950 | S63436D | 23 | 949-950 | S64493D | 23 | 949-950 | ||
| S63251S | 08 | 562-563 | S63436S | 08 | 562-563 | S64493S | 01 | 091-093 | ||
| S63252A | 08 | 562-563 | S63437A | 08 | 562-563 | S64494A | 01 | 073-074 | ||
| S63252A | 24 | 963-965 | S63437A | 24 | 963-965 | S64494A | 24 | 963-965 | ||
| S63252D | 23 | 949-950 | S63437D | 23 | 949-950 | S64494D | 23 | 949-950 | ||
| S63252S | 08 | 562-563 | S63437S | 08 | 562-563 | S64494S | 01 | 091-093 | ||
| S63253A | 08 | 562-563 | S63438A | 08 | 562-563 | S64495A | 01 | 073-074 | ||
| S63253A | 24 | 963-965 | S63438A | 24 | 963-965 | S64495A | 24 | 963-965 | ||
| S63253D | 23 | 949-950 | S63438D | 23 | 949-950 | S64495D | 23 | 949-950 | ||
| S63253S | 08 | 562-563 | S63438S | 08 | 562-563 | S64495S | 01 | 091-093 | ||
| S63254A | 08 | 562-563 | S63439A | 08 | 562-563 | S64496A | 01 | 073-074 | ||
| S63254A | 24 | 963-965 | S63439A | 24 | 963-965 | S64496A | 24 | 963-965 | ||
| S63254D | 23 | 949-950 | S63439D | 23 | 949-950 | S64496D | 23 | 949-950 | ||
| S63254S | 08 | 562-563 | S63439S | 08 | 562-563 | S64496S | 01 | 091-093 | ||
| S63255A | 08 | 562-563 | S63490A | 08 | 562-563 | S64497A | 01 | 073-074 | ||
| S63255A | 24 | 963-965 | S63490A | 24 | 963-965 | S64497A | 24 | 963-965 | ||
| S63255D | 23 | 949-950 | S63490D | 23 | 949-950 | S64497D | 23 | 949-950 | ||
| S63255S | 08 | 562-563 | S63490S | 08 | 562-563 | S64497S | 01 | 091-093 | ||
| S63256A | 08 | 562-563 | S63491A | 08 | 562-563 | S64498A | 01 | 073-074 | ||
| S63256A | 24 | 963-965 | S63491A | 24 | 963-965 | S64498A | 24 | 963-965 | ||
| S63256D | 23 | 949-950 | S63491D | 23 | 949-950 | S64498D | 23 | 949-950 | ||
| S63256S | 08 | 562-563 | S63491S | 08 | 562-563 | S64498S | 01 | 091-093 | ||
| S63257A | 08 | 562-563 | S63492A | 08 | 562-563 | S648X1A | 01 | 073-074 | ||
| S63257A | 24 | 963-965 | S63492A | 24 | 963-965 | S648X1A | 24 | 963-965 | ||
| S63257D | 23 | 949-950 | S63492D | 23 | 949-950 | S648X1D | 23 | 949-950 | ||
| S63257S | 08 | 562-563 | S63492S | 08 | 562-563 | S648X1S | 01 | 091-093 | ||
| S63258A | 08 | 562-563 | S63493A | 08 | 562-563 | S648X2A | 01 | 073-074 | ||
| S63258A | 24 | 963-965 | S63493A | 24 | 963-965 | S648X2A | 24 | 963-965 | ||
| S63258D | 23 | 949-950 | S63493D | 23 | 949-950 | S648X2D | 23 | 949-950 | ||
| S63258S | 08 | 562-563 | S63493S | 08 | 562-563 | S648X2S | 01 | 091-093 | ||
| S63259A | 08 | 562-563 | S63494A | 08 | 562-563 | S648X9A | 01 | 073-074 | ||
| S63259A | 24 | 963-965 | S63494A | 24 | 963-965 | S648X9A | 24 | 963-965 | ||
| S63259D | 23 | 949-950 | S63494D | 23 | 949-950 | S648X9D | 23 | 949-950 | ||
