ICD-10-CM/PCS MS-DRG v41.0 Definitions Manual |
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Diagnosis Code/MDC/MS-DRG Index |
Page 61 of 75 |
A000 B2781 C5712 C8418 D3002 E093219 E133599 F18251 G9204 H18811 H47529 I2541 I69315 J3503 K5731 L812 M05539 M21069 M45A7 M7070 M84444P M86559 N158 O0380 O3130X1 O365133 O6023X0 P2889 Q738 S0005XS S02610G S06384S S12400D S20374D S24144D S31149D S32443D S36209D S41119A S42354A S45012D S52001S S52244P S52389Q S53421A S59149K S61240D S62225A S62615D S63298D S66190D S71102D S72064P S7221XC S72412K S75192S S82009N S82192P S82444Q S8291XP S8700XD S91204D S92301D S93526S S99249B T22422D T24439A T370X5A T43013S T474X5S T5492XD T65292D T82111D T8613 Z808 |
DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
---|---|---|---|---|---|---|---|---|---|---|
S8700XD | 23 | 949-950 | S89222P | 08 | 564-566 | S90559D | 23 | 949-950 | ||
S8700XS | 09 | 604-605 | S89222S | 08 | 559-561 | S90559S | 09 | 604-605 | ||
S8701XA | 21 | 913-914 | S89229A | 08 | 562-563 | S90561A | 09 | 606-607 | ||
S8701XA | 24 | 963-965 | S89229A | 24 | 963-965 | S90561A | 24 | 963-965 | ||
S8701XD | 23 | 949-950 | S89229D | 08 | 559-561 | S90561D | 23 | 949-950 | ||
S8701XS | 09 | 604-605 | S89229G | 08 | 559-561 | S90561S | 09 | 604-605 | ||
S8702XA | 21 | 913-914 | S89229K | 08 | 564-566 | S90562A | 09 | 606-607 | ||
S8702XA | 24 | 963-965 | S89229P | 08 | 564-566 | S90562A | 24 | 963-965 | ||
S8702XD | 23 | 949-950 | S89229S | 08 | 559-561 | S90562D | 23 | 949-950 | ||
S8702XS | 09 | 604-605 | S89291A | 08 | 562-563 | S90562S | 09 | 604-605 | ||
S8780XA | 21 | 913-914 | S89291A | 24 | 963-965 | S90569A | 09 | 606-607 | ||
S8780XA | 24 | 963-965 | S89291D | 08 | 559-561 | S90569A | 24 | 963-965 | ||
S8780XD | 23 | 949-950 | S89291G | 08 | 559-561 | S90569D | 23 | 949-950 | ||
S8780XS | 09 | 604-605 | S89291K | 08 | 564-566 | S90569S | 09 | 604-605 | ||
S8781XA | 21 | 913-914 | S89291P | 08 | 564-566 | S90571A | 09 | 604-605 | ||
S8781XA | 24 | 963-965 | S89291S | 08 | 559-561 | S90571A | 24 | 963-965 | ||
S8781XD | 23 | 949-950 | S89292A | 08 | 562-563 | S90571D | 23 | 949-950 | ||
S8781XS | 09 | 604-605 | S89292A | 24 | 963-965 | S90571S | 09 | 604-605 | ||
S8782XA | 21 | 913-914 | S89292D | 08 | 559-561 | S90572A | 09 | 604-605 | ||
S8782XA | 24 | 963-965 | S89292G | 08 | 559-561 | S90572A | 24 | 963-965 | ||
S8782XD | 23 | 949-950 | S89292K | 08 | 564-566 | S90572D | 23 | 949-950 | ||
S8782XS | 09 | 604-605 | S89292P | 08 | 564-566 | S90572S | 09 | 604-605 | ||
S88011A | 21 | 913-914 | S89292S | 08 | 559-561 | S90579A | 09 | 604-605 | ||
S88011A | 24 | 963-965 | S89299A | 08 | 562-563 | S90579A | 24 | 963-965 | ||
S88011D | 23 | 949-950 | S89299A | 24 | 963-965 | S90579D | 23 | 949-950 | ||
S88011S | 08 | 559-561 | S89299D | 08 | 559-561 | S90579S | 09 | 604-605 | ||
S88012A | 21 | 913-914 | S89299G | 08 | 559-561 | S90811A | 09 | 604-605 | ||
S88012A | 24 | 963-965 | S89299K | 08 | 564-566 | S90811A | 24 | 963-965 | ||
S88012D | 23 | 949-950 | S89299P | 08 | 564-566 | S90811D | 23 | 949-950 | ||
S88012S | 08 | 559-561 | S89299S | 08 | 559-561 | S90811S | 09 | 604-605 | ||
S88019A | 21 | 913-914 | S89301A | 08 | 562-563 | S90812A | 09 | 604-605 | ||
S88019A | 24 | 963-965 | S89301A | 24 | 963-965 | S90812A | 24 | 963-965 | ||
S88019D | 23 | 949-950 | S89301D | 08 | 559-561 | S90812D | 23 | 949-950 | ||
S88019S | 08 | 559-561 | S89301G | 08 | 559-561 | S90812S | 09 | 604-605 | ||
S88021A | 21 | 913-914 | S89301K | 08 | 564-566 | S90819A | 09 | 604-605 | ||
S88021A | 24 | 963-965 | S89301P | 08 | 564-566 | S90819A | 24 | 963-965 | ||
S88021D | 23 | 949-950 | S89301S | 08 | 559-561 | S90819D | 23 | 949-950 | ||
S88021S | 08 | 559-561 | S89302A | 08 | 562-563 | S90819S | 09 | 604-605 | ||
S88022A | 21 | 913-914 | S89302A | 24 | 963-965 | S90821A | 09 | 606-607 | ||
S88022A | 24 | 963-965 | S89302D | 08 | 559-561 | S90821A | 24 | 963-965 | ||
S88022D | 23 | 949-950 | S89302G | 08 | 559-561 | S90821D | 23 | 949-950 | ||
