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 51 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S65500D | 23 | 949-950 | S66201D | 23 | 949-950 | S66596D | 23 | 949-950 | ||
| S65500S | 05 | 299-301 | S66201S | 21 | 913-914 | S66596S | 21 | 913-914 | ||
| S65501A | 21 | 913-914 | S66202A | 21 | 913-914 | S66597A | 21 | 913-914 | ||
| S65501A | 24 | 963-965 | S66202A | 24 | 963-965 | S66597A | 24 | 963-965 | ||
| S65501D | 23 | 949-950 | S66202D | 23 | 949-950 | S66597D | 23 | 949-950 | ||
| S65501S | 05 | 299-301 | S66202S | 21 | 913-914 | S66597S | 21 | 913-914 | ||
| S65502A | 21 | 913-914 | S66209A | 21 | 913-914 | S66598A | 21 | 913-914 | ||
| S65502A | 24 | 963-965 | S66209A | 24 | 963-965 | S66598A | 24 | 963-965 | ||
| S65502D | 23 | 949-950 | S66209D | 23 | 949-950 | S66598D | 23 | 949-950 | ||
| S65502S | 05 | 299-301 | S66209S | 21 | 913-914 | S66598S | 21 | 913-914 | ||
| S65503A | 21 | 913-914 | S66211A | 08 | 562-563 | S66599A | 21 | 913-914 | ||
| S65503A | 24 | 963-965 | S66211A | 24 | 963-965 | S66599A | 24 | 963-965 | ||
| S65503D | 23 | 949-950 | S66211D | 23 | 949-950 | S66599D | 23 | 949-950 | ||
| S65503S | 05 | 299-301 | S66211S | 08 | 562-563 | S66599S | 21 | 913-914 | ||
| S65504A | 21 | 913-914 | S66212A | 08 | 562-563 | S66801A | 21 | 913-914 | ||
| S65504A | 24 | 963-965 | S66212A | 24 | 963-965 | S66801A | 24 | 963-965 | ||
| S65504D | 23 | 949-950 | S66212D | 23 | 949-950 | S66801D | 23 | 949-950 | ||
| S65504S | 05 | 299-301 | S66212S | 08 | 562-563 | S66801S | 21 | 913-914 | ||
| S65505A | 21 | 913-914 | S66219A | 08 | 562-563 | S66802A | 21 | 913-914 | ||
| S65505A | 24 | 963-965 | S66219A | 24 | 963-965 | S66802A | 24 | 963-965 | ||
| S65505D | 23 | 949-950 | S66219D | 23 | 949-950 | S66802D | 23 | 949-950 | ||
| S65505S | 05 | 299-301 | S66219S | 08 | 562-563 | S66802S | 21 | 913-914 | ||
| S65506A | 21 | 913-914 | S66221A | 08 | 564-566 | S66809A | 21 | 913-914 | ||
| S65506A | 24 | 963-965 | S66221A | 24 | 963-965 | S66809A | 24 | 963-965 | ||
| S65506D | 23 | 949-950 | S66221D | 23 | 949-950 | S66809D | 23 | 949-950 | ||
| S65506S | 05 | 299-301 | S66221S | 09 | 604-605 | S66809S | 21 | 913-914 | ||
| S65507A | 21 | 913-914 | S66222A | 08 | 564-566 | S66811A | 08 | 562-563 | ||
| S65507A | 24 | 963-965 | S66222A | 24 | 963-965 | S66811A | 24 | 963-965 | ||
| S65507D | 23 | 949-950 | S66222D | 23 | 949-950 | S66811D | 23 | 949-950 | ||
| S65507S | 05 | 299-301 | S66222S | 09 | 604-605 | S66811S | 08 | 562-563 | ||
| S65508A | 21 | 913-914 | S66229A | 08 | 564-566 | S66812A | 08 | 562-563 | ||
| S65508A | 24 | 963-965 | S66229A | 24 | 963-965 | S66812A | 24 | 963-965 | ||
| S65508D | 23 | 949-950 | S66229D | 23 | 949-950 | S66812D | 23 | 949-950 | ||
| S65508S | 05 | 299-301 | S66229S | 09 | 604-605 | S66812S | 08 | 562-563 | ||
| S65509A | 21 | 913-914 | S66291A | 21 | 913-914 | S66819A | 08 | 562-563 | ||
| S65509A | 24 | 963-965 | S66291A | 24 | 963-965 | S66819A | 24 | 963-965 | ||
| S65509D | 23 | 949-950 | S66291D | 23 | 949-950 | S66819D | 23 | 949-950 | ||
| S65509S | 05 | 299-301 | S66291S | 21 | 913-914 | S66819S | 08 | 562-563 | ||
| S65510A | 21 | 913-914 | S66292A | 21 | 913-914 | S66821A | 08 | 564-566 | ||
| S65510A | 24 | 963-965 | S66292A | 24 | 963-965 | S66821A | 24 | 963-965 | ||
| S65510D | 23 | 949-950 | S66292D | 23 | 949-950 | S66821D | 23 | 949-950 | ||
| S65510S | 05 | 299-301 | S66292S | 21 | 913-914 | S66821S | 09 | 604-605 | ||
| S65511A | 21 | 913-914 | S66299A | 21 | 913-914 | S66822A | 08 | 564-566 | ||
| S65511A | 24 | 963-965 | S66299A | 24 | 963-965 | S66822A | 24 | 963-965 | ||
| S65511D | 23 | 949-950 | S66299D | 23 | 949-950 | S66822D | 23 | 949-950 | ||
| S65511S | 05 | 299-301 | S66299S | 21 | 913-914 | S66822S | 09 | 604-605 | ||
| S65512A | 21 | 913-914 | S66300A | 21 | 913-914 | S66829A | 08 | 564-566 | ||
| S65512A | 24 | 963-965 | S66300A | 24 | 963-965 | S66829A | 24 | 963-965 | ||
| S65512D | 23 | 949-950 | S66300D | 23 | 949-950 | S66829D | 23 | 949-950 | ||