| S63259S | 08 | 562-563 | S63494S | 08 | 562-563 | S648X9S | 01 | 091-093 | ||
| S63260A | 08 | 562-563 | S63495A | 08 | 562-563 | S6490XA | 01 | 073-074 | ||
| S63260A | 24 | 963-965 | S63495A | 24 | 963-965 | S6490XA | 24 | 963-965 | ||
| S63260D | 23 | 949-950 | S63495D | 23 | 949-950 | S6490XD | 23 | 949-950 | ||
| S63260S | 08 | 562-563 | S63495S | 08 | 562-563 | S6490XS | 01 | 091-093 | ||
| S63261A | 08 | 562-563 | S63496A | 08 | 562-563 | S6491XA | 01 | 073-074 | ||
| S63261A | 24 | 963-965 | S63496A | 24 | 963-965 | S6491XA | 24 | 963-965 | ||
| S63261D | 23 | 949-950 | S63496D | 23 | 949-950 | S6491XD | 23 | 949-950 | ||
| S63261S | 08 | 562-563 | S63496S | 08 | 562-563 | S6491XS | 01 | 091-093 | ||
| S63262A | 08 | 562-563 | S63497A | 08 | 562-563 | S6492XA | 01 | 073-074 | ||
| S63262A | 24 | 963-965 | S63497A | 24 | 963-965 | S6492XA | 24 | 963-965 | ||
| S63262D | 23 | 949-950 | S63497D | 23 | 949-950 | S6492XD | 23 | 949-950 | ||
| S63262S | 08 | 562-563 | S63497S | 08 | 562-563 | S6492XS | 01 | 091-093 | ||
| S63263A | 08 | 562-563 | S63498A | 08 | 562-563 | S65001A | 21 | 913-914 | ||
| S63263A | 24 | 963-965 | S63498A | 24 | 963-965 | S65001A | 24 | 963-965 | ||
| S63263D | 23 | 949-950 | S63498D | 23 | 949-950 | S65001D | 23 | 949-950 | ||
| S63263S | 08 | 562-563 | S63498S | 08 | 562-563 | S65001S | 05 | 299-301 | ||
| S63264A | 08 | 562-563 | S63499A | 08 | 562-563 | S65002A | 21 | 913-914 | ||
| S63264A | 24 | 963-965 | S63499A | 24 | 963-965 | S65002A | 24 | 963-965 | ||
| S63264D | 23 | 949-950 | S63499D | 23 | 949-950 | S65002D | 23 | 949-950 | ||
| S63264S | 08 | 562-563 | S63499S | 08 | 562-563 | S65002S | 05 | 299-301 | ||
| S63265A | 08 | 562-563 | S63501A | 08 | 562-563 | S65009A | 21 | 913-914 | ||
| S63265A | 24 | 963-965 | S63501A | 24 | 963-965 | S65009A | 24 | 963-965 | ||
| S63265D | 23 | 949-950 | S63501D | 23 | 949-950 | S65009D | 23 | 949-950 | ||
| S63265S | 08 | 562-563 | S63501S | 08 | 562-563 | S65009S | 05 | 299-301 | ||
| S63266A | 08 | 562-563 | S63502A | 08 | 562-563 | S65011A | 21 | 913-914 | ||
| S63266A | 24 | 963-965 | S63502A | 24 | 963-965 | S65011A | 24 | 963-965 | ||
| S63266D | 23 | 949-950 | S63502D | 23 | 949-950 | S65011D | 23 | 949-950 | ||
| S63266S | 08 | 562-563 | S63502S | 08 | 562-563 | S65011S | 05 | 299-301 | ||
| S63267A | 08 | 562-563 | S63509A | 08 | 562-563 | S65012A | 21 | 913-914 | ||
| S63267A | 24 | 963-965 | S63509A | 24 | 963-965 | S65012A | 24 | 963-965 | ||
| S63267D | 23 | 949-950 | S63509D | 23 | 949-950 | S65012D | 23 | 949-950 | ||