S88022S | 08 | 559-561 | S89302K | 08 | 564-566 | S90821S | 09 | 604-605 | ||
S88029A | 21 | 913-914 | S89302P | 08 | 564-566 | S90822A | 09 | 606-607 | ||
S88029A | 24 | 963-965 | S89302S | 08 | 559-561 | S90822A | 24 | 963-965 | ||
S88029D | 23 | 949-950 | S89309A | 08 | 562-563 | S90822D | 23 | 949-950 | ||
S88029S | 08 | 559-561 | S89309A | 24 | 963-965 | S90822S | 09 | 604-605 | ||
S88111A | 21 | 913-914 | S89309D | 08 | 559-561 | S90829A | 09 | 606-607 | ||
S88111A | 24 | 963-965 | S89309G | 08 | 559-561 | S90829A | 24 | 963-965 | ||
S88111D | 23 | 949-950 | S89309K | 08 | 564-566 | S90829D | 23 | 949-950 | ||
S88111S | 08 | 559-561 | S89309P | 08 | 564-566 | S90829S | 09 | 604-605 | ||
S88112A | 21 | 913-914 | S89309S | 08 | 559-561 | S90841A | 09 | 604-605 | ||
S88112A | 24 | 963-965 | S89311A | 08 | 562-563 | S90841A | 24 | 963-965 | ||
S88112D | 23 | 949-950 | S89311A | 24 | 963-965 | S90841D | 23 | 949-950 | ||
S88112S | 08 | 559-561 | S89311D | 08 | 559-561 | S90841S | 09 | 604-605 | ||
S88119A | 21 | 913-914 | S89311G | 08 | 559-561 | S90842A | 09 | 604-605 | ||
S88119A | 24 | 963-965 | S89311K | 08 | 564-566 | S90842A | 24 | 963-965 | ||
S88119D | 23 | 949-950 | S89311P | 08 | 564-566 | S90842D | 23 | 949-950 | ||
S88119S | 08 | 559-561 | S89311S | 08 | 559-561 | S90842S | 09 | 604-605 | ||
S88121A | 21 | 913-914 | S89312A | 08 | 562-563 | S90849A | 09 | 604-605 | ||
S88121A | 24 | 963-965 | S89312A | 24 | 963-965 | S90849A | 24 | 963-965 | ||
S88121D | 23 | 949-950 | S89312D | 08 | 559-561 | S90849D | 23 | 949-950 | ||
S88121S | 08 | 559-561 | S89312G | 08 | 559-561 | S90849S | 09 | 604-605 | ||
S88122A | 21 | 913-914 | S89312K | 08 | 564-566 | S90851A | 09 | 604-605 | ||
S88122A | 24 | 963-965 | S89312P | 08 | 564-566 | S90851A | 24 | 963-965 | ||
S88122D | 23 | 949-950 | S89312S | 08 | 559-561 | S90851D | 23 | 949-950 | ||
S88122S | 08 | 559-561 | S89319A | 08 | 562-563 | S90851S | 09 | 604-605 | ||
S88129A | 21 | 913-914 | S89319A | 24 | 963-965 | S90852A | 09 | 604-605 | ||
S88129A | 24 | 963-965 | S89319D | 08 | 559-561 | S90852A | 24 | 963-965 | ||
S88129D | 23 | 949-950 | S89319G | 08 | 559-561 | S90852D | 23 | 949-950 | ||
S88129S | 08 | 559-561 | S89319K | 08 | 564-566 | S90852S | 09 | 604-605 | ||
S88911A | 21 | 913-914 | S89319P | 08 | 564-566 | S90859A | 09 | 604-605 | ||
S88911A | 24 | 963-965 | S89319S | 08 | 559-561 | S90859A | 24 | 963-965 | ||
S88911D | 23 | 949-950 | S89321A | 08 | 562-563 | S90859D | 23 | 949-950 | ||
S88911S | 08 | 559-561 | S89321A | 24 | 963-965 | S90859S | 09 | 604-605 | ||
S88912A | 21 | 913-914 | S89321D | 08 | 559-561 | S90861A | 09 | 606-607 | ||
S88912A | 24 | 963-965 | S89321G | 08 | 559-561 | S90861A | 24 | 963-965 | ||
S88912D | 23 | 949-950 | S89321K | 08 | 564-566 | S90861D | 23 | 949-950 | ||
S88912S | 08 | 559-561 | S89321P | 08 | 564-566 | S90861S | 09 | 604-605 | ||
S88919A | 21 | 913-914 | S89321S | 08 | 559-561 | S90862A | 09 | 606-607 | ||
S88919A | 24 | 963-965 | S89322A | 08 | 562-563 | S90862A | 24 | 963-965 | ||
S88919D | 23 | 949-950 | S89322A | 24 | 963-965 | S90862D | 23 | 949-950 | ||
S88919S | 08 | 559-561 | S89322D | 08 | 559-561 | S90862S | 09 | 604-605 | ||
S88921A | 21 | 913-914 | S89322G | 08 | 559-561 | S90869A | 09 | 606-607 | ||
S88921A | 24 | 963-965 | S89322K | 08 | 564-566 | S90869A | 24 | 963-965 | ||
S88921D | 23 | 949-950 | S89322P | 08 | 564-566 | S90869D | 23 | 949-950 | ||
S88921S | 08 | 559-561 | S89322S | 08 | 559-561 | S90869S | 09 | 604-605 | ||
S88922A | 21 | 913-914 | S89329A | 08 | 562-563 | S90871A | 09 | 604-605 | ||
S88922A | 24 | 963-965 | S89329A | 24 | 963-965 | S90871A | 24 | 963-965 | ||
S88922D | 23 | 949-950 | S89329D | 08 | 559-561 | S90871D | 23 | 949-950 | ||
S88922S | 08 | 559-561 | S89329G | 08 | 559-561 | S90871S | 09 | 604-605 | ||
S88929A | 21 | 913-914 | S89329K | 08 | 564-566 | S90872A | 09 | 604-605 | ||
S88929A | 24 | 963-965 | S89329P | 08 | 564-566 | S90872A | 24 | 963-965 | ||
S88929D | 23 | 949-950 | S89329S | 08 | 559-561 | S90872D | 23 | 949-950 | ||