| S65512S | 05 | 299-301 | S66300S | 21 | 913-914 | S66829S | 09 | 604-605 | ||
| S65513A | 21 | 913-914 | S66301A | 21 | 913-914 | S66891A | 21 | 913-914 | ||
| S65513A | 24 | 963-965 | S66301A | 24 | 963-965 | S66891A | 24 | 963-965 | ||
| S65513D | 23 | 949-950 | S66301D | 23 | 949-950 | S66891D | 23 | 949-950 | ||
| S65513S | 05 | 299-301 | S66301S | 21 | 913-914 | S66891S | 21 | 913-914 | ||
| S65514A | 21 | 913-914 | S66302A | 21 | 913-914 | S66892A | 21 | 913-914 | ||
| S65514A | 24 | 963-965 | S66302A | 24 | 963-965 | S66892A | 24 | 963-965 | ||
| S65514D | 23 | 949-950 | S66302D | 23 | 949-950 | S66892D | 23 | 949-950 | ||
| S65514S | 05 | 299-301 | S66302S | 21 | 913-914 | S66892S | 21 | 913-914 | ||
| S65515A | 21 | 913-914 | S66303A | 21 | 913-914 | S66899A | 21 | 913-914 | ||
| S65515A | 24 | 963-965 | S66303A | 24 | 963-965 | S66899A | 24 | 963-965 | ||
| S65515D | 23 | 949-950 | S66303D | 23 | 949-950 | S66899D | 23 | 949-950 | ||
| S65515S | 05 | 299-301 | S66303S | 21 | 913-914 | S66899S | 21 | 913-914 | ||
| S65516A | 21 | 913-914 | S66304A | 21 | 913-914 | S66901A | 21 | 913-914 | ||
| S65516A | 24 | 963-965 | S66304A | 24 | 963-965 | S66901A | 24 | 963-965 | ||
| S65516D | 23 | 949-950 | S66304D | 23 | 949-950 | S66901D | 23 | 949-950 | ||
| S65516S | 05 | 299-301 | S66304S | 21 | 913-914 | S66901S | 21 | 913-914 | ||
| S65517A | 21 | 913-914 | S66305A | 21 | 913-914 | S66902A | 21 | 913-914 | ||
| S65517A | 24 | 963-965 | S66305A | 24 | 963-965 | S66902A | 24 | 963-965 | ||
| S65517D | 23 | 949-950 | S66305D | 23 | 949-950 | S66902D | 23 | 949-950 | ||
| S65517S | 05 | 299-301 | S66305S | 21 | 913-914 | S66902S | 21 | 913-914 | ||
| S65518A | 21 | 913-914 | S66306A | 21 | 913-914 | S66909A | 21 | 913-914 | ||
| S65518A | 24 | 963-965 | S66306A | 24 | 963-965 | S66909A | 24 | 963-965 | ||
| S65518D | 23 | 949-950 | S66306D | 23 | 949-950 | S66909D | 23 | 949-950 | ||
| S65518S | 05 | 299-301 | S66306S | 21 | 913-914 | S66909S | 21 | 913-914 | ||
| S65519A | 21 | 913-914 | S66307A | 21 | 913-914 | S66911A | 08 | 562-563 | ||
| S65519A | 24 | 963-965 | S66307A | 24 | 963-965 | S66911A | 24 | 963-965 | ||
| S65519D | 23 | 949-950 | S66307D | 23 | 949-950 | S66911D | 23 | 949-950 | ||
| S65519S | 05 | 299-301 | S66307S | 21 | 913-914 | S66911S | 08 | 562-563 | ||
| S65590A | 21 | 913-914 | S66308A | 21 | 913-914 | S66912A | 08 | 562-563 | ||
| S65590A | 24 | 963-965 | S66308A | 24 | 963-965 | S66912A | 24 | 963-965 | ||
| S65590D | 23 | 949-950 | S66308D | 23 | 949-950 | S66912D | 23 | 949-950 | ||
| S65590S | 05 | 299-301 | S66308S | 21 | 913-914 | S66912S | 08 | 562-563 | ||
| S65591A | 21 | 913-914 | S66309A | 21 | 913-914 | S66919A | 08 | 562-563 | ||
| S65591A | 24 | 963-965 | S66309A | 24 | 963-965 | S66919A | 24 | 963-965 | ||
| S65591D | 23 | 949-950 | S66309D | 23 | 949-950 | S66919D | 23 | 949-950 | ||
| S65591S | 05 | 299-301 | S66309S | 21 | 913-914 | S66919S | 08 | 562-563 | ||
| S65592A | 21 | 913-914 | S66310A | 08 | 562-563 | S66921A | 08 | 564-566 | ||
| S65592A | 24 | 963-965 | S66310A | 24 | 963-965 | S66921A | 24 | 963-965 | ||
| S65592D | 23 | 949-950 | S66310D | 23 | 949-950 | S66921D | 23 | 949-950 | ||
| S65592S | 05 | 299-301 | S66310S | 08 | 562-563 | S66921S | 09 | 604-605 | ||
| S65593A | 21 | 913-914 | S66311A | 08 | 562-563 | S66922A | 08 | 564-566 | ||
| S65593A | 24 | 963-965 | S66311A | 24 | 963-965 | S66922A | 24 | 963-965 | ||
| S65593D | 23 | 949-950 | S66311D | 23 | 949-950 | S66922D | 23 | 949-950 | ||
| S65593S | 05 | 299-301 | S66311S | 08 | 562-563 | S66922S | 09 | 604-605 | ||
| S65594A | 21 | 913-914 | S66312A | 08 | 562-563 | S66929A | 08 | 564-566 | ||
| S65594A | 24 | 963-965 | S66312A | 24 | 963-965 | S66929A | 24 | 963-965 | ||
| S65594D | 23 | 949-950 | S66312D | 23 | 949-950 | S66929D | 23 | 949-950 | ||
| S65594S | 05 | 299-301 | S66312S | 08 | 562-563 | S66929S | 09 | 604-605 | ||
| S65595A | 21 | 913-914 | S66313A | 08 | 562-563 | S66991A | 21 | 913-914 | ||
