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 64 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S93103D | 23 | 949-950 | S93629D | 23 | 949-950 | S96291D | 23 | 949-950 | ||
| S93103S | 08 | 562-563 | S93629S | 08 | 562-563 | S96291S | 21 | 913-914 | ||
| S93104A | 08 | 562-563 | S93691A | 08 | 562-563 | S96292A | 21 | 913-914 | ||
| S93104A | 24 | 963-965 | S93691A | 24 | 963-965 | S96292A | 24 | 963-965 | ||
| S93104D | 23 | 949-950 | S93691D | 23 | 949-950 | S96292D | 23 | 949-950 | ||
| S93104S | 08 | 562-563 | S93691S | 08 | 562-563 | S96292S | 21 | 913-914 | ||
| S93105A | 08 | 562-563 | S93692A | 08 | 562-563 | S96299A | 21 | 913-914 | ||
| S93105A | 24 | 963-965 | S93692A | 24 | 963-965 | S96299A | 24 | 963-965 | ||
| S93105D | 23 | 949-950 | S93692D | 23 | 949-950 | S96299D | 23 | 949-950 | ||
| S93105S | 08 | 562-563 | S93692S | 08 | 562-563 | S96299S | 21 | 913-914 | ||
| S93106A | 08 | 562-563 | S93699A | 08 | 562-563 | S96801A | 21 | 913-914 | ||
| S93106A | 24 | 963-965 | S93699A | 24 | 963-965 | S96801A | 24 | 963-965 | ||
| S93106D | 23 | 949-950 | S93699D | 23 | 949-950 | S96801D | 23 | 949-950 | ||
| S93106S | 08 | 562-563 | S93699S | 08 | 562-563 | S96801S | 21 | 913-914 | ||
| S93111A | 08 | 562-563 | S9400XA | 01 | 073-074 | S96802A | 21 | 913-914 | ||
| S93111A | 24 | 963-965 | S9400XA | 24 | 963-965 | S96802A | 24 | 963-965 | ||
| S93111D | 23 | 949-950 | S9400XD | 23 | 949-950 | S96802D | 23 | 949-950 | ||
| S93111S | 08 | 562-563 | S9400XS | 01 | 091-093 | S96802S | 21 | 913-914 | ||
| S93112A | 08 | 562-563 | S9401XA | 01 | 073-074 | S96809A | 21 | 913-914 | ||
| S93112A | 24 | 963-965 | S9401XA | 24 | 963-965 | S96809A | 24 | 963-965 | ||
| S93112D | 23 | 949-950 | S9401XD | 23 | 949-950 | S96809D | 23 | 949-950 | ||
| S93112S | 08 | 562-563 | S9401XS | 01 | 091-093 | S96809S | 21 | 913-914 | ||
| S93113A | 08 | 562-563 | S9402XA | 01 | 073-074 | S96811A | 08 | 562-563 | ||
| S93113A | 24 | 963-965 | S9402XA | 24 | 963-965 | S96811A | 24 | 963-965 | ||
| S93113D | 23 | 949-950 | S9402XD | 23 | 949-950 | S96811D | 23 | 949-950 | ||
| S93113S | 08 | 562-563 | S9402XS | 01 | 091-093 | S96811S | 08 | 562-563 | ||
| S93114A | 08 | 562-563 | S9410XA | 01 | 073-074 | S96812A | 08 | 562-563 | ||
| S93114A | 24 | 963-965 | S9410XA | 24 | 963-965 | S96812A | 24 | 963-965 | ||
| S93114D | 23 | 949-950 | S9410XD | 23 | 949-950 | S96812D | 23 | 949-950 | ||
| S93114S | 08 | 562-563 | S9410XS | 01 | 091-093 | S96812S | 08 | 562-563 | ||
| S93115A | 08 | 562-563 | S9411XA | 01 | 073-074 | S96819A | 08 | 562-563 | ||
| S93115A | 24 | 963-965 | S9411XA | 24 | 963-965 | S96819A | 24 | 963-965 | ||
| S93115D | 23 | 949-950 | S9411XD | 23 | 949-950 | S96819D | 23 | 949-950 | ||
| S93115S | 08 | 562-563 | S9411XS | 01 | 091-093 | S96819S | 08 | 562-563 | ||
| S93116A | 08 | 562-563 | S9412XA | 01 | 073-074 | S96821A | 08 | 564-566 | ||
| S93116A | 24 | 963-965 | S9412XA | 24 | 963-965 | S96821A | 24 | 963-965 | ||
| S93116D | 23 | 949-950 | S9412XD | 23 | 949-950 | S96821D | 23 | 949-950 | ||
| S93116S | 08 | 562-563 | S9412XS | 01 | 091-093 | S96821S | 09 | 604-605 | ||
| S93119A | 08 | 562-563 | S9420XA | 01 | 073-074 | S96822A | 08 | 564-566 | ||
| S93119A | 24 | 963-965 | S9420XA | 24 | 963-965 | S96822A | 24 | 963-965 | ||
| S93119D | 23 | 949-950 | S9420XD | 23 | 949-950 | S96822D | 23 | 949-950 | ||
| S93119S | 08 | 562-563 | S9420XS | 01 | 091-093 | S96822S | 09 | 604-605 | ||
| S93121A | 08 | 562-563 | S9421XA | 01 | 073-074 | S96829A | 08 | 564-566 | ||
| S93121A | 24 | 963-965 | S9421XA | 24 | 963-965 | S96829A | 24 | 963-965 | ||
| S93121D | 23 | 949-950 | S9421XD | 23 | 949-950 | S96829D | 23 | 949-950 | ||
| S93121S | 08 | 562-563 | S9421XS | 01 | 091-093 | S96829S | 09 | 604-605 | ||
| S93122A | 08 | 562-563 | S9422XA | 01 | 073-074 | S96891A | 21 | 913-914 | ||
| S93122A | 24 | 963-965 | S9422XA | 24 | 963-965 | S96891A | 24 | 963-965 | ||
| S93122D | 23 | 949-950 | S9422XD | 23 | 949-950 | S96891D | 23 | 949-950 | ||