S88929S | 08 | 559-561 | S89391A | 08 | 562-563 | S90872S | 09 | 604-605 | ||
S89001A | 08 | 562-563 | S89391A | 24 | 963-965 | S90879A | 09 | 604-605 | ||
S89001A | 24 | 963-965 | S89391D | 08 | 559-561 | S90879A | 24 | 963-965 | ||
S89001D | 08 | 559-561 | S89391G | 08 | 559-561 | S90879D | 23 | 949-950 | ||
S89001G | 08 | 559-561 | S89391K | 08 | 564-566 | S90879S | 09 | 604-605 | ||
S89001K | 08 | 564-566 | S89391P | 08 | 564-566 | S90911A | 09 | 604-605 | ||
S89001P | 08 | 564-566 | S89391S | 08 | 559-561 | S90911A | 24 | 963-965 | ||
S89001S | 08 | 559-561 | S89392A | 08 | 562-563 | S90911D | 23 | 949-950 | ||
S89002A | 08 | 562-563 | S89392A | 24 | 963-965 | S90911S | 09 | 604-605 | ||
S89002A | 24 | 963-965 | S89392D | 08 | 559-561 | S90912A | 09 | 604-605 | ||
S89002D | 08 | 559-561 | S89392G | 08 | 559-561 | S90912A | 24 | 963-965 | ||
S89002G | 08 | 559-561 | S89392K | 08 | 564-566 | S90912D | 23 | 949-950 | ||
S89002K | 08 | 564-566 | S89392P | 08 | 564-566 | S90912S | 09 | 604-605 | ||
S89002P | 08 | 564-566 | S89392S | 08 | 559-561 | S90919A | 09 | 604-605 | ||
S89002S | 08 | 559-561 | S89399A | 08 | 562-563 | S90919A | 24 | 963-965 | ||
S89009A | 08 | 562-563 | S89399A | 24 | 963-965 | S90919D | 23 | 949-950 | ||
S89009A | 24 | 963-965 | S89399D | 08 | 559-561 | S90919S | 09 | 604-605 | ||
S89009D | 08 | 559-561 | S89399G | 08 | 559-561 | S90921A | 09 | 604-605 | ||
S89009G | 08 | 559-561 | S89399K | 08 | 564-566 | S90921A | 24 | 963-965 | ||
S89009K | 08 | 564-566 | S89399P | 08 | 564-566 | S90921D | 23 | 949-950 | ||
S89009P | 08 | 564-566 | S89399S | 08 | 559-561 | S90921S | 09 | 604-605 | ||
S89009S | 08 | 559-561 | S8980XA | 21 | 913-914 | S90922A | 09 | 604-605 | ||
S89011A | 08 | 562-563 | S8980XA | 24 | 963-965 | S90922A | 24 | 963-965 | ||
S89011A | 24 | 963-965 | S8980XD | 23 | 949-950 | S90922D | 23 | 949-950 | ||
S89011D | 08 | 559-561 | S8980XS | 21 | 913-914 | S90922S | 09 | 604-605 | ||
S89011G | 08 | 559-561 | S8981XA | 21 | 913-914 | S90929A | 09 | 604-605 | ||
S89011K | 08 | 564-566 | S8981XA | 24 | 963-965 | S90929A | 24 | 963-965 | ||
S89011P | 08 | 564-566 | S8981XD | 23 | 949-950 | S90929D | 23 | 949-950 | ||
S89011S | 08 | 559-561 | S8981XS | 21 | 913-914 | S90929S | 09 | 604-605 | ||
S89012A | 08 | 562-563 | S8982XA | 21 | 913-914 | S90931A | 09 | 604-605 | ||
S89012A | 24 | 963-965 | S8982XA | 24 | 963-965 | S90931A | 24 | 963-965 | ||
S89012D | 08 | 559-561 | S8982XD | 23 | 949-950 | S90931D | 23 | 949-950 | ||
S89012G | 08 | 559-561 | S8982XS | 21 | 913-914 | S90931S | 09 | 604-605 | ||
S89012K | 08 | 564-566 | S8990XA | 21 | 913-914 | S90932A | 09 | 604-605 | ||
S89012P | 08 | 564-566 | S8990XA | 24 | 963-965 | S90932A | 24 | 963-965 | ||
S89012S | 08 | 559-561 | S8990XD | 23 | 949-950 | S90932D | 23 | 949-950 | ||
S89019A | 08 | 562-563 | S8990XS | 21 | 913-914 | S90932S | 09 | 604-605 | ||
S89019A | 24 | 963-965 | S8991XA | 21 | 913-914 | S90933A | 09 | 604-605 | ||
S89019D | 08 | 559-561 | S8991XA | 24 | 963-965 | S90933A | 24 | 963-965 | ||
S89019G | 08 | 559-561 | S8991XD | 23 | 949-950 | S90933D | 23 | 949-950 | ||
S89019K | 08 | 564-566 | S8991XS | 21 | 913-914 | S90933S | 09 | 604-605 | ||
S89019P | 08 | 564-566 | S8992XA | 21 | 913-914 | S90934A | 09 | 604-605 | ||
S89019S | 08 | 559-561 | S8992XA | 24 | 963-965 | S90934A | 24 | 963-965 | ||
S89021A | 08 | 562-563 | S8992XD | 23 | 949-950 | S90934D | 23 | 949-950 | ||
S89021A | 24 | 963-965 | S8992XS | 21 | 913-914 | S90934S | 09 | 604-605 | ||
S89021D | 08 | 559-561 | S9000XA | 09 | 604-605 | S90935A | 09 | 604-605 | ||
S89021G | 08 | 559-561 | S9000XA | 24 | 963-965 | S90935A | 24 | 963-965 | ||
S89021K | 08 | 564-566 | S9000XD | 23 | 949-950 | S90935D | 23 | 949-950 | ||
S89021P | 08 | 564-566 | S9000XS | 09 | 604-605 | S90935S | 09 | 604-605 | ||
S89021S | 08 | 559-561 | S9001XA | 09 | 604-605 | S90936A | 09 | 604-605 | ||
S89022A | 08 | 562-563 | S9001XA | 24 | 963-965 | S90936A | 24 | 963-965 | ||