| S65595A | 24 | 963-965 | S66313A | 24 | 963-965 | S66991A | 24 | 963-965 | ||
| S65595D | 23 | 949-950 | S66313D | 23 | 949-950 | S66991D | 23 | 949-950 | ||
| S65595S | 05 | 299-301 | S66313S | 08 | 562-563 | S66991S | 21 | 913-914 | ||
| S65596A | 21 | 913-914 | S66314A | 08 | 562-563 | S66992A | 21 | 913-914 | ||
| S65596A | 24 | 963-965 | S66314A | 24 | 963-965 | S66992A | 24 | 963-965 | ||
| S65596D | 23 | 949-950 | S66314D | 23 | 949-950 | S66992D | 23 | 949-950 | ||
| S65596S | 05 | 299-301 | S66314S | 08 | 562-563 | S66992S | 21 | 913-914 | ||
| S65597A | 21 | 913-914 | S66315A | 08 | 562-563 | S66999A | 21 | 913-914 | ||
| S65597A | 24 | 963-965 | S66315A | 24 | 963-965 | S66999A | 24 | 963-965 | ||
| S65597D | 23 | 949-950 | S66315D | 23 | 949-950 | S66999D | 23 | 949-950 | ||
| S65597S | 05 | 299-301 | S66315S | 08 | 562-563 | S66999S | 21 | 913-914 | ||
| S65598A | 21 | 913-914 | S66316A | 08 | 562-563 | S6700XA | 21 | 913-914 | ||
| S65598A | 24 | 963-965 | S66316A | 24 | 963-965 | S6700XA | 24 | 963-965 | ||
| S65598D | 23 | 949-950 | S66316D | 23 | 949-950 | S6700XD | 23 | 949-950 | ||
| S65598S | 05 | 299-301 | S66316S | 08 | 562-563 | S6700XS | 09 | 604-605 | ||
| S65599A | 21 | 913-914 | S66317A | 08 | 562-563 | S6701XA | 21 | 913-914 | ||
| S65599A | 24 | 963-965 | S66317A | 24 | 963-965 | S6701XA | 24 | 963-965 | ||
| S65599D | 23 | 949-950 | S66317D | 23 | 949-950 | S6701XD | 23 | 949-950 | ||
| S65599S | 05 | 299-301 | S66317S | 08 | 562-563 | S6701XS | 09 | 604-605 | ||
| S65801A | 21 | 913-914 | S66318A | 08 | 562-563 | S6702XA | 21 | 913-914 | ||
| S65801A | 24 | 963-965 | S66318A | 24 | 963-965 | S6702XA | 24 | 963-965 | ||
| S65801D | 23 | 949-950 | S66318D | 23 | 949-950 | S6702XD | 23 | 949-950 | ||
| S65801S | 05 | 299-301 | S66318S | 08 | 562-563 | S6702XS | 09 | 604-605 | ||
| S65802A | 21 | 913-914 | S66319A | 08 | 562-563 | S6710XA | 21 | 913-914 | ||
| S65802A | 24 | 963-965 | S66319A | 24 | 963-965 | S6710XA | 24 | 963-965 | ||
| S65802D | 23 | 949-950 | S66319D | 23 | 949-950 | S6710XD | 23 | 949-950 | ||
| S65802S | 05 | 299-301 | S66319S | 08 | 562-563 | S6710XS | 09 | 604-605 | ||
| S65809A | 21 | 913-914 | S66320A | 08 | 564-566 | S67190A | 21 | 913-914 | ||
| S65809A | 24 | 963-965 | S66320A | 24 | 963-965 | S67190A | 24 | 963-965 | ||
| S65809D | 23 | 949-950 | S66320D | 23 | 949-950 | S67190D | 23 | 949-950 | ||
| S65809S | 05 | 299-301 | S66320S | 09 | 604-605 | S67190S | 09 | 604-605 | ||
| S65811A | 21 | 913-914 | S66321A | 08 | 564-566 | S67191A | 21 | 913-914 | ||
| S65811A | 24 | 963-965 | S66321A | 24 | 963-965 | S67191A | 24 | 963-965 | ||
| S65811D | 23 | 949-950 | S66321D | 23 | 949-950 | S67191D | 23 | 949-950 | ||
| S65811S | 05 | 299-301 | S66321S | 09 | 604-605 | S67191S | 09 | 604-605 | ||
| S65812A | 21 | 913-914 | S66322A | 08 | 564-566 | S67192A | 21 | 913-914 | ||
| S65812A | 24 | 963-965 | S66322A | 24 | 963-965 | S67192A | 24 | 963-965 | ||
| S65812D | 23 | 949-950 | S66322D | 23 | 949-950 | S67192D | 23 | 949-950 | ||
| S65812S | 05 | 299-301 | S66322S | 09 | 604-605 | S67192S | 09 | 604-605 | ||
| S65819A | 21 | 913-914 | S66323A | 08 | 564-566 | S67193A | 21 | 913-914 | ||
| S65819A | 24 | 963-965 | S66323A | 24 | 963-965 | S67193A | 24 | 963-965 | ||
| S65819D | 23 | 949-950 | S66323D | 23 | 949-950 | S67193D | 23 | 949-950 | ||
| S65819S | 05 | 299-301 | S66323S | 09 | 604-605 | S67193S | 09 | 604-605 | ||
| S65891A | 21 | 913-914 | S66324A | 08 | 564-566 | S67194A | 21 | 913-914 | ||
| S65891A | 24 | 963-965 | S66324A | 24 | 963-965 | S67194A | 24 | 963-965 | ||
| S65891D | 23 | 949-950 | S66324D | 23 | 949-950 | S67194D | 23 | 949-950 | ||
| S65891S | 05 | 299-301 | S66324S | 09 | 604-605 | S67194S | 09 | 604-605 | ||
| S65892A | 21 | 913-914 | S66325A | 08 | 564-566 | S67195A | 21 | 913-914 | ||
| S65892A | 24 | 963-965 | S66325A | 24 | 963-965 | S67195A | 24 | 963-965 | ||
| S65892D | 23 | 949-950 | S66325D | 23 | 949-950 | S67195D | 23 | 949-950 | ||