| S93122S | 08 | 562-563 | S9422XS | 01 | 091-093 | S96891S | 21 | 913-914 | ||
| S93123A | 08 | 562-563 | S9430XA | 01 | 073-074 | S96892A | 21 | 913-914 | ||
| S93123A | 24 | 963-965 | S9430XA | 24 | 963-965 | S96892A | 24 | 963-965 | ||
| S93123D | 23 | 949-950 | S9430XD | 23 | 949-950 | S96892D | 23 | 949-950 | ||
| S93123S | 08 | 562-563 | S9430XS | 01 | 091-093 | S96892S | 21 | 913-914 | ||
| S93124A | 08 | 562-563 | S9431XA | 01 | 073-074 | S96899A | 21 | 913-914 | ||
| S93124A | 24 | 963-965 | S9431XA | 24 | 963-965 | S96899A | 24 | 963-965 | ||
| S93124D | 23 | 949-950 | S9431XD | 23 | 949-950 | S96899D | 23 | 949-950 | ||
| S93124S | 08 | 562-563 | S9431XS | 01 | 091-093 | S96899S | 21 | 913-914 | ||
| S93125A | 08 | 562-563 | S9432XA | 01 | 073-074 | S96901A | 21 | 913-914 | ||
| S93125A | 24 | 963-965 | S9432XA | 24 | 963-965 | S96901A | 24 | 963-965 | ||
| S93125D | 23 | 949-950 | S9432XD | 23 | 949-950 | S96901D | 23 | 949-950 | ||
| S93125S | 08 | 562-563 | S9432XS | 01 | 091-093 | S96901S | 21 | 913-914 | ||
| S93126A | 08 | 562-563 | S948X1A | 01 | 073-074 | S96902A | 21 | 913-914 | ||
| S93126A | 24 | 963-965 | S948X1A | 24 | 963-965 | S96902A | 24 | 963-965 | ||
| S93126D | 23 | 949-950 | S948X1D | 23 | 949-950 | S96902D | 23 | 949-950 | ||
| S93126S | 08 | 562-563 | S948X1S | 01 | 091-093 | S96902S | 21 | 913-914 | ||
| S93129A | 08 | 562-563 | S948X2A | 01 | 073-074 | S96909A | 21 | 913-914 | ||
| S93129A | 24 | 963-965 | S948X2A | 24 | 963-965 | S96909A | 24 | 963-965 | ||
| S93129D | 23 | 949-950 | S948X2D | 23 | 949-950 | S96909D | 23 | 949-950 | ||
| S93129S | 08 | 562-563 | S948X2S | 01 | 091-093 | S96909S | 21 | 913-914 | ||
| S93131A | 08 | 562-563 | S948X9A | 01 | 073-074 | S96911A | 08 | 562-563 | ||
| S93131A | 24 | 963-965 | S948X9A | 24 | 963-965 | S96911A | 24 | 963-965 | ||
| S93131D | 23 | 949-950 | S948X9D | 23 | 949-950 | S96911D | 23 | 949-950 | ||
| S93131S | 08 | 562-563 | S948X9S | 01 | 091-093 | S96911S | 08 | 562-563 | ||
| S93132A | 08 | 562-563 | S9490XA | 01 | 073-074 | S96912A | 08 | 562-563 | ||
| S93132A | 24 | 963-965 | S9490XA | 24 | 963-965 | S96912A | 24 | 963-965 | ||
| S93132D | 23 | 949-950 | S9490XD | 23 | 949-950 | S96912D | 23 | 949-950 | ||
| S93132S | 08 | 562-563 | S9490XS | 01 | 091-093 | S96912S | 08 | 562-563 | ||
| S93133A | 08 | 562-563 | S9491XA | 01 | 073-074 | S96919A | 08 | 562-563 | ||
| S93133A | 24 | 963-965 | S9491XA | 24 | 963-965 | S96919A | 24 | 963-965 | ||
| S93133D | 23 | 949-950 | S9491XD | 23 | 949-950 | S96919D | 23 | 949-950 | ||
| S93133S | 08 | 562-563 | S9491XS | 01 | 091-093 | S96919S | 08 | 562-563 | ||
| S93134A | 08 | 562-563 | S9492XA | 01 | 073-074 | S96921A | 08 | 564-566 | ||
| S93134A | 24 | 963-965 | S9492XA | 24 | 963-965 | S96921A | 24 | 963-965 | ||
| S93134D | 23 | 949-950 | S9492XD | 23 | 949-950 | S96921D | 23 | 949-950 | ||
| S93134S | 08 | 562-563 | S9492XS | 01 | 091-093 | S96921S | 09 | 604-605 | ||
| S93135A | 08 | 562-563 | S95001A | 21 | 913-914 | S96922A | 08 | 564-566 | ||
| S93135A | 24 | 963-965 | S95001A | 24 | 963-965 | S96922A | 24 | 963-965 | ||
| S93135D | 23 | 949-950 | S95001D | 23 | 949-950 | S96922D | 23 | 949-950 | ||
| S93135S | 08 | 562-563 | S95001S | 05 | 299-301 | S96922S | 09 | 604-605 | ||
| S93136A | 08 | 562-563 | S95002A | 21 | 913-914 | S96929A | 08 | 564-566 | ||
| S93136A | 24 | 963-965 | S95002A | 24 | 963-965 | S96929A | 24 | 963-965 | ||
| S93136D | 23 | 949-950 | S95002D | 23 | 949-950 | S96929D | 23 | 949-950 | ||
| S93136S | 08 | 562-563 | S95002S | 05 | 299-301 | S96929S | 09 | 604-605 | ||
| S93139A | 08 | 562-563 | S95009A | 21 | 913-914 | S96991A | 21 | 913-914 | ||
| S93139A | 24 | 963-965 | S95009A | 24 | 963-965 | S96991A | 24 | 963-965 | ||
| S93139D | 23 | 949-950 | S95009D | 23 | 949-950 | S96991D | 23 | 949-950 | ||
| S93139S | 08 | 562-563 | S95009S | 05 | 299-301 | S96991S | 21 | 913-914 | ||
| S93141A | 08 | 562-563 | S95011A | 21 | 913-914 | S96992A | 21 | 913-914 | ||