S89022A | 24 | 963-965 | S9001XD | 23 | 949-950 | S90936D | 23 | 949-950 | ||
S89022D | 08 | 559-561 | S9001XS | 09 | 604-605 | S90936S | 09 | 604-605 | ||
S89022G | 08 | 559-561 | S9002XA | 09 | 604-605 | S91001A | 09 | 604-605 | ||
S89022K | 08 | 564-566 | S9002XA | 24 | 963-965 | S91001A | 24 | 963-965 | ||
S89022P | 08 | 564-566 | S9002XD | 23 | 949-950 | S91001D | 23 | 949-950 | ||
S89022S | 08 | 559-561 | S9002XS | 09 | 604-605 | S91001S | 09 | 604-605 | ||
S89029A | 08 | 562-563 | S90111A | 09 | 604-605 | S91002A | 09 | 604-605 | ||
S89029A | 24 | 963-965 | S90111A | 24 | 963-965 | S91002A | 24 | 963-965 | ||
S89029D | 08 | 559-561 | S90111D | 23 | 949-950 | S91002D | 23 | 949-950 | ||
S89029G | 08 | 559-561 | S90111S | 09 | 604-605 | S91002S | 09 | 604-605 | ||
S89029K | 08 | 564-566 | S90112A | 09 | 604-605 | S91009A | 09 | 604-605 | ||
S89029P | 08 | 564-566 | S90112A | 24 | 963-965 | S91009A | 24 | 963-965 | ||
S89029S | 08 | 559-561 | S90112D | 23 | 949-950 | S91009D | 23 | 949-950 | ||
S89031A | 08 | 562-563 | S90112S | 09 | 604-605 | S91009S | 09 | 604-605 | ||
S89031A | 24 | 963-965 | S90119A | 09 | 604-605 | S91011A | 09 | 604-605 | ||
S89031D | 08 | 559-561 | S90119A | 24 | 963-965 | S91011A | 24 | 963-965 | ||
S89031G | 08 | 559-561 | S90119D | 23 | 949-950 | S91011D | 23 | 949-950 | ||
S89031K | 08 | 564-566 | S90119S | 09 | 604-605 | S91011S | 09 | 604-605 | ||
S89031P | 08 | 564-566 | S90121A | 09 | 604-605 | S91012A | 09 | 604-605 | ||
S89031S | 08 | 559-561 | S90121A | 24 | 963-965 | S91012A | 24 | 963-965 | ||
S89032A | 08 | 562-563 | S90121D | 23 | 949-950 | S91012D | 23 | 949-950 | ||
S89032A | 24 | 963-965 | S90121S | 09 | 604-605 | S91012S | 09 | 604-605 | ||
S89032D | 08 | 559-561 | S90122A | 09 | 604-605 | S91019A | 09 | 604-605 | ||
S89032G | 08 | 559-561 | S90122A | 24 | 963-965 | S91019A | 24 | 963-965 | ||
S89032K | 08 | 564-566 | S90122D | 23 | 949-950 | S91019D | 23 | 949-950 | ||
S89032P | 08 | 564-566 | S90122S | 09 | 604-605 | S91019S | 09 | 604-605 | ||
S89032S | 08 | 559-561 | S90129A | 09 | 604-605 | S91021A | 21 | 913-914 | ||
S89039A | 08 | 562-563 | S90129A | 24 | 963-965 | S91021A | 24 | 963-965 | ||
S89039A | 24 | 963-965 | S90129D | 23 | 949-950 | S91021D | 23 | 949-950 | ||
S89039D | 08 | 559-561 | S90129S | 09 | 604-605 | S91021S | 09 | 604-605 | ||
S89039G | 08 | 559-561 | S90211A | 09 | 604-605 | S91022A | 21 | 913-914 | ||
S89039K | 08 | 564-566 | S90211A | 24 | 963-965 | S91022A | 24 | 963-965 | ||
S89039P | 08 | 564-566 | S90211D | 23 | 949-950 | S91022D | 23 | 949-950 | ||
S89039S | 08 | 559-561 | S90211S | 09 | 604-605 | S91022S | 09 | 604-605 | ||
S89041A | 08 | 562-563 | S90212A | 09 | 604-605 | S91029A | 21 | 913-914 | ||
S89041A | 24 | 963-965 | S90212A | 24 | 963-965 | S91029A | 24 | 963-965 | ||
S89041D | 08 | 559-561 | S90212D | 23 | 949-950 | S91029D | 23 | 949-950 | ||
S89041G | 08 | 559-561 | S90212S | 09 | 604-605 | S91029S | 09 | 604-605 | ||
S89041K | 08 | 564-566 | S90219A | 09 | 604-605 | S91031A | 09 | 604-605 | ||
S89041P | 08 | 564-566 | S90219A | 24 | 963-965 | S91031A | 24 | 963-965 | ||
S89041S | 08 | 559-561 | S90219D | 23 | 949-950 | S91031D | 23 | 949-950 | ||
S89042A | 08 | 562-563 | S90219S | 09 | 604-605 | S91031S | 09 | 604-605 | ||
S89042A | 24 | 963-965 | S90221A | 09 | 604-605 | S91032A | 09 | 604-605 | ||
S89042D | 08 | 559-561 | S90221A | 24 | 963-965 | S91032A | 24 | 963-965 | ||
S89042G | 08 | 559-561 | S90221D | 23 | 949-950 | S91032D | 23 | 949-950 | ||
S89042K | 08 | 564-566 | S90221S | 09 | 604-605 | S91032S | 09 | 604-605 | ||
S89042P | 08 | 564-566 | S90222A | 09 | 604-605 | S91039A | 09 | 604-605 | ||
S89042S | 08 | 559-561 | S90222A | 24 | 963-965 | S91039A | 24 | 963-965 | ||
S89049A | 08 | 562-563 | S90222D | 23 | 949-950 | S91039D | 23 | 949-950 | ||
S89049A | 24 | 963-965 | S90222S | 09 | 604-605 | S91039S | 09 | 604-605 | ||
S89049D | 08 | 559-561 | S90229A | 09 | 604-605 | S91041A | 21 | 913-914 | ||
S89049G | 08 | 559-561 | S90229A | 24 | 963-965 | S91041A | 24 | 963-965 | ||