| S65892S | 05 | 299-301 | S66325S | 09 | 604-605 | S67195S | 09 | 604-605 | ||
| S65899A | 21 | 913-914 | S66326A | 08 | 564-566 | S67196A | 21 | 913-914 | ||
| S65899A | 24 | 963-965 | S66326A | 24 | 963-965 | S67196A | 24 | 963-965 | ||
| S65899D | 23 | 949-950 | S66326D | 23 | 949-950 | S67196D | 23 | 949-950 | ||
| S65899S | 05 | 299-301 | S66326S | 09 | 604-605 | S67196S | 09 | 604-605 | ||
| S65901A | 21 | 913-914 | S66327A | 08 | 564-566 | S67197A | 21 | 913-914 | ||
| S65901A | 24 | 963-965 | S66327A | 24 | 963-965 | S67197A | 24 | 963-965 | ||
| S65901D | 23 | 949-950 | S66327D | 23 | 949-950 | S67197D | 23 | 949-950 | ||
| S65901S | 05 | 299-301 | S66327S | 09 | 604-605 | S67197S | 09 | 604-605 | ||
| S65902A | 21 | 913-914 | S66328A | 08 | 564-566 | S67198A | 21 | 913-914 | ||
| S65902A | 24 | 963-965 | S66328A | 24 | 963-965 | S67198A | 24 | 963-965 | ||
| S65902D | 23 | 949-950 | S66328D | 23 | 949-950 | S67198D | 23 | 949-950 | ||
| S65902S | 05 | 299-301 | S66328S | 09 | 604-605 | S67198S | 09 | 604-605 | ||
| S65909A | 21 | 913-914 | S66329A | 08 | 564-566 | S6720XA | 21 | 913-914 | ||
| S65909A | 24 | 963-965 | S66329A | 24 | 963-965 | S6720XA | 24 | 963-965 | ||
| S65909D | 23 | 949-950 | S66329D | 23 | 949-950 | S6720XD | 23 | 949-950 | ||
| S65909S | 05 | 299-301 | S66329S | 09 | 604-605 | S6720XS | 09 | 604-605 | ||
| S65911A | 21 | 913-914 | S66390A | 21 | 913-914 | S6721XA | 21 | 913-914 | ||
| S65911A | 24 | 963-965 | S66390A | 24 | 963-965 | S6721XA | 24 | 963-965 | ||
| S65911D | 23 | 949-950 | S66390D | 23 | 949-950 | S6721XD | 23 | 949-950 | ||
| S65911S | 05 | 299-301 | S66390S | 21 | 913-914 | S6721XS | 09 | 604-605 | ||
| S65912A | 21 | 913-914 | S66391A | 21 | 913-914 | S6722XA | 21 | 913-914 | ||
| S65912A | 24 | 963-965 | S66391A | 24 | 963-965 | S6722XA | 24 | 963-965 | ||
| S65912D | 23 | 949-950 | S66391D | 23 | 949-950 | S6722XD | 23 | 949-950 | ||
| S65912S | 05 | 299-301 | S66391S | 21 | 913-914 | S6722XS | 09 | 604-605 | ||
| S65919A | 21 | 913-914 | S66392A | 21 | 913-914 | S6730XA | 21 | 913-914 | ||
| S65919A | 24 | 963-965 | S66392A | 24 | 963-965 | S6730XA | 24 | 963-965 | ||
| S65919D | 23 | 949-950 | S66392D | 23 | 949-950 | S6730XD | 23 | 949-950 | ||
| S65919S | 05 | 299-301 | S66392S | 21 | 913-914 | S6730XS | 09 | 604-605 | ||
| S65991A | 21 | 913-914 | S66393A | 21 | 913-914 | S6731XA | 21 | 913-914 | ||
| S65991A | 24 | 963-965 | S66393A | 24 | 963-965 | S6731XA | 24 | 963-965 | ||
| S65991D | 23 | 949-950 | S66393D | 23 | 949-950 | S6731XD | 23 | 949-950 | ||
| S65991S | 05 | 299-301 | S66393S | 21 | 913-914 | S6731XS | 09 | 604-605 | ||
| S65992A | 21 | 913-914 | S66394A | 21 | 913-914 | S6732XA | 21 | 913-914 | ||
| S65992A | 24 | 963-965 | S66394A | 24 | 963-965 | S6732XA | 24 | 963-965 | ||
| S65992D | 23 | 949-950 | S66394D | 23 | 949-950 | S6732XD | 23 | 949-950 | ||
| S65992S | 05 | 299-301 | S66394S | 21 | 913-914 | S6732XS | 09 | 604-605 | ||
| S65999A | 21 | 913-914 | S66395A | 21 | 913-914 | S6740XA | 21 | 913-914 | ||
| S65999A | 24 | 963-965 | S66395A | 24 | 963-965 | S6740XA | 24 | 963-965 | ||
| S65999D | 23 | 949-950 | S66395D | 23 | 949-950 | S6740XD | 23 | 949-950 | ||
| S65999S | 05 | 299-301 | S66395S | 21 | 913-914 | S6740XS | 09 | 604-605 | ||
| S66001A | 21 | 913-914 | S66396A | 21 | 913-914 | S6741XA | 21 | 913-914 | ||
| S66001A | 24 | 963-965 | S66396A | 24 | 963-965 | S6741XA | 24 | 963-965 | ||
| S66001D | 23 | 949-950 | S66396D | 23 | 949-950 | S6741XD | 23 | 949-950 | ||
| S66001S | 21 | 913-914 | S66396S | 21 | 913-914 | S6741XS | 09 | 604-605 | ||
| S66002A | 21 | 913-914 | S66397A | 21 | 913-914 | S6742XA | 21 | 913-914 | ||
| S66002A | 24 | 963-965 | S66397A | 24 | 963-965 | S6742XA | 24 | 963-965 | ||
| S66002D | 23 | 949-950 | S66397D | 23 | 949-950 | S6742XD | 23 | 949-950 | ||
| S66002S | 21 | 913-914 | S66397S | 21 | 913-914 | S6742XS | 09 | 604-605 | ||
| S66009A | 21 | 913-914 | S66398A | 21 | 913-914 | S6790XA | 21 | 913-914 | ||
| S66009A | 24 | 963-965 | S66398A | 24 | 963-965 | S6790XA | 24 | 963-965 | ||