| S63267S | 08 | 562-563 | S63509S | 08 | 562-563 | S65012S | 05 | 299-301 | ||
| S63268A | 08 | 562-563 | S63511A | 08 | 562-563 | S65019A | 21 | 913-914 | ||
| S63268A | 24 | 963-965 | S63511A | 24 | 963-965 | S65019A | 24 | 963-965 | ||
| S63268D | 23 | 949-950 | S63511D | 23 | 949-950 | S65019D | 23 | 949-950 | ||
| S63268S | 08 | 562-563 | S63511S | 08 | 562-563 | S65019S | 05 | 299-301 | ||
| S63269A | 08 | 562-563 | S63512A | 08 | 562-563 | S65091A | 21 | 913-914 | ||
| S63269A | 24 | 963-965 | S63512A | 24 | 963-965 | S65091A | 24 | 963-965 | ||
| S63269D | 23 | 949-950 | S63512D | 23 | 949-950 | S65091D | 23 | 949-950 | ||
| S63269S | 08 | 562-563 | S63512S | 08 | 562-563 | S65091S | 05 | 299-301 | ||
| S63270A | 08 | 562-563 | S63519A | 08 | 562-563 | S65092A | 21 | 913-914 | ||
| S63270A | 24 | 963-965 | S63519A | 24 | 963-965 | S65092A | 24 | 963-965 | ||
| S63270D | 23 | 949-950 | S63519D | 23 | 949-950 | S65092D | 23 | 949-950 | ||
| S63270S | 08 | 562-563 | S63519S | 08 | 562-563 | S65092S | 05 | 299-301 | ||
| S63271A | 08 | 562-563 | S63521A | 08 | 562-563 | S65099A | 21 | 913-914 | ||
| S63271A | 24 | 963-965 | S63521A | 24 | 963-965 | S65099A | 24 | 963-965 | ||
| S63271D | 23 | 949-950 | S63521D | 23 | 949-950 | S65099D | 23 | 949-950 | ||
| S63271S | 08 | 562-563 | S63521S | 08 | 562-563 | S65099S | 05 | 299-301 | ||
| S63272A | 08 | 562-563 | S63522A | 08 | 562-563 | S65101A | 21 | 913-914 | ||
| S63272A | 24 | 963-965 | S63522A | 24 | 963-965 | S65101A | 24 | 963-965 | ||
| S63272D | 23 | 949-950 | S63522D | 23 | 949-950 | S65101D | 23 | 949-950 | ||
| S63272S | 08 | 562-563 | S63522S | 08 | 562-563 | S65101S | 05 | 299-301 | ||
| S63273A | 08 | 562-563 | S63529A | 08 | 562-563 | S65102A | 21 | 913-914 | ||
| S63273A | 24 | 963-965 | S63529A | 24 | 963-965 | S65102A | 24 | 963-965 | ||
| S63273D | 23 | 949-950 | S63529D | 23 | 949-950 | S65102D | 23 | 949-950 | ||
| S63273S | 08 | 562-563 | S63529S | 08 | 562-563 | S65102S | 05 | 299-301 | ||
| S63274A | 08 | 562-563 | S63591A | 08 | 562-563 | S65109A | 21 | 913-914 | ||
| S63274A | 24 | 963-965 | S63591A | 24 | 963-965 | S65109A | 24 | 963-965 | ||
| S63274D | 23 | 949-950 | S63591D | 23 | 949-950 | S65109D | 23 | 949-950 | ||
| S63274S | 08 | 562-563 | S63591S | 08 | 562-563 | S65109S | 05 | 299-301 | ||
| S63275A | 08 | 562-563 | S63592A | 08 | 562-563 | S65111A | 21 | 913-914 | ||
| S63275A | 24 | 963-965 | S63592A | 24 | 963-965 | S65111A | 24 | 963-965 | ||
| S63275D | 23 | 949-950 | S63592D | 23 | 949-950 | S65111D | 23 | 949-950 | ||
| S63275S | 08 | 562-563 | S63592S | 08 | 562-563 | S65111S | 05 | 299-301 | ||