S89049K | 08 | 564-566 | S90229D | 23 | 949-950 | S91041D | 23 | 949-950 | ||
S89049P | 08 | 564-566 | S90229S | 09 | 604-605 | S91041S | 09 | 604-605 | ||
S89049S | 08 | 559-561 | S9030XA | 09 | 604-605 | S91042A | 21 | 913-914 | ||
S89091A | 08 | 562-563 | S9030XA | 24 | 963-965 | S91042A | 24 | 963-965 | ||
S89091A | 24 | 963-965 | S9030XD | 23 | 949-950 | S91042D | 23 | 949-950 | ||
S89091D | 08 | 559-561 | S9030XS | 09 | 604-605 | S91042S | 09 | 604-605 | ||
S89091G | 08 | 559-561 | S9031XA | 09 | 604-605 | S91049A | 21 | 913-914 | ||
S89091K | 08 | 564-566 | S9031XA | 24 | 963-965 | S91049A | 24 | 963-965 | ||
S89091P | 08 | 564-566 | S9031XD | 23 | 949-950 | S91049D | 23 | 949-950 | ||
S89091S | 08 | 559-561 | S9031XS | 09 | 604-605 | S91049S | 09 | 604-605 | ||
S89092A | 08 | 562-563 | S9032XA | 09 | 604-605 | S91051A | 09 | 604-605 | ||
S89092A | 24 | 963-965 | S9032XA | 24 | 963-965 | S91051A | 24 | 963-965 | ||
S89092D | 08 | 559-561 | S9032XD | 23 | 949-950 | S91051D | 23 | 949-950 | ||
S89092G | 08 | 559-561 | S9032XS | 09 | 604-605 | S91051S | 09 | 604-605 | ||
S89092K | 08 | 564-566 | S90411A | 09 | 604-605 | S91052A | 09 | 604-605 | ||
S89092P | 08 | 564-566 | S90411A | 24 | 963-965 | S91052A | 24 | 963-965 | ||
S89092S | 08 | 559-561 | S90411D | 23 | 949-950 | S91052D | 23 | 949-950 | ||
S89099A | 08 | 562-563 | S90411S | 09 | 604-605 | S91052S | 09 | 604-605 | ||
S89099A | 24 | 963-965 | S90412A | 09 | 604-605 | S91059A | 09 | 604-605 | ||
S89099D | 08 | 559-561 | S90412A | 24 | 963-965 | S91059A | 24 | 963-965 | ||
S89099G | 08 | 559-561 | S90412D | 23 | 949-950 | S91059D | 23 | 949-950 | ||
S89099K | 08 | 564-566 | S90412S | 09 | 604-605 | S91059S | 09 | 604-605 | ||
S89099P | 08 | 564-566 | S90413A | 09 | 604-605 | S91101A | 09 | 604-605 | ||
S89099S | 08 | 559-561 | S90413A | 24 | 963-965 | S91101A | 24 | 963-965 | ||
S89101A | 08 | 562-563 | S90413D | 23 | 949-950 | S91101D | 23 | 949-950 | ||
S89101A | 24 | 963-965 | S90413S | 09 | 604-605 | S91101S | 09 | 604-605 | ||
S89101D | 08 | 559-561 | S90414A | 09 | 604-605 | S91102A | 09 | 604-605 | ||
S89101G | 08 | 559-561 | S90414A | 24 | 963-965 | S91102A | 24 | 963-965 | ||
S89101K | 08 | 564-566 | S90414D | 23 | 949-950 | S91102D | 23 | 949-950 | ||
S89101P | 08 | 564-566 | S90414S | 09 | 604-605 | S91102S | 09 | 604-605 | ||
S89101S | 08 | 559-561 | S90415A | 09 | 604-605 | S91103A | 09 | 604-605 | ||
S89102A | 08 | 562-563 | S90415A | 24 | 963-965 | S91103A | 24 | 963-965 | ||
S89102A | 24 | 963-965 | S90415D | 23 | 949-950 | S91103D | 23 | 949-950 | ||
S89102D | 08 | 559-561 | S90415S | 09 | 604-605 | S91103S | 09 | 604-605 | ||
S89102G | 08 | 559-561 | S90416A | 09 | 604-605 | S91104A | 09 | 604-605 | ||
S89102K | 08 | 564-566 | S90416A | 24 | 963-965 | S91104A | 24 | 963-965 | ||
S89102P | 08 | 564-566 | S90416D | 23 | 949-950 | S91104D | 23 | 949-950 | ||
S89102S | 08 | 559-561 | S90416S | 09 | 604-605 | S91104S | 09 | 604-605 | ||
S89109A | 08 | 562-563 | S90421A | 09 | 606-607 | S91105A | 09 | 604-605 | ||
S89109A | 24 | 963-965 | S90421A | 24 | 963-965 | S91105A | 24 | 963-965 | ||
S89109D | 08 | 559-561 | S90421D | 23 | 949-950 | S91105D | 23 | 949-950 | ||
S89109G | 08 | 559-561 | S90421S | 09 | 604-605 | S91105S | 09 | 604-605 | ||
S89109K | 08 | 564-566 | S90422A | 09 | 606-607 | S91106A | 09 | 604-605 | ||
S89109P | 08 | 564-566 | S90422A | 24 | 963-965 | S91106A | 24 | 963-965 | ||
S89109S | 08 | 559-561 | S90422D | 23 | 949-950 | S91106D | 23 | 949-950 | ||
S89111A | 08 | 562-563 | S90422S | 09 | 604-605 | S91106S | 09 | 604-605 | ||
S89111A | 24 | 963-965 | S90423A | 09 | 606-607 | S91109A | 09 | 604-605 | ||
S89111D | 08 | 559-561 | S90423A | 24 | 963-965 | S91109A | 24 | 963-965 | ||
S89111G | 08 | 559-561 | S90423D | 23 | 949-950 | S91109D | 23 | 949-950 | ||
S89111K | 08 | 564-566 | S90423S | 09 | 604-605 | S91109S | 09 | 604-605 | ||
S89111P | 08 | 564-566 | S90424A | 09 | 606-607 | S91111A | 09 | 604-605 | ||