| S66009D | 23 | 949-950 | S66398D | 23 | 949-950 | S6790XD | 23 | 949-950 | ||
| S66009S | 21 | 913-914 | S66398S | 21 | 913-914 | S6790XS | 09 | 604-605 | ||
| S66011A | 08 | 562-563 | S66399A | 21 | 913-914 | S6791XA | 21 | 913-914 | ||
| S66011A | 24 | 963-965 | S66399A | 24 | 963-965 | S6791XA | 24 | 963-965 | ||
| S66011D | 23 | 949-950 | S66399D | 23 | 949-950 | S6791XD | 23 | 949-950 | ||
| S66011S | 08 | 562-563 | S66399S | 21 | 913-914 | S6791XS | 09 | 604-605 | ||
| S66012A | 08 | 562-563 | S66401A | 21 | 913-914 | S6792XA | 21 | 913-914 | ||
| S66012A | 24 | 963-965 | S66401A | 24 | 963-965 | S6792XA | 24 | 963-965 | ||
| S66012D | 23 | 949-950 | S66401D | 23 | 949-950 | S6792XD | 23 | 949-950 | ||
| S66012S | 08 | 562-563 | S66401S | 21 | 913-914 | S6792XS | 09 | 604-605 | ||
| S66019A | 08 | 562-563 | S66402A | 21 | 913-914 | S68011A | 21 | 913-914 | ||
| S66019A | 24 | 963-965 | S66402A | 24 | 963-965 | S68011A | 24 | 963-965 | ||
| S66019D | 23 | 949-950 | S66402D | 23 | 949-950 | S68011D | 23 | 949-950 | ||
| S66019S | 08 | 562-563 | S66402S | 21 | 913-914 | S68011S | 08 | 559-561 | ||
| S66021A | 08 | 564-566 | S66409A | 21 | 913-914 | S68012A | 21 | 913-914 | ||
| S66021A | 24 | 963-965 | S66409A | 24 | 963-965 | S68012A | 24 | 963-965 | ||
| S66021D | 23 | 949-950 | S66409D | 23 | 949-950 | S68012D | 23 | 949-950 | ||
| S66021S | 09 | 604-605 | S66409S | 21 | 913-914 | S68012S | 08 | 559-561 | ||
| S66022A | 08 | 564-566 | S66411A | 08 | 562-563 | S68019A | 21 | 913-914 | ||
| S66022A | 24 | 963-965 | S66411A | 24 | 963-965 | S68019A | 24 | 963-965 | ||
| S66022D | 23 | 949-950 | S66411D | 23 | 949-950 | S68019D | 23 | 949-950 | ||
| S66022S | 09 | 604-605 | S66411S | 08 | 562-563 | S68019S | 08 | 559-561 | ||
| S66029A | 08 | 564-566 | S66412A | 08 | 562-563 | S68021A | 21 | 913-914 | ||
| S66029A | 24 | 963-965 | S66412A | 24 | 963-965 | S68021A | 24 | 963-965 | ||
| S66029D | 23 | 949-950 | S66412D | 23 | 949-950 | S68021D | 23 | 949-950 | ||
| S66029S | 09 | 604-605 | S66412S | 08 | 562-563 | S68021S | 08 | 559-561 | ||
| S66091A | 21 | 913-914 | S66419A | 08 | 562-563 | S68022A | 21 | 913-914 | ||
| S66091A | 24 | 963-965 | S66419A | 24 | 963-965 | S68022A | 24 | 963-965 | ||
| S66091D | 23 | 949-950 | S66419D | 23 | 949-950 | S68022D | 23 | 949-950 | ||
| S66091S | 21 | 913-914 | S66419S | 08 | 562-563 | S68022S | 08 | 559-561 | ||
| S66092A | 21 | 913-914 | S66421A | 08 | 564-566 | S68029A | 21 | 913-914 | ||
| S66092A | 24 | 963-965 | S66421A | 24 | 963-965 | S68029A | 24 | 963-965 | ||
| S66092D | 23 | 949-950 | S66421D | 23 | 949-950 | S68029D | 23 | 949-950 | ||
| S66092S | 21 | 913-914 | S66421S | 09 | 604-605 | S68029S | 08 | 559-561 | ||
| S66099A | 21 | 913-914 | S66422A | 08 | 564-566 | S68110A | 21 | 913-914 | ||
| S66099A | 24 | 963-965 | S66422A | 24 | 963-965 | S68110A | 24 | 963-965 | ||
| S66099D | 23 | 949-950 | S66422D | 23 | 949-950 | S68110D | 23 | 949-950 | ||
| S66099S | 21 | 913-914 | S66422S | 09 | 604-605 | S68110S | 08 | 559-561 | ||
| S66100A | 21 | 913-914 | S66429A | 08 | 564-566 | S68111A | 21 | 913-914 | ||
| S66100A | 24 | 963-965 | S66429A | 24 | 963-965 | S68111A | 24 | 963-965 | ||
| S66100D | 23 | 949-950 | S66429D | 23 | 949-950 | S68111D | 23 | 949-950 | ||
| S66100S | 21 | 913-914 | S66429S | 09 | 604-605 | S68111S | 08 | 559-561 | ||
| S66101A | 21 | 913-914 | S66491A | 21 | 913-914 | S68112A | 21 | 913-914 | ||
| S66101A | 24 | 963-965 | S66491A | 24 | 963-965 | S68112A | 24 | 963-965 | ||
| S66101D | 23 | 949-950 | S66491D | 23 | 949-950 | S68112D | 23 | 949-950 | ||
| S66101S | 21 | 913-914 | S66491S | 21 | 913-914 | S68112S | 08 | 559-561 | ||
| S66102A | 21 | 913-914 | S66492A | 21 | 913-914 | S68113A | 21 | 913-914 | ||
| S66102A | 24 | 963-965 | S66492A | 24 | 963-965 | S68113A | 24 | 963-965 | ||
| S66102D | 23 | 949-950 | S66492D | 23 | 949-950 | S68113D | 23 | 949-950 | ||
| S66102S | 21 | 913-914 | S66492S | 21 | 913-914 | S68113S | 08 | 559-561 | ||