| S63276A | 08 | 562-563 | S63599A | 08 | 562-563 | S65112A | 21 | 913-914 | ||
| S63276A | 24 | 963-965 | S63599A | 24 | 963-965 | S65112A | 24 | 963-965 | ||
| S63276D | 23 | 949-950 | S63599D | 23 | 949-950 | S65112D | 23 | 949-950 | ||
| S63276S | 08 | 562-563 | S63599S | 08 | 562-563 | S65112S | 05 | 299-301 | ||
| S63277A | 08 | 562-563 | S63601A | 08 | 562-563 | S65119A | 21 | 913-914 | ||
| S63277A | 24 | 963-965 | S63601A | 24 | 963-965 | S65119A | 24 | 963-965 | ||
| S63277D | 23 | 949-950 | S63601D | 23 | 949-950 | S65119D | 23 | 949-950 | ||
| S63277S | 08 | 562-563 | S63601S | 08 | 562-563 | S65119S | 05 | 299-301 | ||
| S63278A | 08 | 562-563 | S63602A | 08 | 562-563 | S65191A | 21 | 913-914 | ||
| S63278A | 24 | 963-965 | S63602A | 24 | 963-965 | S65191A | 24 | 963-965 | ||
| S63278D | 23 | 949-950 | S63602D | 23 | 949-950 | S65191D | 23 | 949-950 | ||
| S63278S | 08 | 562-563 | S63602S | 08 | 562-563 | S65191S | 05 | 299-301 | ||
| S63279A | 08 | 562-563 | S63609A | 08 | 562-563 | S65192A | 21 | 913-914 | ||
| S63279A | 24 | 963-965 | S63609A | 24 | 963-965 | S65192A | 24 | 963-965 | ||
| S63279D | 23 | 949-950 | S63609D | 23 | 949-950 | S65192D | 23 | 949-950 | ||
| S63279S | 08 | 562-563 | S63609S | 08 | 562-563 | S65192S | 05 | 299-301 | ||
| S63280A | 08 | 562-563 | S63610A | 08 | 562-563 | S65199A | 21 | 913-914 | ||
| S63280A | 24 | 963-965 | S63610A | 24 | 963-965 | S65199A | 24 | 963-965 | ||
| S63280D | 23 | 949-950 | S63610D | 23 | 949-950 | S65199D | 23 | 949-950 | ||
| S63280S | 08 | 562-563 | S63610S | 08 | 562-563 | S65199S | 05 | 299-301 | ||
| S63281A | 08 | 562-563 | S63611A | 08 | 562-563 | S65201A | 21 | 913-914 | ||
| S63281A | 24 | 963-965 | S63611A | 24 | 963-965 | S65201A | 24 | 963-965 | ||
| S63281D | 23 | 949-950 | S63611D | 23 | 949-950 | S65201D | 23 | 949-950 | ||
| S63281S | 08 | 562-563 | S63611S | 08 | 562-563 | S65201S | 05 | 299-301 | ||
| S63282A | 08 | 562-563 | S63612A | 08 | 562-563 | S65202A | 21 | 913-914 | ||
| S63282A | 24 | 963-965 | S63612A | 24 | 963-965 | S65202A | 24 | 963-965 | ||
| S63282D | 23 | 949-950 | S63612D | 23 | 949-950 | S65202D | 23 | 949-950 | ||
| S63282S | 08 | 562-563 | S63612S | 08 | 562-563 | S65202S | 05 | 299-301 | ||
| S63283A | 08 | 562-563 | S63613A | 08 | 562-563 | S65209A | 21 | 913-914 | ||
| S63283A | 24 | 963-965 | S63613A | 24 | 963-965 | S65209A | 24 | 963-965 | ||
| S63283D | 23 | 949-950 | S63613D | 23 | 949-950 | S65209D | 23 | 949-950 | ||
| S63283S | 08 | 562-563 | S63613S | 08 | 562-563 | S65209S | 05 | 299-301 | ||
| S63284A | 08 | 562-563 | S63614A | 08 | 562-563 | S65211A | 21 | 913-914 | ||