| S93141A | 24 | 963-965 | S95011A | 24 | 963-965 | S96992A | 24 | 963-965 | ||
| S93141D | 23 | 949-950 | S95011D | 23 | 949-950 | S96992D | 23 | 949-950 | ||
| S93141S | 08 | 562-563 | S95011S | 05 | 299-301 | S96992S | 21 | 913-914 | ||
| S93142A | 08 | 562-563 | S95012A | 21 | 913-914 | S96999A | 21 | 913-914 | ||
| S93142A | 24 | 963-965 | S95012A | 24 | 963-965 | S96999A | 24 | 963-965 | ||
| S93142D | 23 | 949-950 | S95012D | 23 | 949-950 | S96999D | 23 | 949-950 | ||
| S93142S | 08 | 562-563 | S95012S | 05 | 299-301 | S96999S | 21 | 913-914 | ||
| S93143A | 08 | 562-563 | S95019A | 21 | 913-914 | S9700XA | 21 | 913-914 | ||
| S93143A | 24 | 963-965 | S95019A | 24 | 963-965 | S9700XA | 24 | 963-965 | ||
| S93143D | 23 | 949-950 | S95019D | 23 | 949-950 | S9700XD | 23 | 949-950 | ||
| S93143S | 08 | 562-563 | S95019S | 05 | 299-301 | S9700XS | 09 | 604-605 | ||
| S93144A | 08 | 562-563 | S95091A | 21 | 913-914 | S9701XA | 21 | 913-914 | ||
| S93144A | 24 | 963-965 | S95091A | 24 | 963-965 | S9701XA | 24 | 963-965 | ||
| S93144D | 23 | 949-950 | S95091D | 23 | 949-950 | S9701XD | 23 | 949-950 | ||
| S93144S | 08 | 562-563 | S95091S | 05 | 299-301 | S9701XS | 09 | 604-605 | ||
| S93145A | 08 | 562-563 | S95092A | 21 | 913-914 | S9702XA | 21 | 913-914 | ||
| S93145A | 24 | 963-965 | S95092A | 24 | 963-965 | S9702XA | 24 | 963-965 | ||
| S93145D | 23 | 949-950 | S95092D | 23 | 949-950 | S9702XD | 23 | 949-950 | ||
| S93145S | 08 | 562-563 | S95092S | 05 | 299-301 | S9702XS | 09 | 604-605 | ||
| S93146A | 08 | 562-563 | S95099A | 21 | 913-914 | S97101A | 21 | 913-914 | ||
| S93146A | 24 | 963-965 | S95099A | 24 | 963-965 | S97101A | 24 | 963-965 | ||
| S93146D | 23 | 949-950 | S95099D | 23 | 949-950 | S97101D | 23 | 949-950 | ||
| S93146S | 08 | 562-563 | S95099S | 05 | 299-301 | S97101S | 09 | 604-605 | ||
| S93149A | 08 | 562-563 | S95101A | 21 | 913-914 | S97102A | 21 | 913-914 | ||
| S93149A | 24 | 963-965 | S95101A | 24 | 963-965 | S97102A | 24 | 963-965 | ||
| S93149D | 23 | 949-950 | S95101D | 23 | 949-950 | S97102D | 23 | 949-950 | ||
| S93149S | 08 | 562-563 | S95101S | 05 | 299-301 | S97102S | 09 | 604-605 | ||
| S93301A | 08 | 562-563 | S95102A | 21 | 913-914 | S97109A | 21 | 913-914 | ||
| S93301A | 24 | 963-965 | S95102A | 24 | 963-965 | S97109A | 24 | 963-965 | ||
| S93301D | 23 | 949-950 | S95102D | 23 | 949-950 | S97109D | 23 | 949-950 | ||
| S93301S | 08 | 562-563 | S95102S | 05 | 299-301 | S97109S | 09 | 604-605 | ||
| S93302A | 08 | 562-563 | S95109A | 21 | 913-914 | S97111A | 21 | 913-914 | ||
| S93302A | 24 | 963-965 | S95109A | 24 | 963-965 | S97111A | 24 | 963-965 | ||
| S93302D | 23 | 949-950 | S95109D | 23 | 949-950 | S97111D | 23 | 949-950 | ||
| S93302S | 08 | 562-563 | S95109S | 05 | 299-301 | S97111S | 09 | 604-605 | ||
| S93303A | 08 | 562-563 | S95111A | 21 | 913-914 | S97112A | 21 | 913-914 | ||
| S93303A | 24 | 963-965 | S95111A | 24 | 963-965 | S97112A | 24 | 963-965 | ||
| S93303D | 23 | 949-950 | S95111D | 23 | 949-950 | S97112D | 23 | 949-950 | ||
| S93303S | 08 | 562-563 | S95111S | 05 | 299-301 | S97112S | 09 | 604-605 | ||
| S93304A | 08 | 562-563 | S95112A | 21 | 913-914 | S97119A | 21 | 913-914 | ||
| S93304A | 24 | 963-965 | S95112A | 24 | 963-965 | S97119A | 24 | 963-965 | ||
| S93304D | 23 | 949-950 | S95112D | 23 | 949-950 | S97119D | 23 | 949-950 | ||
| S93304S | 08 | 562-563 | S95112S | 05 | 299-301 | S97119S | 09 | 604-605 | ||
| S93305A | 08 | 562-563 | S95119A | 21 | 913-914 | S97121A | 21 | 913-914 | ||
| S93305A | 24 | 963-965 | S95119A | 24 | 963-965 | S97121A | 24 | 963-965 | ||
| S93305D | 23 | 949-950 | S95119D | 23 | 949-950 | S97121D | 23 | 949-950 | ||
| S93305S | 08 | 562-563 | S95119S | 05 | 299-301 | S97121S | 09 | 604-605 | ||
| S93306A | 08 | 562-563 | S95191A | 21 | 913-914 | S97122A | 21 | 913-914 | ||
| S93306A | 24 | 963-965 | S95191A | 24 | 963-965 | S97122A | 24 | 963-965 | ||
| S93306D | 23 | 949-950 | S95191D | 23 | 949-950 | S97122D | 23 | 949-950 | ||