| S66103A | 21 | 913-914 | S66499A | 21 | 913-914 | S68114A | 21 | 913-914 | ||
| S66103A | 24 | 963-965 | S66499A | 24 | 963-965 | S68114A | 24 | 963-965 | ||
| S66103D | 23 | 949-950 | S66499D | 23 | 949-950 | S68114D | 23 | 949-950 | ||
| S66103S | 21 | 913-914 | S66499S | 21 | 913-914 | S68114S | 08 | 559-561 | ||
| S66104A | 21 | 913-914 | S66500A | 21 | 913-914 | S68115A | 21 | 913-914 | ||
| S66104A | 24 | 963-965 | S66500A | 24 | 963-965 | S68115A | 24 | 963-965 | ||
| S66104D | 23 | 949-950 | S66500D | 23 | 949-950 | S68115D | 23 | 949-950 | ||
| S66104S | 21 | 913-914 | S66500S | 21 | 913-914 | S68115S | 08 | 559-561 | ||
| S66105A | 21 | 913-914 | S66501A | 21 | 913-914 | S68116A | 21 | 913-914 | ||
| S66105A | 24 | 963-965 | S66501A | 24 | 963-965 | S68116A | 24 | 963-965 | ||
| S66105D | 23 | 949-950 | S66501D | 23 | 949-950 | S68116D | 23 | 949-950 | ||
| S66105S | 21 | 913-914 | S66501S | 21 | 913-914 | S68116S | 08 | 559-561 | ||
| S66106A | 21 | 913-914 | S66502A | 21 | 913-914 | S68117A | 21 | 913-914 | ||
| S66106A | 24 | 963-965 | S66502A | 24 | 963-965 | S68117A | 24 | 963-965 | ||
| S66106D | 23 | 949-950 | S66502D | 23 | 949-950 | S68117D | 23 | 949-950 | ||
| S66106S | 21 | 913-914 | S66502S | 21 | 913-914 | S68117S | 08 | 559-561 | ||
| S66107A | 21 | 913-914 | S66503A | 21 | 913-914 | S68118A | 21 | 913-914 | ||
| S66107A | 24 | 963-965 | S66503A | 24 | 963-965 | S68118A | 24 | 963-965 | ||
| S66107D | 23 | 949-950 | S66503D | 23 | 949-950 | S68118D | 23 | 949-950 | ||
| S66107S | 21 | 913-914 | S66503S | 21 | 913-914 | S68118S | 08 | 559-561 | ||
| S66108A | 21 | 913-914 | S66504A | 21 | 913-914 | S68119A | 21 | 913-914 | ||
| S66108A | 24 | 963-965 | S66504A | 24 | 963-965 | S68119A | 24 | 963-965 | ||
| S66108D | 23 | 949-950 | S66504D | 23 | 949-950 | S68119D | 23 | 949-950 | ||
| S66108S | 21 | 913-914 | S66504S | 21 | 913-914 | S68119S | 08 | 559-561 | ||
| S66109A | 21 | 913-914 | S66505A | 21 | 913-914 | S68120A | 21 | 913-914 | ||
| S66109A | 24 | 963-965 | S66505A | 24 | 963-965 | S68120A | 24 | 963-965 | ||
| S66109D | 23 | 949-950 | S66505D | 23 | 949-950 | S68120D | 23 | 949-950 | ||
| S66109S | 21 | 913-914 | S66505S | 21 | 913-914 | S68120S | 08 | 559-561 | ||
| S66110A | 08 | 562-563 | S66506A | 21 | 913-914 | S68121A | 21 | 913-914 | ||
| S66110A | 24 | 963-965 | S66506A | 24 | 963-965 | S68121A | 24 | 963-965 | ||
| S66110D | 23 | 949-950 | S66506D | 23 | 949-950 | S68121D | 23 | 949-950 | ||
| S66110S | 08 | 562-563 | S66506S | 21 | 913-914 | S68121S | 08 | 559-561 | ||
| S66111A | 08 | 562-563 | S66507A | 21 | 913-914 | S68122A | 21 | 913-914 | ||
| S66111A | 24 | 963-965 | S66507A | 24 | 963-965 | S68122A | 24 | 963-965 | ||
| S66111D | 23 | 949-950 | S66507D | 23 | 949-950 | S68122D | 23 | 949-950 | ||
| S66111S | 08 | 562-563 | S66507S | 21 | 913-914 | S68122S | 08 | 559-561 | ||
| S66112A | 08 | 562-563 | S66508A | 21 | 913-914 | S68123A | 21 | 913-914 | ||
| S66112A | 24 | 963-965 | S66508A | 24 | 963-965 | S68123A | 24 | 963-965 | ||
| S66112D | 23 | 949-950 | S66508D | 23 | 949-950 | S68123D | 23 | 949-950 | ||
| S66112S | 08 | 562-563 | S66508S | 21 | 913-914 | S68123S | 08 | 559-561 | ||
| S66113A | 08 | 562-563 | S66509A | 21 | 913-914 | S68124A | 21 | 913-914 | ||
| S66113A | 24 | 963-965 | S66509A | 24 | 963-965 | S68124A | 24 | 963-965 | ||
| S66113D | 23 | 949-950 | S66509D | 23 | 949-950 | S68124D | 23 | 949-950 | ||
| S66113S | 08 | 562-563 | S66509S | 21 | 913-914 | S68124S | 08 | 559-561 | ||
| S66114A | 08 | 562-563 | S66510A | 08 | 562-563 | S68125A | 21 | 913-914 | ||
| S66114A | 24 | 963-965 | S66510A | 24 | 963-965 | S68125A | 24 | 963-965 | ||
| S66114D | 23 | 949-950 | S66510D | 23 | 949-950 | S68125D | 23 | 949-950 | ||
| S66114S | 08 | 562-563 | S66510S | 08 | 562-563 | S68125S | 08 | 559-561 | ||
| S66115A | 08 | 562-563 | S66511A | 08 | 562-563 | S68126A | 21 | 913-914 | ||
| S66115A | 24 | 963-965 | S66511A | 24 | 963-965 | S68126A | 24 | 963-965 | ||