| S63284A | 24 | 963-965 | S63614A | 24 | 963-965 | S65211A | 24 | 963-965 | ||
| S63284D | 23 | 949-950 | S63614D | 23 | 949-950 | S65211D | 23 | 949-950 | ||
| S63284S | 08 | 562-563 | S63614S | 08 | 562-563 | S65211S | 05 | 299-301 | ||
| S63285A | 08 | 562-563 | S63615A | 08 | 562-563 | S65212A | 21 | 913-914 | ||
| S63285A | 24 | 963-965 | S63615A | 24 | 963-965 | S65212A | 24 | 963-965 | ||
| S63285D | 23 | 949-950 | S63615D | 23 | 949-950 | S65212D | 23 | 949-950 | ||
| S63285S | 08 | 562-563 | S63615S | 08 | 562-563 | S65212S | 05 | 299-301 | ||
| S63286A | 08 | 562-563 | S63616A | 08 | 562-563 | S65219A | 21 | 913-914 | ||
| S63286A | 24 | 963-965 | S63616A | 24 | 963-965 | S65219A | 24 | 963-965 | ||
| S63286D | 23 | 949-950 | S63616D | 23 | 949-950 | S65219D | 23 | 949-950 | ||
| S63286S | 08 | 562-563 | S63616S | 08 | 562-563 | S65219S | 05 | 299-301 | ||
| S63287A | 08 | 562-563 | S63617A | 08 | 562-563 | S65291A | 21 | 913-914 | ||
| S63287A | 24 | 963-965 | S63617A | 24 | 963-965 | S65291A | 24 | 963-965 | ||
| S63287D | 23 | 949-950 | S63617D | 23 | 949-950 | S65291D | 23 | 949-950 | ||
| S63287S | 08 | 562-563 | S63617S | 08 | 562-563 | S65291S | 05 | 299-301 | ||
| S63288A | 08 | 562-563 | S63618A | 08 | 562-563 | S65292A | 21 | 913-914 | ||
| S63288A | 24 | 963-965 | S63618A | 24 | 963-965 | S65292A | 24 | 963-965 | ||
| S63288D | 23 | 949-950 | S63618D | 23 | 949-950 | S65292D | 23 | 949-950 | ||
| S63288S | 08 | 562-563 | S63618S | 08 | 562-563 | S65292S | 05 | 299-301 | ||
| S63289A | 08 | 562-563 | S63619A | 08 | 562-563 | S65299A | 21 | 913-914 | ||
| S63289A | 24 | 963-965 | S63619A | 24 | 963-965 | S65299A | 24 | 963-965 | ||
| S63289D | 23 | 949-950 | S63619D | 23 | 949-950 | S65299D | 23 | 949-950 | ||
| S63289S | 08 | 562-563 | S63619S | 08 | 562-563 | S65299S | 05 | 299-301 | ||
| S63290A | 08 | 562-563 | S63621A | 08 | 562-563 | S65301A | 21 | 913-914 | ||
| S63290A | 24 | 963-965 | S63621A | 24 | 963-965 | S65301A | 24 | 963-965 | ||
| S63290D | 23 | 949-950 | S63621D | 23 | 949-950 | S65301D | 23 | 949-950 | ||
| S63290S | 08 | 562-563 | S63621S | 08 | 562-563 | S65301S | 05 | 299-301 | ||
| S63291A | 08 | 562-563 | S63622A | 08 | 562-563 | S65302A | 21 | 913-914 | ||
| S63291A | 24 | 963-965 | S63622A | 24 | 963-965 | S65302A | 24 | 963-965 | ||
| S63291D | 23 | 949-950 | S63622D | 23 | 949-950 | S65302D | 23 | 949-950 | ||
| S63291S | 08 | 562-563 | S63622S | 08 | 562-563 | S65302S | 05 | 299-301 | ||
| S63292A | 08 | 562-563 | S63629A | 08 | 562-563 | S65309A | 21 | 913-914 | ||