| S93306S | 08 | 562-563 | S95191S | 05 | 299-301 | S97122S | 09 | 604-605 | ||
| S93311A | 08 | 562-563 | S95192A | 21 | 913-914 | S97129A | 21 | 913-914 | ||
| S93311A | 24 | 963-965 | S95192A | 24 | 963-965 | S97129A | 24 | 963-965 | ||
| S93311D | 23 | 949-950 | S95192D | 23 | 949-950 | S97129D | 23 | 949-950 | ||
| S93311S | 08 | 562-563 | S95192S | 05 | 299-301 | S97129S | 09 | 604-605 | ||
| S93312A | 08 | 562-563 | S95199A | 21 | 913-914 | S9780XA | 21 | 913-914 | ||
| S93312A | 24 | 963-965 | S95199A | 24 | 963-965 | S9780XA | 24 | 963-965 | ||
| S93312D | 23 | 949-950 | S95199D | 23 | 949-950 | S9780XD | 23 | 949-950 | ||
| S93312S | 08 | 562-563 | S95199S | 05 | 299-301 | S9780XS | 09 | 604-605 | ||
| S93313A | 08 | 562-563 | S95201A | 21 | 913-914 | S9781XA | 21 | 913-914 | ||
| S93313A | 24 | 963-965 | S95201A | 24 | 963-965 | S9781XA | 24 | 963-965 | ||
| S93313D | 23 | 949-950 | S95201D | 23 | 949-950 | S9781XD | 23 | 949-950 | ||
| S93313S | 08 | 562-563 | S95201S | 05 | 299-301 | S9781XS | 09 | 604-605 | ||
| S93314A | 08 | 562-563 | S95202A | 21 | 913-914 | S9782XA | 21 | 913-914 | ||
| S93314A | 24 | 963-965 | S95202A | 24 | 963-965 | S9782XA | 24 | 963-965 | ||
| S93314D | 23 | 949-950 | S95202D | 23 | 949-950 | S9782XD | 23 | 949-950 | ||
| S93314S | 08 | 562-563 | S95202S | 05 | 299-301 | S9782XS | 09 | 604-605 | ||
| S93315A | 08 | 562-563 | S95209A | 21 | 913-914 | S98011A | 21 | 913-914 | ||
| S93315A | 24 | 963-965 | S95209A | 24 | 963-965 | S98011A | 24 | 963-965 | ||
| S93315D | 23 | 949-950 | S95209D | 23 | 949-950 | S98011D | 23 | 949-950 | ||
| S93315S | 08 | 562-563 | S95209S | 05 | 299-301 | S98011S | 08 | 559-561 | ||
| S93316A | 08 | 562-563 | S95211A | 21 | 913-914 | S98012A | 21 | 913-914 | ||
| S93316A | 24 | 963-965 | S95211A | 24 | 963-965 | S98012A | 24 | 963-965 | ||
| S93316D | 23 | 949-950 | S95211D | 23 | 949-950 | S98012D | 23 | 949-950 | ||
| S93316S | 08 | 562-563 | S95211S | 05 | 299-301 | S98012S | 08 | 559-561 | ||
| S93321A | 08 | 562-563 | S95212A | 21 | 913-914 | S98019A | 21 | 913-914 | ||
| S93321A | 24 | 963-965 | S95212A | 24 | 963-965 | S98019A | 24 | 963-965 | ||
| S93321D | 23 | 949-950 | S95212D | 23 | 949-950 | S98019D | 23 | 949-950 | ||
| S93321S | 08 | 562-563 | S95212S | 05 | 299-301 | S98019S | 08 | 559-561 | ||
| S93322A | 08 | 562-563 | S95219A | 21 | 913-914 | S98021A | 21 | 913-914 | ||
| S93322A | 24 | 963-965 | S95219A | 24 | 963-965 | S98021A | 24 | 963-965 | ||
| S93322D | 23 | 949-950 | S95219D | 23 | 949-950 | S98021D | 23 | 949-950 | ||
| S93322S | 08 | 562-563 | S95219S | 05 | 299-301 | S98021S | 08 | 559-561 | ||
| S93323A | 08 | 562-563 | S95291A | 21 | 913-914 | S98022A | 21 | 913-914 | ||
| S93323A | 24 | 963-965 | S95291A | 24 | 963-965 | S98022A | 24 | 963-965 | ||
| S93323D | 23 | 949-950 | S95291D | 23 | 949-950 | S98022D | 23 | 949-950 | ||
| S93323S | 08 | 562-563 | S95291S | 05 | 299-301 | S98022S | 08 | 559-561 | ||
| S93324A | 08 | 562-563 | S95292A | 21 | 913-914 | S98029A | 21 | 913-914 | ||
| S93324A | 24 | 963-965 | S95292A | 24 | 963-965 | S98029A | 24 | 963-965 | ||
| S93324D | 23 | 949-950 | S95292D | 23 | 949-950 | S98029D | 23 | 949-950 | ||
| S93324S | 08 | 562-563 | S95292S | 05 | 299-301 | S98029S | 08 | 559-561 | ||
| S93325A | 08 | 562-563 | S95299A | 21 | 913-914 | S98111A | 21 | 913-914 | ||
| S93325A | 24 | 963-965 | S95299A | 24 | 963-965 | S98111A | 24 | 963-965 | ||
| S93325D | 23 | 949-950 | S95299D | 23 | 949-950 | S98111D | 23 | 949-950 | ||
| S93325S | 08 | 562-563 | S95299S | 05 | 299-301 | S98111S | 08 | 559-561 | ||
| S93326A | 08 | 562-563 | S95801A | 21 | 913-914 | S98112A | 21 | 913-914 | ||
| S93326A | 24 | 963-965 | S95801A | 24 | 963-965 | S98112A | 24 | 963-965 | ||
| S93326D | 23 | 949-950 | S95801D | 23 | 949-950 | S98112D | 23 | 949-950 | ||
| S93326S | 08 | 562-563 | S95801S | 05 | 299-301 | S98112S | 08 | 559-561 | ||
| S93331A | 08 | 562-563 | S95802A | 21 | 913-914 | S98119A | 21 | 913-914 | ||
| S93331A | 24 | 963-965 | S95802A | 24 | 963-965 | S98119A | 24 | 963-965 | ||