S89111S | 08 | 559-561 | S90424A | 24 | 963-965 | S91111A | 24 | 963-965 | ||
S89112A | 08 | 562-563 | S90424D | 23 | 949-950 | S91111D | 23 | 949-950 | ||
S89112A | 24 | 963-965 | S90424S | 09 | 604-605 | S91111S | 09 | 604-605 | ||
S89112D | 08 | 559-561 | S90425A | 09 | 606-607 | S91112A | 09 | 604-605 | ||
S89112G | 08 | 559-561 | S90425A | 24 | 963-965 | S91112A | 24 | 963-965 | ||
S89112K | 08 | 564-566 | S90425D | 23 | 949-950 | S91112D | 23 | 949-950 | ||
S89112P | 08 | 564-566 | S90425S | 09 | 604-605 | S91112S | 09 | 604-605 | ||
S89112S | 08 | 559-561 | S90426A | 09 | 606-607 | S91113A | 09 | 604-605 | ||
S89119A | 08 | 562-563 | S90426A | 24 | 963-965 | S91113A | 24 | 963-965 | ||
S89119A | 24 | 963-965 | S90426D | 23 | 949-950 | S91113D | 23 | 949-950 | ||
S89119D | 08 | 559-561 | S90426S | 09 | 604-605 | S91113S | 09 | 604-605 | ||
S89119G | 08 | 559-561 | S90441A | 09 | 604-605 | S91114A | 09 | 604-605 | ||
S89119K | 08 | 564-566 | S90441A | 24 | 963-965 | S91114A | 24 | 963-965 | ||
S89119P | 08 | 564-566 | S90441D | 23 | 949-950 | S91114D | 23 | 949-950 | ||
S89119S | 08 | 559-561 | S90441S | 09 | 604-605 | S91114S | 09 | 604-605 | ||
S89121A | 08 | 562-563 | S90442A | 09 | 604-605 | S91115A | 09 | 604-605 | ||
S89121A | 24 | 963-965 | S90442A | 24 | 963-965 | S91115A | 24 | 963-965 | ||
S89121D | 08 | 559-561 | S90442D | 23 | 949-950 | S91115D | 23 | 949-950 | ||
S89121G | 08 | 559-561 | S90442S | 09 | 604-605 | S91115S | 09 | 604-605 | ||
S89121K | 08 | 564-566 | S90443A | 09 | 604-605 | S91116A | 09 | 604-605 | ||
S89121P | 08 | 564-566 | S90443A | 24 | 963-965 | S91116A | 24 | 963-965 | ||
S89121S | 08 | 559-561 | S90443D | 23 | 949-950 | S91116D | 23 | 949-950 | ||
S89122A | 08 | 562-563 | S90443S | 09 | 604-605 | S91116S | 09 | 604-605 | ||
S89122A | 24 | 963-965 | S90444A | 09 | 604-605 | S91119A | 09 | 604-605 | ||
S89122D | 08 | 559-561 | S90444A | 24 | 963-965 | S91119A | 24 | 963-965 | ||
S89122G | 08 | 559-561 | S90444D | 23 | 949-950 | S91119D | 23 | 949-950 | ||
S89122K | 08 | 564-566 | S90444S | 09 | 604-605 | S91119S | 09 | 604-605 | ||
S89122P | 08 | 564-566 | S90445A | 09 | 604-605 | S91121A | 21 | 913-914 | ||
S89122S | 08 | 559-561 | S90445A | 24 | 963-965 | S91121A | 24 | 963-965 | ||
S89129A | 08 | 562-563 | S90445D | 23 | 949-950 | S91121D | 23 | 949-950 | ||
S89129A | 24 | 963-965 | S90445S | 09 | 604-605 | S91121S | 09 | 604-605 | ||
S89129D | 08 | 559-561 | S90446A | 09 | 604-605 | S91122A | 21 | 913-914 | ||
S89129G | 08 | 559-561 | S90446A | 24 | 963-965 | S91122A | 24 | 963-965 | ||
S89129K | 08 | 564-566 | S90446D | 23 | 949-950 | S91122D | 23 | 949-950 | ||
S89129P | 08 | 564-566 | S90446S | 09 | 604-605 | S91122S | 09 | 604-605 | ||
S89129S | 08 | 559-561 | S90451A | 09 | 604-605 | S91123A | 21 | 913-914 | ||
S89131A | 08 | 562-563 | S90451A | 24 | 963-965 | S91123A | 24 | 963-965 | ||
S89131A | 24 | 963-965 | S90451D | 23 | 949-950 | S91123D | 23 | 949-950 | ||
S89131D | 08 | 559-561 | S90451S | 09 | 604-605 | S91123S | 09 | 604-605 | ||
S89131G | 08 | 559-561 | S90452A | 09 | 604-605 | S91124A | 21 | 913-914 | ||
S89131K | 08 | 564-566 | S90452A | 24 | 963-965 | S91124A | 24 | 963-965 | ||
S89131P | 08 | 564-566 | S90452D | 23 | 949-950 | S91124D | 23 | 949-950 | ||
S89131S | 08 | 559-561 | S90452S | 09 | 604-605 | S91124S | 09 | 604-605 | ||
S89132A | 08 | 562-563 | S90453A | 09 | 604-605 | S91125A | 21 | 913-914 | ||
S89132A | 24 | 963-965 | S90453A | 24 | 963-965 | S91125A | 24 | 963-965 | ||
S89132D | 08 | 559-561 | S90453D | 23 | 949-950 | S91125D | 23 | 949-950 | ||
S89132G | 08 | 559-561 | S90453S | 09 | 604-605 | S91125S | 09 | 604-605 | ||
S89132K | 08 | 564-566 | S90454A | 09 | 604-605 | S91126A | 21 | 913-914 | ||
S89132P | 08 | 564-566 | S90454A | 24 | 963-965 | S91126A | 24 | 963-965 | ||
S89132S | 08 | 559-561 | S90454D | 23 | 949-950 | S91126D | 23 | 949-950 | ||
S89139A | 08 | 562-563 | S90454S | 09 | 604-605 | S91126S | 09 | 604-605 | ||
S89139A | 24 | 963-965 | S90455A | 09 | 604-605 | S91129A | 21 | 913-914 | ||