| S63292A | 24 | 963-965 | S63629A | 24 | 963-965 | S65309A | 24 | 963-965 | ||
| S63292D | 23 | 949-950 | S63629D | 23 | 949-950 | S65309D | 23 | 949-950 | ||
| S63292S | 08 | 562-563 | S63629S | 08 | 562-563 | S65309S | 05 | 299-301 | ||
| S63293A | 08 | 562-563 | S63630A | 08 | 562-563 | S65311A | 21 | 913-914 | ||
| S63293A | 24 | 963-965 | S63630A | 24 | 963-965 | S65311A | 24 | 963-965 | ||
| S63293D | 23 | 949-950 | S63630D | 23 | 949-950 | S65311D | 23 | 949-950 | ||
| S63293S | 08 | 562-563 | S63630S | 08 | 562-563 | S65311S | 05 | 299-301 | ||
| S63294A | 08 | 562-563 | S63631A | 08 | 562-563 | S65312A | 21 | 913-914 | ||
| S63294A | 24 | 963-965 | S63631A | 24 | 963-965 | S65312A | 24 | 963-965 | ||
| S63294D | 23 | 949-950 | S63631D | 23 | 949-950 | S65312D | 23 | 949-950 | ||
| S63294S | 08 | 562-563 | S63631S | 08 | 562-563 | S65312S | 05 | 299-301 | ||
| S63295A | 08 | 562-563 | S63632A | 08 | 562-563 | S65319A | 21 | 913-914 | ||
| S63295A | 24 | 963-965 | S63632A | 24 | 963-965 | S65319A | 24 | 963-965 | ||
| S63295D | 23 | 949-950 | S63632D | 23 | 949-950 | S65319D | 23 | 949-950 | ||
| S63295S | 08 | 562-563 | S63632S | 08 | 562-563 | S65319S | 05 | 299-301 | ||
| S63296A | 08 | 562-563 | S63633A | 08 | 562-563 | S65391A | 21 | 913-914 | ||
| S63296A | 24 | 963-965 | S63633A | 24 | 963-965 | S65391A | 24 | 963-965 | ||
| S63296D | 23 | 949-950 | S63633D | 23 | 949-950 | S65391D | 23 | 949-950 | ||
| S63296S | 08 | 562-563 | S63633S | 08 | 562-563 | S65391S | 05 | 299-301 | ||
| S63297A | 08 | 562-563 | S63634A | 08 | 562-563 | S65392A | 21 | 913-914 | ||
| S63297A | 24 | 963-965 | S63634A | 24 | 963-965 | S65392A | 24 | 963-965 | ||
| S63297D | 23 | 949-950 | S63634D | 23 | 949-950 | S65392D | 23 | 949-950 | ||
| S63297S | 08 | 562-563 | S63634S | 08 | 562-563 | S65392S | 05 | 299-301 | ||
| S63298A | 08 | 562-563 | S63635A | 08 | 562-563 | S65399A | 21 | 913-914 | ||
| S63298A | 24 | 963-965 | S63635A | 24 | 963-965 | S65399A | 24 | 963-965 | ||
| S63298D | 23 | 949-950 | S63635D | 23 | 949-950 | S65399D | 23 | 949-950 | ||
| S63298S | 08 | 562-563 | S63635S | 08 | 562-563 | S65399S | 05 | 299-301 | ||
| S63299A | 08 | 562-563 | S63636A | 08 | 562-563 | S65401A | 21 | 913-914 | ||
| S63299A | 24 | 963-965 | S63636A | 24 | 963-965 | S65401A | 24 | 963-965 | ||
| S63299D | 23 | 949-950 | S63636D | 23 | 949-950 | S65401D | 23 | 949-950 | ||
| S63299S | 08 | 562-563 | S63636S | 08 | 562-563 | S65401S | 05 | 299-301 | ||
| S63301A | 08 | 562-563 | S63637A | 08 | 562-563 | S65402A | 21 | 913-914 | ||
| S63301A | 24 | 963-965 | S63637A | 24 | 963-965 | S65402A | 24 | 963-965 | ||