| S93331D | 23 | 949-950 | S95802D | 23 | 949-950 | S98119D | 23 | 949-950 | ||
| S93331S | 08 | 562-563 | S95802S | 05 | 299-301 | S98119S | 08 | 559-561 | ||
| S93332A | 08 | 562-563 | S95809A | 21 | 913-914 | S98121A | 21 | 913-914 | ||
| S93332A | 24 | 963-965 | S95809A | 24 | 963-965 | S98121A | 24 | 963-965 | ||
| S93332D | 23 | 949-950 | S95809D | 23 | 949-950 | S98121D | 23 | 949-950 | ||
| S93332S | 08 | 562-563 | S95809S | 05 | 299-301 | S98121S | 08 | 559-561 | ||
| S93333A | 08 | 562-563 | S95811A | 21 | 913-914 | S98122A | 21 | 913-914 | ||
| S93333A | 24 | 963-965 | S95811A | 24 | 963-965 | S98122A | 24 | 963-965 | ||
| S93333D | 23 | 949-950 | S95811D | 23 | 949-950 | S98122D | 23 | 949-950 | ||
| S93333S | 08 | 562-563 | S95811S | 05 | 299-301 | S98122S | 08 | 559-561 | ||
| S93334A | 08 | 562-563 | S95812A | 21 | 913-914 | S98129A | 21 | 913-914 | ||
| S93334A | 24 | 963-965 | S95812A | 24 | 963-965 | S98129A | 24 | 963-965 | ||
| S93334D | 23 | 949-950 | S95812D | 23 | 949-950 | S98129D | 23 | 949-950 | ||
| S93334S | 08 | 562-563 | S95812S | 05 | 299-301 | S98129S | 08 | 559-561 | ||
| S93335A | 08 | 562-563 | S95819A | 21 | 913-914 | S98131A | 21 | 913-914 | ||
| S93335A | 24 | 963-965 | S95819A | 24 | 963-965 | S98131A | 24 | 963-965 | ||
| S93335D | 23 | 949-950 | S95819D | 23 | 949-950 | S98131D | 23 | 949-950 | ||
| S93335S | 08 | 562-563 | S95819S | 05 | 299-301 | S98131S | 08 | 559-561 | ||
| S93336A | 08 | 562-563 | S95891A | 21 | 913-914 | S98132A | 21 | 913-914 | ||
| S93336A | 24 | 963-965 | S95891A | 24 | 963-965 | S98132A | 24 | 963-965 | ||
| S93336D | 23 | 949-950 | S95891D | 23 | 949-950 | S98132D | 23 | 949-950 | ||
| S93336S | 08 | 562-563 | S95891S | 05 | 299-301 | S98132S | 08 | 559-561 | ||
| S93401A | 08 | 562-563 | S95892A | 21 | 913-914 | S98139A | 21 | 913-914 | ||
| S93401A | 24 | 963-965 | S95892A | 24 | 963-965 | S98139A | 24 | 963-965 | ||
| S93401D | 23 | 949-950 | S95892D | 23 | 949-950 | S98139D | 23 | 949-950 | ||
| S93401S | 08 | 562-563 | S95892S | 05 | 299-301 | S98139S | 08 | 559-561 | ||
| S93402A | 08 | 562-563 | S95899A | 21 | 913-914 | S98141A | 21 | 913-914 | ||
| S93402A | 24 | 963-965 | S95899A | 24 | 963-965 | S98141A | 24 | 963-965 | ||
| S93402D | 23 | 949-950 | S95899D | 23 | 949-950 | S98141D | 23 | 949-950 | ||
| S93402S | 08 | 562-563 | S95899S | 05 | 299-301 | S98141S | 08 | 559-561 | ||
| S93409A | 08 | 562-563 | S95901A | 21 | 913-914 | S98142A | 21 | 913-914 | ||
| S93409A | 24 | 963-965 | S95901A | 24 | 963-965 | S98142A | 24 | 963-965 | ||
| S93409D | 23 | 949-950 | S95901D | 23 | 949-950 | S98142D | 23 | 949-950 | ||
| S93409S | 08 | 562-563 | S95901S | 05 | 299-301 | S98142S | 08 | 559-561 | ||
| S93411A | 08 | 562-563 | S95902A | 21 | 913-914 | S98149A | 21 | 913-914 | ||
| S93411A | 24 | 963-965 | S95902A | 24 | 963-965 | S98149A | 24 | 963-965 | ||
| S93411D | 23 | 949-950 | S95902D | 23 | 949-950 | S98149D | 23 | 949-950 | ||
| S93411S | 08 | 562-563 | S95902S | 05 | 299-301 | S98149S | 08 | 559-561 | ||
| S93412A | 08 | 562-563 | S95909A | 21 | 913-914 | S98211A | 21 | 913-914 | ||
| S93412A | 24 | 963-965 | S95909A | 24 | 963-965 | S98211A | 24 | 963-965 | ||
| S93412D | 23 | 949-950 | S95909D | 23 | 949-950 | S98211D | 23 | 949-950 | ||
| S93412S | 08 | 562-563 | S95909S | 05 | 299-301 | S98211S | 08 | 559-561 | ||
| S93419A | 08 | 562-563 | S95911A | 21 | 913-914 | S98212A | 21 | 913-914 | ||
| S93419A | 24 | 963-965 | S95911A | 24 | 963-965 | S98212A | 24 | 963-965 | ||
| S93419D | 23 | 949-950 | S95911D | 23 | 949-950 | S98212D | 23 | 949-950 | ||
| S93419S | 08 | 562-563 | S95911S | 05 | 299-301 | S98212S | 08 | 559-561 | ||
| S93421A | 08 | 562-563 | S95912A | 21 | 913-914 | S98219A | 21 | 913-914 | ||
| S93421A | 24 | 963-965 | S95912A | 24 | 963-965 | S98219A | 24 | 963-965 | ||
| S93421D | 23 | 949-950 | S95912D | 23 | 949-950 | S98219D | 23 | 949-950 | ||
| S93421S | 08 | 562-563 | S95912S | 05 | 299-301 | S98219S | 08 | 559-561 | ||