| S66115D | 23 | 949-950 | S66511D | 23 | 949-950 | S68126D | 23 | 949-950 | ||
| S66115S | 08 | 562-563 | S66511S | 08 | 562-563 | S68126S | 08 | 559-561 | ||
| S66116A | 08 | 562-563 | S66512A | 08 | 562-563 | S68127A | 21 | 913-914 | ||
| S66116A | 24 | 963-965 | S66512A | 24 | 963-965 | S68127A | 24 | 963-965 | ||
| S66116D | 23 | 949-950 | S66512D | 23 | 949-950 | S68127D | 23 | 949-950 | ||
| S66116S | 08 | 562-563 | S66512S | 08 | 562-563 | S68127S | 08 | 559-561 | ||
| S66117A | 08 | 562-563 | S66513A | 08 | 562-563 | S68128A | 21 | 913-914 | ||
| S66117A | 24 | 963-965 | S66513A | 24 | 963-965 | S68128A | 24 | 963-965 | ||
| S66117D | 23 | 949-950 | S66513D | 23 | 949-950 | S68128D | 23 | 949-950 | ||
| S66117S | 08 | 562-563 | S66513S | 08 | 562-563 | S68128S | 08 | 559-561 | ||
| S66118A | 08 | 562-563 | S66514A | 08 | 562-563 | S68129A | 21 | 913-914 | ||
| S66118A | 24 | 963-965 | S66514A | 24 | 963-965 | S68129A | 24 | 963-965 | ||
| S66118D | 23 | 949-950 | S66514D | 23 | 949-950 | S68129D | 23 | 949-950 | ||
| S66118S | 08 | 562-563 | S66514S | 08 | 562-563 | S68129S | 08 | 559-561 | ||
| S66119A | 08 | 562-563 | S66515A | 08 | 562-563 | S68411A | 21 | 913-914 | ||
| S66119A | 24 | 963-965 | S66515A | 24 | 963-965 | S68411A | 24 | 963-965 | ||
| S66119D | 23 | 949-950 | S66515D | 23 | 949-950 | S68411D | 23 | 949-950 | ||
| S66119S | 08 | 562-563 | S66515S | 08 | 562-563 | S68411S | 08 | 559-561 | ||
| S66120A | 08 | 564-566 | S66516A | 08 | 562-563 | S68412A | 21 | 913-914 | ||
| S66120A | 24 | 963-965 | S66516A | 24 | 963-965 | S68412A | 24 | 963-965 | ||
| S66120D | 23 | 949-950 | S66516D | 23 | 949-950 | S68412D | 23 | 949-950 | ||
| S66120S | 09 | 604-605 | S66516S | 08 | 562-563 | S68412S | 08 | 559-561 | ||
| S66121A | 08 | 564-566 | S66517A | 08 | 562-563 | S68419A | 21 | 913-914 | ||
| S66121A | 24 | 963-965 | S66517A | 24 | 963-965 | S68419A | 24 | 963-965 | ||
| S66121D | 23 | 949-950 | S66517D | 23 | 949-950 | S68419D | 23 | 949-950 | ||
| S66121S | 09 | 604-605 | S66517S | 08 | 562-563 | S68419S | 08 | 559-561 | ||
| S66122A | 08 | 564-566 | S66518A | 08 | 562-563 | S68421A | 21 | 913-914 | ||
| S66122A | 24 | 963-965 | S66518A | 24 | 963-965 | S68421A | 24 | 963-965 | ||
| S66122D | 23 | 949-950 | S66518D | 23 | 949-950 | S68421D | 23 | 949-950 | ||
| S66122S | 09 | 604-605 | S66518S | 08 | 562-563 | S68421S | 08 | 559-561 | ||
| S66123A | 08 | 564-566 | S66519A | 08 | 562-563 | S68422A | 21 | 913-914 | ||
| S66123A | 24 | 963-965 | S66519A | 24 | 963-965 | S68422A | 24 | 963-965 | ||
| S66123D | 23 | 949-950 | S66519D | 23 | 949-950 | S68422D | 23 | 949-950 | ||
| S66123S | 09 | 604-605 | S66519S | 08 | 562-563 | S68422S | 08 | 559-561 | ||
| S66124A | 08 | 564-566 | S66520A | 08 | 564-566 | S68429A | 21 | 913-914 | ||
| S66124A | 24 | 963-965 | S66520A | 24 | 963-965 | S68429A | 24 | 963-965 | ||
| S66124D | 23 | 949-950 | S66520D | 23 | 949-950 | S68429D | 23 | 949-950 | ||
| S66124S | 09 | 604-605 | S66520S | 09 | 604-605 | S68429S | 08 | 559-561 | ||
| S66125A | 08 | 564-566 | S66521A | 08 | 564-566 | S68511A | 21 | 913-914 | ||
| S66125A | 24 | 963-965 | S66521A | 24 | 963-965 | S68511A | 24 | 963-965 | ||
| S66125D | 23 | 949-950 | S66521D | 23 | 949-950 | S68511D | 23 | 949-950 | ||
| S66125S | 09 | 604-605 | S66521S | 09 | 604-605 | S68511S | 08 | 559-561 | ||
| S66126A | 08 | 564-566 | S66522A | 08 | 564-566 | S68512A | 21 | 913-914 | ||
| S66126A | 24 | 963-965 | S66522A | 24 | 963-965 | S68512A | 24 | 963-965 | ||
| S66126D | 23 | 949-950 | S66522D | 23 | 949-950 | S68512D | 23 | 949-950 | ||
| S66126S | 09 | 604-605 | S66522S | 09 | 604-605 | S68512S | 08 | 559-561 | ||
| S66127A | 08 | 564-566 | S66523A | 08 | 564-566 | S68519A | 21 | 913-914 | ||
| S66127A | 24 | 963-965 | S66523A | 24 | 963-965 | S68519A | 24 | 963-965 | ||
| S66127D | 23 | 949-950 | S66523D | 23 | 949-950 | S68519D | 23 | 949-950 | ||
| S66127S | 09 | 604-605 | S66523S | 09 | 604-605 | S68519S | 08 | 559-561 | ||