| S63301D | 23 | 949-950 | S63637D | 23 | 949-950 | S65402D | 23 | 949-950 | ||
| S63301S | 08 | 562-563 | S63637S | 08 | 562-563 | S65402S | 05 | 299-301 | ||
| S63302A | 08 | 562-563 | S63638A | 08 | 562-563 | S65409A | 21 | 913-914 | ||
| S63302A | 24 | 963-965 | S63638A | 24 | 963-965 | S65409A | 24 | 963-965 | ||
| S63302D | 23 | 949-950 | S63638D | 23 | 949-950 | S65409D | 23 | 949-950 | ||
| S63302S | 08 | 562-563 | S63638S | 08 | 562-563 | S65409S | 05 | 299-301 | ||
| S63309A | 08 | 562-563 | S63639A | 08 | 562-563 | S65411A | 21 | 913-914 | ||
| S63309A | 24 | 963-965 | S63639A | 24 | 963-965 | S65411A | 24 | 963-965 | ||
| S63309D | 23 | 949-950 | S63639D | 23 | 949-950 | S65411D | 23 | 949-950 | ||
| S63309S | 08 | 562-563 | S63639S | 08 | 562-563 | S65411S | 05 | 299-301 | ||
| S63311A | 08 | 562-563 | S63641A | 08 | 562-563 | S65412A | 21 | 913-914 | ||
| S63311A | 24 | 963-965 | S63641A | 24 | 963-965 | S65412A | 24 | 963-965 | ||
| S63311D | 23 | 949-950 | S63641D | 23 | 949-950 | S65412D | 23 | 949-950 | ||
| S63311S | 08 | 562-563 | S63641S | 08 | 562-563 | S65412S | 05 | 299-301 | ||
| S63312A | 08 | 562-563 | S63642A | 08 | 562-563 | S65419A | 21 | 913-914 | ||
| S63312A | 24 | 963-965 | S63642A | 24 | 963-965 | S65419A | 24 | 963-965 | ||
| S63312D | 23 | 949-950 | S63642D | 23 | 949-950 | S65419D | 23 | 949-950 | ||
| S63312S | 08 | 562-563 | S63642S | 08 | 562-563 | S65419S | 05 | 299-301 | ||
| S63319A | 08 | 562-563 | S63649A | 08 | 562-563 | S65491A | 21 | 913-914 | ||
| S63319A | 24 | 963-965 | S63649A | 24 | 963-965 | S65491A | 24 | 963-965 | ||
| S63319D | 23 | 949-950 | S63649D | 23 | 949-950 | S65491D | 23 | 949-950 | ||
| S63319S | 08 | 562-563 | S63649S | 08 | 562-563 | S65491S | 05 | 299-301 | ||
| S63321A | 08 | 562-563 | S63650A | 08 | 562-563 | S65492A | 21 | 913-914 | ||
| S63321A | 24 | 963-965 | S63650A | 24 | 963-965 | S65492A | 24 | 963-965 | ||
| S63321D | 23 | 949-950 | S63650D | 23 | 949-950 | S65492D | 23 | 949-950 | ||
| S63321S | 08 | 562-563 | S63650S | 08 | 562-563 | S65492S | 05 | 299-301 | ||
| S63322A | 08 | 562-563 | S63651A | 08 | 562-563 | S65499A | 21 | 913-914 | ||
| S63322A | 24 | 963-965 | S63651A | 24 | 963-965 | S65499A | 24 | 963-965 | ||
| S63322D | 23 | 949-950 | S63651D | 23 | 949-950 | S65499D | 23 | 949-950 | ||
| S63322S | 08 | 562-563 | S63651S | 08 | 562-563 | S65499S | 05 | 299-301 | ||
| S63329A | 08 | 562-563 | S63652A | 08 | 562-563 | S65500A | 21 | 913-914 | ||
| S63329A | 24 | 963-965 | S63652A | 24 | 963-965 | S65500A | 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 |