| S93422A | 08 | 562-563 | S95919A | 21 | 913-914 | S98221A | 21 | 913-914 | ||
| S93422A | 24 | 963-965 | S95919A | 24 | 963-965 | S98221A | 24 | 963-965 | ||
| S93422D | 23 | 949-950 | S95919D | 23 | 949-950 | S98221D | 23 | 949-950 | ||
| S93422S | 08 | 562-563 | S95919S | 05 | 299-301 | S98221S | 08 | 559-561 | ||
| S93429A | 08 | 562-563 | S95991A | 21 | 913-914 | S98222A | 21 | 913-914 | ||
| S93429A | 24 | 963-965 | S95991A | 24 | 963-965 | S98222A | 24 | 963-965 | ||
| S93429D | 23 | 949-950 | S95991D | 23 | 949-950 | S98222D | 23 | 949-950 | ||
| S93429S | 08 | 562-563 | S95991S | 05 | 299-301 | S98222S | 08 | 559-561 | ||
| S93431A | 08 | 562-563 | S95992A | 21 | 913-914 | S98229A | 21 | 913-914 | ||
| S93431A | 24 | 963-965 | S95992A | 24 | 963-965 | S98229A | 24 | 963-965 | ||
| S93431D | 23 | 949-950 | S95992D | 23 | 949-950 | S98229D | 23 | 949-950 | ||
| S93431S | 08 | 562-563 | S95992S | 05 | 299-301 | S98229S | 08 | 559-561 | ||
| S93432A | 08 | 562-563 | S95999A | 21 | 913-914 | S98311A | 21 | 913-914 | ||
| S93432A | 24 | 963-965 | S95999A | 24 | 963-965 | S98311A | 24 | 963-965 | ||
| S93432D | 23 | 949-950 | S95999D | 23 | 949-950 | S98311D | 23 | 949-950 | ||
| S93432S | 08 | 562-563 | S95999S | 05 | 299-301 | S98311S | 08 | 559-561 | ||
| S93439A | 08 | 562-563 | S96001A | 21 | 913-914 | S98312A | 21 | 913-914 | ||
| S93439A | 24 | 963-965 | S96001A | 24 | 963-965 | S98312A | 24 | 963-965 | ||
| S93439D | 23 | 949-950 | S96001D | 23 | 949-950 | S98312D | 23 | 949-950 | ||
| S93439S | 08 | 562-563 | S96001S | 21 | 913-914 | S98312S | 08 | 559-561 | ||
| S93491A | 08 | 562-563 | S96002A | 21 | 913-914 | S98319A | 21 | 913-914 | ||
| S93491A | 24 | 963-965 | S96002A | 24 | 963-965 | S98319A | 24 | 963-965 | ||
| S93491D | 23 | 949-950 | S96002D | 23 | 949-950 | S98319D | 23 | 949-950 | ||
| S93491S | 08 | 562-563 | S96002S | 21 | 913-914 | S98319S | 08 | 559-561 | ||
| S93492A | 08 | 562-563 | S96009A | 21 | 913-914 | S98321A | 21 | 913-914 | ||
| S93492A | 24 | 963-965 | S96009A | 24 | 963-965 | S98321A | 24 | 963-965 | ||
| S93492D | 23 | 949-950 | S96009D | 23 | 949-950 | S98321D | 23 | 949-950 | ||
| S93492S | 08 | 562-563 | S96009S | 21 | 913-914 | S98321S | 08 | 559-561 | ||
| S93499A | 08 | 562-563 | S96011A | 08 | 562-563 | S98322A | 21 | 913-914 | ||
| S93499A | 24 | 963-965 | S96011A | 24 | 963-965 | S98322A | 24 | 963-965 | ||
| S93499D | 23 | 949-950 | S96011D | 23 | 949-950 | S98322D | 23 | 949-950 | ||
| S93499S | 08 | 562-563 | S96011S | 08 | 562-563 | S98322S | 08 | 559-561 | ||
| S93501A | 08 | 562-563 | S96012A | 08 | 562-563 | S98329A | 21 | 913-914 | ||
| S93501A | 24 | 963-965 | S96012A | 24 | 963-965 | S98329A | 24 | 963-965 | ||
| S93501D | 23 | 949-950 | S96012D | 23 | 949-950 | S98329D | 23 | 949-950 | ||
| S93501S | 08 | 562-563 | S96012S | 08 | 562-563 | S98329S | 08 | 559-561 | ||
| S93502A | 08 | 562-563 | S96019A | 08 | 562-563 | S98911A | 21 | 913-914 | ||
| S93502A | 24 | 963-965 | S96019A | 24 | 963-965 | S98911A | 24 | 963-965 | ||
| S93502D | 23 | 949-950 | S96019D | 23 | 949-950 | S98911D | 23 | 949-950 | ||
| S93502S | 08 | 562-563 | S96019S | 08 | 562-563 | S98911S | 08 | 559-561 | ||
| S93503A | 08 | 562-563 | S96021A | 08 | 564-566 | S98912A | 21 | 913-914 | ||
| S93503A | 24 | 963-965 | S96021A | 24 | 963-965 | S98912A | 24 | 963-965 | ||
| S93503D | 23 | 949-950 | S96021D | 23 | 949-950 | S98912D | 23 | 949-950 | ||
| S93503S | 08 | 562-563 | S96021S | 09 | 604-605 | S98912S | 08 | 559-561 | ||
| S93504A | 08 | 562-563 | S96022A | 08 | 564-566 | S98919A | 21 | 913-914 | ||
| S93504A | 24 | 963-965 | S96022A | 24 | 963-965 | S98919A | 24 | 963-965 | ||
| S93504D | 23 | 949-950 | S96022D | 23 | 949-950 | S98919D | 23 | 949-950 | ||
| S93504S | 08 | 562-563 | S96022S | 09 | 604-605 | S98919S | 08 | 559-561 | ||
| S93505A | 08 | 562-563 | S96029A | 08 | 564-566 | S98921A | 21 | 913-914 | ||
| S93505A | 24 | 963-965 | S96029A | 24 | 963-965 | S98921A | 24 | 963-965 | ||