| S66128A | 08 | 564-566 | S66524A | 08 | 564-566 | S68521A | 21 | 913-914 | ||
| S66128A | 24 | 963-965 | S66524A | 24 | 963-965 | S68521A | 24 | 963-965 | ||
| S66128D | 23 | 949-950 | S66524D | 23 | 949-950 | S68521D | 23 | 949-950 | ||
| S66128S | 09 | 604-605 | S66524S | 09 | 604-605 | S68521S | 08 | 559-561 | ||
| S66129A | 08 | 564-566 | S66525A | 08 | 564-566 | S68522A | 21 | 913-914 | ||
| S66129A | 24 | 963-965 | S66525A | 24 | 963-965 | S68522A | 24 | 963-965 | ||
| S66129D | 23 | 949-950 | S66525D | 23 | 949-950 | S68522D | 23 | 949-950 | ||
| S66129S | 09 | 604-605 | S66525S | 09 | 604-605 | S68522S | 08 | 559-561 | ||
| S66190A | 21 | 913-914 | S66526A | 08 | 564-566 | S68529A | 21 | 913-914 | ||
| S66190A | 24 | 963-965 | S66526A | 24 | 963-965 | S68529A | 24 | 963-965 | ||
| S66190D | 23 | 949-950 | S66526D | 23 | 949-950 | S68529D | 23 | 949-950 | ||
| S66190S | 21 | 913-914 | S66526S | 09 | 604-605 | S68529S | 08 | 559-561 | ||
| S66191A | 21 | 913-914 | S66527A | 08 | 564-566 | S68610A | 21 | 913-914 | ||
| S66191A | 24 | 963-965 | S66527A | 24 | 963-965 | S68610A | 24 | 963-965 | ||
| S66191D | 23 | 949-950 | S66527D | 23 | 949-950 | S68610D | 23 | 949-950 | ||
| S66191S | 21 | 913-914 | S66527S | 09 | 604-605 | S68610S | 08 | 559-561 | ||
| S66192A | 21 | 913-914 | S66528A | 08 | 564-566 | S68611A | 21 | 913-914 | ||
| S66192A | 24 | 963-965 | S66528A | 24 | 963-965 | S68611A | 24 | 963-965 | ||
| S66192D | 23 | 949-950 | S66528D | 23 | 949-950 | S68611D | 23 | 949-950 | ||
| S66192S | 21 | 913-914 | S66528S | 09 | 604-605 | S68611S | 08 | 559-561 | ||
| S66193A | 21 | 913-914 | S66529A | 08 | 564-566 | S68612A | 21 | 913-914 | ||
| S66193A | 24 | 963-965 | S66529A | 24 | 963-965 | S68612A | 24 | 963-965 | ||
| S66193D | 23 | 949-950 | S66529D | 23 | 949-950 | S68612D | 23 | 949-950 | ||
| S66193S | 21 | 913-914 | S66529S | 09 | 604-605 | S68612S | 08 | 559-561 | ||
| S66194A | 21 | 913-914 | S66590A | 21 | 913-914 | S68613A | 21 | 913-914 | ||
| S66194A | 24 | 963-965 | S66590A | 24 | 963-965 | S68613A | 24 | 963-965 | ||
| S66194D | 23 | 949-950 | S66590D | 23 | 949-950 | S68613D | 23 | 949-950 | ||
| S66194S | 21 | 913-914 | S66590S | 21 | 913-914 | S68613S | 08 | 559-561 | ||
| S66195A | 21 | 913-914 | S66591A | 21 | 913-914 | S68614A | 21 | 913-914 | ||
| S66195A | 24 | 963-965 | S66591A | 24 | 963-965 | S68614A | 24 | 963-965 | ||
| S66195D | 23 | 949-950 | S66591D | 23 | 949-950 | S68614D | 23 | 949-950 | ||
| S66195S | 21 | 913-914 | S66591S | 21 | 913-914 | S68614S | 08 | 559-561 | ||
| S66196A | 21 | 913-914 | S66592A | 21 | 913-914 | S68615A | 21 | 913-914 | ||
| S66196A | 24 | 963-965 | S66592A | 24 | 963-965 | S68615A | 24 | 963-965 | ||
| S66196D | 23 | 949-950 | S66592D | 23 | 949-950 | S68615D | 23 | 949-950 | ||
| S66196S | 21 | 913-914 | S66592S | 21 | 913-914 | S68615S | 08 | 559-561 | ||
| S66197A | 21 | 913-914 | S66593A | 21 | 913-914 | S68616A | 21 | 913-914 | ||
| S66197A | 24 | 963-965 | S66593A | 24 | 963-965 | S68616A | 24 | 963-965 | ||
| S66197D | 23 | 949-950 | S66593D | 23 | 949-950 | S68616D | 23 | 949-950 | ||
| S66197S | 21 | 913-914 | S66593S | 21 | 913-914 | S68616S | 08 | 559-561 | ||
| S66198A | 21 | 913-914 | S66594A | 21 | 913-914 | S68617A | 21 | 913-914 | ||
| S66198A | 24 | 963-965 | S66594A | 24 | 963-965 | S68617A | 24 | 963-965 | ||
| S66198D | 23 | 949-950 | S66594D | 23 | 949-950 | S68617D | 23 | 949-950 | ||
| S66198S | 21 | 913-914 | S66594S | 21 | 913-914 | S68617S | 08 | 559-561 | ||
| S66199A | 21 | 913-914 | S66595A | 21 | 913-914 | S68618A | 21 | 913-914 | ||
| S66199A | 24 | 963-965 | S66595A | 24 | 963-965 | S68618A | 24 | 963-965 | ||
| S66199D | 23 | 949-950 | S66595D | 23 | 949-950 | S68618D | 23 | 949-950 | ||
| S66199S | 21 | 913-914 | S66595S | 21 | 913-914 | S68618S | 08 | 559-561 | ||
| S66201A | 21 | 913-914 | S66596A | 21 | 913-914 | S68619A | 21 | 913-914 | ||
| S66201A | 24 | 963-965 | S66596A | 24 | 963-965 | S68619A | 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 |