S89139D | 08 | 559-561 | S90455A | 24 | 963-965 | S91129A | 24 | 963-965 | ||
S89139G | 08 | 559-561 | S90455D | 23 | 949-950 | S91129D | 23 | 949-950 | ||
S89139K | 08 | 564-566 | S90455S | 09 | 604-605 | S91129S | 09 | 604-605 | ||
S89139P | 08 | 564-566 | S90456A | 09 | 604-605 | S91131A | 09 | 604-605 | ||
S89139S | 08 | 559-561 | S90456A | 24 | 963-965 | S91131A | 24 | 963-965 | ||
S89141A | 08 | 562-563 | S90456D | 23 | 949-950 | S91131D | 23 | 949-950 | ||
S89141A | 24 | 963-965 | S90456S | 09 | 604-605 | S91131S | 09 | 604-605 | ||
S89141D | 08 | 559-561 | S90461A | 09 | 606-607 | S91132A | 09 | 604-605 | ||
S89141G | 08 | 559-561 | S90461A | 24 | 963-965 | S91132A | 24 | 963-965 | ||
S89141K | 08 | 564-566 | S90461D | 23 | 949-950 | S91132D | 23 | 949-950 | ||
S89141P | 08 | 564-566 | S90461S | 09 | 604-605 | S91132S | 09 | 604-605 | ||
S89141S | 08 | 559-561 | S90462A | 09 | 606-607 | S91133A | 09 | 604-605 | ||
S89142A | 08 | 562-563 | S90462A | 24 | 963-965 | S91133A | 24 | 963-965 | ||
S89142A | 24 | 963-965 | S90462D | 23 | 949-950 | S91133D | 23 | 949-950 | ||
S89142D | 08 | 559-561 | S90462S | 09 | 604-605 | S91133S | 09 | 604-605 | ||
S89142G | 08 | 559-561 | S90463A | 09 | 606-607 | S91134A | 09 | 604-605 | ||
S89142K | 08 | 564-566 | S90463A | 24 | 963-965 | S91134A | 24 | 963-965 | ||
S89142P | 08 | 564-566 | S90463D | 23 | 949-950 | S91134D | 23 | 949-950 | ||
S89142S | 08 | 559-561 | S90463S | 09 | 604-605 | S91134S | 09 | 604-605 | ||
S89149A | 08 | 562-563 | S90464A | 09 | 606-607 | S91135A | 09 | 604-605 | ||
S89149A | 24 | 963-965 | S90464A | 24 | 963-965 | S91135A | 24 | 963-965 | ||
S89149D | 08 | 559-561 | S90464D | 23 | 949-950 | S91135D | 23 | 949-950 | ||
S89149G | 08 | 559-561 | S90464S | 09 | 604-605 | S91135S | 09 | 604-605 | ||
S89149K | 08 | 564-566 | S90465A | 09 | 606-607 | S91136A | 09 | 604-605 | ||
S89149P | 08 | 564-566 | S90465A | 24 | 963-965 | S91136A | 24 | 963-965 | ||
S89149S | 08 | 559-561 | S90465D | 23 | 949-950 | S91136D | 23 | 949-950 | ||
S89191A | 08 | 562-563 | S90465S | 09 | 604-605 | S91136S | 09 | 604-605 | ||
S89191A | 24 | 963-965 | S90466A | 09 | 606-607 | S91139A | 09 | 604-605 | ||
S89191D | 08 | 559-561 | S90466A | 24 | 963-965 | S91139A | 24 | 963-965 | ||
S89191G | 08 | 559-561 | S90466D | 23 | 949-950 | S91139D | 23 | 949-950 | ||
S89191K | 08 | 564-566 | S90466S | 09 | 604-605 | S91139S | 09 | 604-605 | ||
S89191P | 08 | 564-566 | S90471A | 09 | 604-605 | S91141A | 21 | 913-914 | ||
S89191S | 08 | 559-561 | S90471A | 24 | 963-965 | S91141A | 24 | 963-965 | ||
S89192A | 08 | 562-563 | S90471D | 23 | 949-950 | S91141D | 23 | 949-950 | ||
S89192A | 24 | 963-965 | S90471S | 09 | 604-605 | S91141S | 09 | 604-605 | ||
S89192D | 08 | 559-561 | S90472A | 09 | 604-605 | S91142A | 21 | 913-914 | ||
S89192G | 08 | 559-561 | S90472A | 24 | 963-965 | S91142A | 24 | 963-965 | ||
S89192K | 08 | 564-566 | S90472D | 23 | 949-950 | S91142D | 23 | 949-950 | ||
S89192P | 08 | 564-566 | S90472S | 09 | 604-605 | S91142S | 09 | 604-605 | ||
S89192S | 08 | 559-561 | S90473A | 09 | 604-605 | S91143A | 21 | 913-914 | ||
S89199A | 08 | 562-563 | S90473A | 24 | 963-965 | S91143A | 24 | 963-965 | ||
S89199A | 24 | 963-965 | S90473D | 23 | 949-950 | S91143D | 23 | 949-950 | ||
S89199D | 08 | 559-561 | S90473S | 09 | 604-605 | S91143S | 09 | 604-605 | ||
S89199G | 08 | 559-561 | S90474A | 09 | 604-605 | S91144A | 21 | 913-914 | ||
S89199K | 08 | 564-566 | S90474A | 24 | 963-965 | S91144A | 24 | 963-965 | ||
S89199P | 08 | 564-566 | S90474D | 23 | 949-950 | S91144D | 23 | 949-950 | ||
S89199S | 08 | 559-561 | S90474S | 09 | 604-605 | S91144S | 09 | 604-605 | ||
S89201A | 08 | 562-563 | S90475A | 09 | 604-605 | S91145A | 21 | 913-914 | ||
S89201A | 24 | 963-965 | S90475A | 24 | 963-965 | S91145A | 24 | 963-965 | ||
S89201D | 08 | 559-561 | S90475D | 23 | 949-950 | S91145D | 23 | 949-950 | ||
S89201G | 08 | 559-561 | S90475S | 09 | 604-605 | S91145S | 09 | 604-605 | ||
S89201K | 08 | 564-566 | S90476A | 09 | 604-605 | S91146A | 21 | 913-914 | ||
S89201P | 08 | 564-566 | S90476A | 24 | 963-965 | S91146A | 24 | 963-965 | ||
S89201S | 08 | 559-561 | S90476D | 23 | 949-950 | S91146D | 23 | 949-950 | ||
S89202A | 08 | 562-563 | S90476S | 09 | 604-605 | S91146S | 09 | 604-605 | ||
S89202A | 24 | 963-965 | S90511A | 09 | 604-605 | S91149A | 21 | 913-914 | ||
S89202D | 08 | 559-561 | S90511A | 24 | 963-965 | S91149A | 24 | 963-965 | ||
S89202G | 08 | 559-561 | S90511D | 23 | 949-950 | S91149D | 23 | 949-950 | ||
S89202K | 08 | 564-566 | S90511S | 09 | 604-605 | S91149S | 09 | 604-605 | ||
S89202P | 08 | 564-566 | S90512A | 09 | 604-605 | S91151A | 09 | 604-605 | ||
S89202S | 08 | 559-561 | S90512A | 24 | 963-965 | S91151A | 24 | 963-965 | ||
S89209A | 08 | 562-563 | S90512D | 23 | 949-950 | S91151D | 23 | 949-950 | ||
S89209A | 24 | 963-965 | S90512S | 09 | 604-605 | S91151S | 09 | 604-605 | ||
S89209D | 08 | 559-561 | S90519A | 09 | 604-605 | S91152A | 09 | 604-605 | ||
S89209G | 08 | 559-561 | S90519A | 24 | 963-965 | S91152A | 24 | 963-965 | ||
S89209K | 08 | 564-566 | S90519D | 23 | 949-950 | S91152D | 23 | 949-950 | ||
S89209P | 08 | 564-566 | S90519S | 09 | 604-605 | S91152S | 09 | 604-605 | ||
S89209S | 08 | 559-561 | S90521A | 09 | 606-607 | S91153A | 09 | 604-605 | ||
S89211A | 08 | 562-563 | S90521A | 24 | 963-965 | S91153A | 24 | 963-965 | ||
S89211A | 24 | 963-965 | S90521D | 23 | 949-950 | S91153D | 23 | 949-950 | ||
S89211D | 08 | 559-561 | S90521S | 09 | 604-605 | S91153S | 09 | 604-605 | ||
S89211G | 08 | 559-561 | S90522A | 09 | 606-607 | S91154A | 09 | 604-605 | ||
S89211K | 08 | 564-566 | S90522A | 24 | 963-965 | S91154A | 24 | 963-965 | ||
S89211P | 08 | 564-566 | S90522D | 23 | 949-950 | S91154D | 23 | 949-950 | ||
S89211S | 08 | 559-561 | S90522S | 09 | 604-605 | S91154S | 09 | 604-605 | ||
S89212A | 08 | 562-563 | S90529A | 09 | 606-607 | S91155A | 09 | 604-605 | ||
S89212A | 24 | 963-965 | S90529A | 24 | 963-965 | S91155A | 24 | 963-965 | ||
S89212D | 08 | 559-561 | S90529D | 23 | 949-950 | S91155D | 23 | 949-950 | ||
S89212G | 08 | 559-561 | S90529S | 09 | 604-605 | S91155S | 09 | 604-605 | ||
S89212K | 08 | 564-566 | S90541A | 09 | 604-605 | S91156A | 09 | 604-605 | ||
S89212P | 08 | 564-566 | S90541A | 24 | 963-965 | S91156A | 24 | 963-965 | ||
S89212S | 08 | 559-561 | S90541D | 23 | 949-950 | S91156D | 23 | 949-950 | ||
S89219A | 08 | 562-563 | S90541S | 09 | 604-605 | S91156S | 09 | 604-605 | ||
S89219A | 24 | 963-965 | S90542A | 09 | 604-605 | S91159A | 09 | 604-605 | ||
S89219D | 08 | 559-561 | S90542A | 24 | 963-965 | S91159A | 24 | 963-965 | ||
S89219G | 08 | 559-561 | S90542D | 23 | 949-950 | S91159D | 23 | 949-950 | ||
S89219K | 08 | 564-566 | S90542S | 09 | 604-605 | S91159S | 09 | 604-605 | ||
S89219P | 08 | 564-566 | S90549A | 09 | 604-605 | S91201A | 09 | 604-605 | ||
S89219S | 08 | 559-561 | S90549A | 24 | 963-965 | S91201A | 24 | 963-965 | ||
S89221A | 08 | 562-563 | S90549D | 23 | 949-950 | S91201D | 23 | 949-950 | ||
S89221A | 24 | 963-965 | S90549S | 09 | 604-605 | S91201S | 09 | 604-605 | ||
S89221D | 08 | 559-561 | S90551A | 09 | 604-605 | S91202A | 09 | 604-605 | ||
S89221G | 08 | 559-561 | S90551A | 24 | 963-965 | S91202A | 24 | 963-965 | ||
S89221K | 08 | 564-566 | S90551D | 23 | 949-950 | S91202D | 23 | 949-950 | ||
S89221P | 08 | 564-566 | S90551S | 09 | 604-605 | S91202S | 09 | 604-605 | ||
S89221S | 08 | 559-561 | S90552A | 09 | 604-605 | S91203A | 09 | 604-605 | ||
S89222A | 08 | 562-563 | S90552A | 24 | 963-965 | S91203A | 24 | 963-965 | ||
S89222A | 24 | 963-965 | S90552D | 23 | 949-950 | S91203D | 23 | 949-950 | ||
S89222D | 08 | 559-561 | S90552S | 09 | 604-605 | S91203S | 09 | 604-605 | ||
S89222G | 08 | 559-561 | S90559A | 09 | 604-605 | S91204A | 09 | 604-605 | ||
S89222K | 08 | 564-566 | S90559A | 24 | 963-965 | S91204A | 24 | 963-965 |
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 13 Oct 2023 12:52:35 CMS, code-revision=349, description-revision=1375 |