| S93505D | 23 | 949-950 | S96029D | 23 | 949-950 | S98921D | 23 | 949-950 | ||
| S93505S | 08 | 562-563 | S96029S | 09 | 604-605 | S98921S | 08 | 559-561 | ||
| S93506A | 08 | 562-563 | S96091A | 21 | 913-914 | S98922A | 21 | 913-914 | ||
| S93506A | 24 | 963-965 | S96091A | 24 | 963-965 | S98922A | 24 | 963-965 | ||
| S93506D | 23 | 949-950 | S96091D | 23 | 949-950 | S98922D | 23 | 949-950 | ||
| S93506S | 08 | 562-563 | S96091S | 21 | 913-914 | S98922S | 08 | 559-561 | ||
| S93509A | 08 | 562-563 | S96092A | 21 | 913-914 | S98929A | 21 | 913-914 | ||
| S93509A | 24 | 963-965 | S96092A | 24 | 963-965 | S98929A | 24 | 963-965 | ||
| S93509D | 23 | 949-950 | S96092D | 23 | 949-950 | S98929D | 23 | 949-950 | ||
| S93509S | 08 | 562-563 | S96092S | 21 | 913-914 | S98929S | 08 | 559-561 | ||
| S93511A | 08 | 562-563 | S96099A | 21 | 913-914 | S99001A | 21 | 913-914 | ||
| S93511A | 24 | 963-965 | S96099A | 24 | 963-965 | S99001A | 24 | 963-965 | ||
| S93511D | 23 | 949-950 | S96099D | 23 | 949-950 | S99001B | 21 | 913-914 | ||
| S93511S | 08 | 562-563 | S96099S | 21 | 913-914 | S99001B | 24 | 963-965 | ||
| S93512A | 08 | 562-563 | S96101A | 21 | 913-914 | S99001D | 23 | 949-950 | ||
| S93512A | 24 | 963-965 | S96101A | 24 | 963-965 | S99001G | 23 | 949-950 | ||
| S93512D | 23 | 949-950 | S96101D | 23 | 949-950 | S99001K | 23 | 949-950 | ||
| S93512S | 08 | 562-563 | S96101S | 21 | 913-914 | S99001P | 23 | 949-950 | ||
| S93513A | 08 | 562-563 | S96102A | 21 | 913-914 | S99001S | 21 | 913-914 | ||
| S93513A | 24 | 963-965 | S96102A | 24 | 963-965 | S99002A | 21 | 913-914 | ||
| S93513D | 23 | 949-950 | S96102D | 23 | 949-950 | S99002A | 24 | 963-965 | ||
| S93513S | 08 | 562-563 | S96102S | 21 | 913-914 | S99002B | 21 | 913-914 | ||
| S93514A | 08 | 562-563 | S96109A | 21 | 913-914 | S99002B | 24 | 963-965 | ||
| S93514A | 24 | 963-965 | S96109A | 24 | 963-965 | S99002D | 23 | 949-950 | ||
| S93514D | 23 | 949-950 | S96109D | 23 | 949-950 | S99002G | 23 | 949-950 | ||
| S93514S | 08 | 562-563 | S96109S | 21 | 913-914 | S99002K | 23 | 949-950 | ||
| S93515A | 08 | 562-563 | S96111A | 08 | 562-563 | S99002P | 23 | 949-950 | ||
| S93515A | 24 | 963-965 | S96111A | 24 | 963-965 | S99002S | 21 | 913-914 | ||
| S93515D | 23 | 949-950 | S96111D | 23 | 949-950 | S99009A | 21 | 913-914 | ||
| S93515S | 08 | 562-563 | S96111S | 08 | 562-563 | S99009A | 24 | 963-965 | ||
| S93516A | 08 | 562-563 | S96112A | 08 | 562-563 | S99009B | 21 | 913-914 | ||
| S93516A | 24 | 963-965 | S96112A | 24 | 963-965 | S99009B | 24 | 963-965 | ||
| S93516D | 23 | 949-950 | S96112D | 23 | 949-950 | S99009D | 23 | 949-950 | ||
| S93516S | 08 | 562-563 | S96112S | 08 | 562-563 | S99009G | 23 | 949-950 | ||
| S93519A | 08 | 562-563 | S96119A | 08 | 562-563 | S99009K | 23 | 949-950 | ||
| S93519A | 24 | 963-965 | S96119A | 24 | 963-965 | S99009P | 23 | 949-950 | ||
| S93519D | 23 | 949-950 | S96119D | 23 | 949-950 | S99009S | 21 | 913-914 | ||
| S93519S | 08 | 562-563 | S96119S | 08 | 562-563 | S99011A | 21 | 913-914 | ||
| S93521A | 08 | 562-563 | S96121A | 08 | 564-566 | S99011A | 24 | 963-965 | ||
| S93521A | 24 | 963-965 | S96121A | 24 | 963-965 | S99011B | 21 | 913-914 | ||
| S93521D | 23 | 949-950 | S96121D | 23 | 949-950 | S99011B | 24 | 963-965 | ||
| S93521S | 08 | 562-563 | S96121S | 09 | 604-605 | S99011D | 23 | 949-950 | ||
| S93522A | 08 | 562-563 | S96122A | 08 | 564-566 | S99011G | 23 | 949-950 | ||
| S93522A | 24 | 963-965 | S96122A | 24 | 963-965 | S99011K | 23 | 949-950 | ||
| S93522D | 23 | 949-950 | S96122D | 23 | 949-950 | S99011P | 23 | 949-950 | ||
| S93522S | 08 | 562-563 | S96122S | 09 | 604-605 | S99011S | 21 | 913-914 | ||
| S93523A | 08 | 562-563 | S96129A | 08 | 564-566 | S99012A | 21 | 913-914 | ||
| S93523A | 24 | 963-965 | S96129A | 24 | 963-965 | S99012A | 24 | 963-965 | ||
| S93523D | 23 | 949-950 | S96129D | 23 | 949-950 | S99012B | 21 | 913-914 | ||
| S93523S | 08 | 562-563 | S96129S | 09 | 604-605 | S99012B | 24 | 963-965 | ||
| S93524A | 08 | 562-563 | S96191A | 21 | 913-914 | S99012D | 23 | 949-950 | ||
| S93524A | 24 | 963-965 | S96191A | 24 | 963-965 | S99012G | 23 | 949-950 | ||
| S93524D | 23 | 949-950 | S96191D | 23 | 949-950 | S99012K | 23 | 949-950 | ||
| S93524S | 08 | 562-563 | S96191S | 21 | 913-914 | S99012P | 23 | 949-950 | ||
| S93525A | 08 | 562-563 | S96192A | 21 | 913-914 | S99012S | 21 | 913-914 | ||
| S93525A | 24 | 963-965 | S96192A | 24 | 963-965 | S99019A | 21 | 913-914 | ||
| S93525D | 23 | 949-950 | S96192D | 23 | 949-950 | S99019A | 24 | 963-965 | ||
| S93525S | 08 | 562-563 | S96192S | 21 | 913-914 | S99019B | 21 | 913-914 | ||
| S93526A | 08 | 562-563 | S96199A | 21 | 913-914 | S99019B | 24 | 963-965 | ||
| S93526A | 24 | 963-965 | S96199A | 24 | 963-965 | S99019D | 23 | 949-950 | ||
| S93526D | 23 | 949-950 | S96199D | 23 | 949-950 | S99019G | 23 | 949-950 | ||
| S93526S | 08 | 562-563 | S96199S | 21 | 913-914 | S99019K | 23 | 949-950 | ||
| S93529A | 08 | 562-563 | S96201A | 21 | 913-914 | S99019P | 23 | 949-950 | ||
| S93529A | 24 | 963-965 | S96201A | 24 | 963-965 | S99019S | 21 | 913-914 | ||
| S93529D | 23 | 949-950 | S96201D | 23 | 949-950 | S99021A | 21 | 913-914 | ||
| S93529S | 08 | 562-563 | S96201S | 21 | 913-914 | S99021A | 24 | 963-965 | ||
| S93601A | 08 | 562-563 | S96202A | 21 | 913-914 | S99021B | 21 | 913-914 | ||
| S93601A | 24 | 963-965 | S96202A | 24 | 963-965 | S99021B | 24 | 963-965 | ||
| S93601D | 23 | 949-950 | S96202D | 23 | 949-950 | S99021D | 23 | 949-950 | ||
| S93601S | 08 | 562-563 | S96202S | 21 | 913-914 | S99021G | 23 | 949-950 | ||
| S93602A | 08 | 562-563 | S96209A | 21 | 913-914 | S99021K | 23 | 949-950 | ||
| S93602A | 24 | 963-965 | S96209A | 24 | 963-965 | S99021P | 23 | 949-950 | ||
| S93602D | 23 | 949-950 | S96209D | 23 | 949-950 | S99021S | 21 | 913-914 | ||
| S93602S | 08 | 562-563 | S96209S | 21 | 913-914 | S99022A | 21 | 913-914 | ||
| S93609A | 08 | 562-563 | S96211A | 08 | 562-563 | S99022A | 24 | 963-965 | ||
| S93609A | 24 | 963-965 | S96211A | 24 | 963-965 | S99022B | 21 | 913-914 | ||
| S93609D | 23 | 949-950 | S96211D | 23 | 949-950 | S99022B | 24 | 963-965 | ||
| S93609S | 08 | 562-563 | S96211S | 08 | 562-563 | S99022D | 23 | 949-950 | ||
| S93611A | 08 | 562-563 | S96212A | 08 | 562-563 | S99022G | 23 | 949-950 | ||
| S93611A | 24 | 963-965 | S96212A | 24 | 963-965 | S99022K | 23 | 949-950 | ||
| S93611D | 23 | 949-950 | S96212D | 23 | 949-950 | S99022P | 23 | 949-950 | ||
| S93611S | 08 | 562-563 | S96212S | 08 | 562-563 | S99022S | 21 | 913-914 | ||
| S93612A | 08 | 562-563 | S96219A | 08 | 562-563 | S99029A | 21 | 913-914 | ||
| S93612A | 24 | 963-965 | S96219A | 24 | 963-965 | S99029A | 24 | 963-965 | ||
| S93612D | 23 | 949-950 | S96219D | 23 | 949-950 | S99029B | 21 | 913-914 | ||
| S93612S | 08 | 562-563 | S96219S | 08 | 562-563 | S99029B | 24 | 963-965 | ||
| S93619A | 08 | 562-563 | S96221A | 08 | 564-566 | S99029D | 23 | 949-950 | ||
| S93619A | 24 | 963-965 | S96221A | 24 | 963-965 | S99029G | 23 | 949-950 | ||
| S93619D | 23 | 949-950 | S96221D | 23 | 949-950 | S99029K | 23 | 949-950 | ||
| S93619S | 08 | 562-563 | S96221S | 09 | 604-605 | S99029P | 23 | 949-950 | ||
| S93621A | 08 | 562-563 | S96222A | 08 | 564-566 | S99029S | 21 | 913-914 | ||
| S93621A | 24 | 963-965 | S96222A | 24 | 963-965 | S99031A | 21 | 913-914 | ||
| S93621D | 23 | 949-950 | S96222D | 23 | 949-950 | S99031A | 24 | 963-965 | ||
| S93621S | 08 | 562-563 | S96222S | 09 | 604-605 | S99031B | 21 | 913-914 | ||
| S93622A | 08 | 562-563 | S96229A | 08 | 564-566 | S99031B | 24 | 963-965 | ||
| S93622A | 24 | 963-965 | S96229A | 24 | 963-965 | S99031D | 23 | 949-950 | ||
| S93622D | 23 | 949-950 | S96229D | 23 | 949-950 | S99031G | 23 | 949-950 | ||
| S93622S | 08 | 562-563 | S96229S | 09 | 604-605 | S99031K | 23 | 949-950 | ||
| S93629A | 08 | 562-563 | S96291A | 21 | 913-914 | S99031P | 23 | 949-950 | ||
| S93629A | 24 | 963-965 | S96291A | 24 | 963-965 | S99031S | 21 | 913-914 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |