ICD-10-CM/PCS MS-DRG v41.0 Definitions Manual |
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Diagnosis Code/MDC/MS-DRG Index |
Page 71 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 | ||
---|---|---|---|---|---|---|---|---|---|---|
T5492XD | 23 | 949-950 | T597X3S | 21 | 922-923 | T63191A | 21 | 917-918 | ||
T5492XS | 21 | 922-923 | T597X4A | 21 | 917-918 | T63191D | 23 | 949-950 | ||
T5493XA | 21 | 917-918 | T597X4D | 23 | 949-950 | T63191S | 21 | 922-923 | ||
T5493XD | 23 | 949-950 | T597X4S | 21 | 922-923 | T63192A | 21 | 917-918 | ||
T5493XS | 21 | 922-923 | T59811A | 21 | 917-918 | T63192D | 23 | 949-950 | ||
T5494XA | 21 | 917-918 | T59811A | 22 | 928-929,934 | T63192S | 21 | 922-923 | ||
T5494XD | 23 | 949-950 | T59811D | 23 | 949-950 | T63193A | 21 | 917-918 | ||
T5494XS | 21 | 922-923 | T59811S | 21 | 922-923 | T63193D | 23 | 949-950 | ||
T550X1A | 21 | 917-918 | T59812A | 21 | 917-918 | T63193S | 21 | 922-923 | ||
T550X1D | 23 | 949-950 | T59812A | 22 | 928-929,934 | T63194A | 21 | 917-918 | ||
T550X1S | 21 | 922-923 | T59812D | 23 | 949-950 | T63194D | 23 | 949-950 | ||
T550X2A | 21 | 917-918 | T59812S | 21 | 922-923 | T63194S | 21 | 922-923 | ||
T550X2D | 23 | 949-950 | T59813A | 21 | 917-918 | T632X1A | 21 | 917-918 | ||
T550X2S | 21 | 922-923 | T59813A | 22 | 928-929,934 | T632X1D | 23 | 949-950 | ||
T550X3A | 21 | 917-918 | T59813D | 23 | 949-950 | T632X1S | 21 | 922-923 | ||
T550X3D | 23 | 949-950 | T59813S | 21 | 922-923 | T632X2A | 21 | 917-918 | ||
T550X3S | 21 | 922-923 | T59814A | 21 | 917-918 | T632X2D | 23 | 949-950 | ||
T550X4A | 21 | 917-918 | T59814A | 22 | 928-929,934 | T632X2S | 21 | 922-923 | ||
T550X4D | 23 | 949-950 | T59814D | 23 | 949-950 | T632X3A | 21 | 917-918 | ||
T550X4S | 21 | 922-923 | T59814S | 21 | 922-923 | T632X3D | 23 | 949-950 | ||
T551X1A | 21 | 917-918 | T59891A | 21 | 917-918 | T632X3S | 21 | 922-923 | ||
T551X1D | 23 | 949-950 | T59891A | 22 | 928-929,934 | T632X4A | 21 | 917-918 | ||
T551X1S | 21 | 922-923 | T59891D | 23 | 949-950 | T632X4D | 23 | 949-950 | ||
T551X2A | 21 | 917-918 | T59891S | 21 | 922-923 | T632X4S | 21 | 922-923 | ||
T551X2D | 23 | 949-950 | T59892A | 21 | 917-918 | T63301A | 21 | 917-918 | ||
T551X2S | 21 | 922-923 | T59892A | 22 | 928-929,934 | T63301D | 23 | 949-950 | ||
T551X3A | 21 | 917-918 | T59892D | 23 | 949-950 | T63301S | 21 | 922-923 | ||
T551X3D | 23 | 949-950 | T59892S | 21 | 922-923 | T63302A | 21 | 917-918 | ||
T551X3S | 21 | 922-923 | T59893A | 21 | 917-918 | T63302D | 23 | 949-950 | ||
T551X4A | 21 | 917-918 | T59893A | 22 | 928-929,934 | T63302S | 21 | 922-923 | ||
T551X4D | 23 | 949-950 | T59893D | 23 | 949-950 | T63303A | 21 | 917-918 | ||
T551X4S | 21 | 922-923 | T59893S | 21 | 922-923 | T63303D | 23 | 949-950 | ||
T560X1A | 21 | 917-918 | T59894A | 21 | 917-918 | T63303S | 21 | 922-923 | ||
T560X1D | 23 | 949-950 | T59894A | 22 | 928-929,934 | T63304A | 21 | 917-918 | ||
T560X1S | 21 | 922-923 | T59894D | 23 | 949-950 | T63304D | 23 | 949-950 | ||
T560X2A | 21 | 917-918 | T59894S | 21 | 922-923 | T63304S | 21 | 922-923 | ||
T560X2D | 23 | 949-950 | T5991XA | 21 | 917-918 | T63311A | 21 | 917-918 | ||
T560X2S | 21 | 922-923 | T5991XA | 22 | 928-929,934 | T63311D | 23 | 949-950 | ||
T560X3A | 21 | 917-918 | T5991XD | 23 | 949-950 | T63311S | 21 | 922-923 | ||
T560X3D | 23 | 949-950 | T5991XS | 21 | 922-923 | T63312A | 21 | 917-918 | ||
T560X3S | 21 | 922-923 | T5992XA | 21 | 917-918 | T63312D | 23 | 949-950 | ||
T560X4A | 21 | 917-918 | T5992XA | 22 | 928-929,934 | T63312S | 21 | 922-923 | ||
T560X4D | 23 | 949-950 | T5992XD | 23 | 949-950 | T63313A | 21 | 917-918 | ||
T560X4S | 21 | 922-923 | T5992XS | 21 | 922-923 | T63313D | 23 | 949-950 | ||
T561X1A | 21 | 917-918 | T5993XA | 21 | 917-918 | T63313S | 21 | 922-923 | ||
T561X1D | 23 | 949-950 | T5993XA | 22 | 928-929,934 | T63314A | 21 | 917-918 | ||
T561X1S | 21 | 922-923 | T5993XD | 23 | 949-950 | T63314D | 23 | 949-950 | ||
T561X2A | 21 | 917-918 | T5993XS | 21 | 922-923 | T63314S | 21 | 922-923 | ||
T561X2D | 23 | 949-950 | T5994XA | 21 | 917-918 | T63321A | 21 | 917-918 | ||
T561X2S | 21 | 922-923 | T5994XA | 22 | 928-929,934 | T63321D | 23 | 949-950 | ||
T561X3A | 21 | 917-918 | T5994XD | 23 | 949-950 | T63321S | 21 | 922-923 | ||
T561X3D | 23 | 949-950 | T5994XS | 21 | 922-923 | T63322A | 21 | 917-918 | ||
T561X3S | 21 | 922-923 | T600X1A | 21 | 917-918 | T63322D | 23 | 949-950 | ||
T561X4A | 21 | 917-918 | T600X1D | 23 | 949-950 | T63322S | 21 | 922-923 | ||
T561X4D | 23 | 949-950 | T600X1S | 21 | 922-923 | T63323A | 21 | 917-918 | ||
T561X4S | 21 | 922-923 | T600X2A | 21 | 917-918 | T63323D | 23 | 949-950 | ||
T562X1A | 21 | 917-918 | T600X2D | 23 | 949-950 | T63323S | 21 | 922-923 | ||
T562X1D | 23 | 949-950 | T600X2S | 21 | 922-923 | T63324A | 21 | 917-918 | ||
T562X1S | 21 | 922-923 | T600X3A | 21 | 917-918 | T63324D | 23 | 949-950 | ||
T562X2A | 21 | 917-918 | T600X3D | 23 | 949-950 | T63324S | 21 | 922-923 | ||
T562X2D | 23 | 949-950 | T600X3S | 21 | 922-923 | T63331A | 21 | 917-918 | ||
T562X2S | 21 | 922-923 | T600X4A | 21 | 917-918 | T63331D | 23 | 949-950 | ||
T562X3A | 21 | 917-918 | T600X4D | 23 | 949-950 | T63331S | 21 | 922-923 | ||
T562X3D | 23 | 949-950 | T600X4S | 21 | 922-923 | T63332A | 21 | 917-918 | ||
T562X3S | 21 | 922-923 | T601X1A | 21 | 917-918 | T63332D | 23 | 949-950 | ||
T562X4A | 21 | 917-918 | T601X1D | 23 | 949-950 | T63332S | 21 | 922-923 | ||
T562X4D | 23 | 949-950 | T601X1S | 21 | 922-923 | T63333A | 21 | 917-918 | ||
T562X4S | 21 | 922-923 | T601X2A | 21 | 917-918 | T63333D | 23 | 949-950 | ||
T563X1A | 21 | 917-918 | T601X2D | 23 | 949-950 | T63333S | 21 | 922-923 | ||
T563X1D | 23 | 949-950 | T601X2S | 21 | 922-923 | T63334A | 21 | 917-918 | ||
T563X1S | 21 | 922-923 | T601X3A | 21 | 917-918 | T63334D | 23 | 949-950 | ||
T563X2A | 21 | 917-918 | T601X3D | 23 | 949-950 | T63334S | 21 | 922-923 | ||
T563X2D | 23 | 949-950 | T601X3S | 21 | 922-923 | T63391A | 21 | 917-918 | ||
T563X2S | 21 | 922-923 | T601X4A | 21 | 917-918 | T63391D | 23 | 949-950 | ||
T563X3A | 21 | 917-918 | T601X4D | 23 | 949-950 | T63391S | 21 | 922-923 | ||
T563X3D | 23 | 949-950 | T601X4S | 21 | 922-923 | T63392A | 21 | 917-918 | ||
T563X3S | 21 | 922-923 | T602X1A | 21 | 917-918 | T63392D | 23 | 949-950 | ||
T563X4A | 21 | 917-918 | T602X1D | 23 | 949-950 | T63392S | 21 | 922-923 | ||
T563X4D | 23 | 949-950 | T602X1S | 21 | 922-923 | T63393A | 21 | 917-918 | ||
T563X4S | 21 | 922-923 | T602X2A | 21 | 917-918 | T63393D | 23 | 949-950 | ||
T564X1A | 21 | 917-918 | T602X2D | 23 | 949-950 | T63393S | 21 | 922-923 | ||
T564X1D | 23 | 949-950 | T602X2S | 21 | 922-923 | T63394A | 21 | 917-918 | ||
T564X1S | 21 | 922-923 | T602X3A | 21 | 917-918 | T63394D | 23 | 949-950 | ||
T564X2A | 21 | 917-918 | T602X3D | 23 | 949-950 | T63394S | 21 | 922-923 | ||
T564X2D | 23 | 949-950 | T602X3S | 21 | 922-923 | T63411A | 21 | 917-918 | ||
T564X2S | 21 | 922-923 | T602X4A | 21 | 917-918 | T63411D | 23 | 949-950 | ||
T564X3A | 21 | 917-918 | T602X4D | 23 | 949-950 | T63411S | 21 | 922-923 | ||
T564X3D | 23 | 949-950 | T602X4S | 21 | 922-923 | T63412A | 21 | 917-918 | ||
T564X3S | 21 | 922-923 | T603X1A | 21 | 917-918 | T63412D | 23 | 949-950 | ||
T564X4A | 21 | 917-918 | T603X1D | 23 | 949-950 | T63412S | 21 | 922-923 | ||
T564X4D | 23 | 949-950 | T603X1S | 21 | 922-923 | T63413A | 21 | 917-918 | ||
T564X4S | 21 | 922-923 | T603X2A | 21 | 917-918 | T63413D | 23 | 949-950 | ||
T565X1A | 21 | 917-918 | T603X2D | 23 | 949-950 | T63413S | 21 | 922-923 | ||
T565X1D | 23 | 949-950 | T603X2S | 21 | 922-923 | T63414A | 21 | 917-918 | ||
T565X1S | 21 | 922-923 | T603X3A | 21 | 917-918 | T63414D | 23 | 949-950 | ||
T565X2A | 21 | 917-918 | T603X3D | 23 | 949-950 | T63414S | 21 | 922-923 | ||
T565X2D | 23 | 949-950 | T603X3S | 21 | 922-923 | T63421A | 21 | 917-918 | ||
T565X2S | 21 | 922-923 | T603X4A | 21 | 917-918 | T63421D | 23 | 949-950 | ||
T565X3A | 21 | 917-918 | T603X4D | 23 | 949-950 | T63421S | 21 | 922-923 | ||
T565X3D | 23 | 949-950 | T603X4S | 21 | 922-923 | T63422A | 21 | 917-918 | ||
T565X3S | 21 | 922-923 | T604X1A | 21 | 917-918 | T63422D | 23 | 949-950 | ||
T565X4A | 21 | 917-918 | T604X1D | 23 | 949-950 | T63422S | 21 | 922-923 | ||
T565X4D | 23 | 949-950 | T604X1S | 21 | 922-923 | T63423A | 21 | 917-918 | ||
T565X4S | 21 | 922-923 | T604X2A | 21 | 917-918 | T63423D | 23 | 949-950 | ||
T566X1A | 21 | 917-918 | T604X2D | 23 | 949-950 | T63423S | 21 | 922-923 | ||
T566X1D | 23 | 949-950 | T604X2S | 21 | 922-923 | T63424A | 21 | 917-918 | ||
T566X1S | 21 | 922-923 | T604X3A | 21 | 917-918 | T63424D | 23 | 949-950 | ||
T566X2A | 21 | 917-918 | T604X3D | 23 | 949-950 | T63424S | 21 | 922-923 | ||
T566X2D | 23 | 949-950 | T604X3S | 21 | 922-923 | T63431A | 21 | 917-918 | ||
T566X2S | 21 | 922-923 | T604X4A | 21 | 917-918 | T63431D | 23 | 949-950 | ||
T566X3A | 21 | 917-918 | T604X4D | 23 | 949-950 | T63431S | 21 | 922-923 | ||
T566X3D | 23 | 949-950 | T604X4S | 21 | 922-923 | T63432A | 21 | 917-918 | ||
T566X3S | 21 | 922-923 | T608X1A | 21 | 917-918 | T63432D | 23 | 949-950 | ||
T566X4A | 21 | 917-918 | T608X1D | 23 | 949-950 | T63432S | 21 | 922-923 | ||
T566X4D | 23 | 949-950 | T608X1S | 21 | 922-923 | T63433A | 21 | 917-918 | ||
T566X4S | 21 | 922-923 | T608X2A | 21 | 917-918 | T63433D | 23 | 949-950 | ||
T567X1A | 21 | 917-918 | T608X2D | 23 | 949-950 | T63433S | 21 | 922-923 | ||
T567X1D | 23 | 949-950 | T608X2S | 21 | 922-923 | T63434A | 21 | 917-918 | ||
T567X1S | 21 | 922-923 | T608X3A | 21 | 917-918 | T63434D | 23 | 949-950 | ||
T567X2A | 21 | 917-918 | T608X3D | 23 | 949-950 | T63434S | 21 | 922-923 | ||
T567X2D | 23 | 949-950 | T608X3S | 21 | 922-923 | T63441A | 21 | 917-918 | ||
T567X2S | 21 | 922-923 | T608X4A | 21 | 917-918 | T63441D | 23 | 949-950 | ||
T567X3A | 21 | 917-918 | T608X4D | 23 | 949-950 | T63441S | 21 | 922-923 | ||
T567X3D | 23 | 949-950 | T608X4S | 21 | 922-923 | T63442A | 21 | 917-918 | ||
T567X3S | 21 | 922-923 | T6091XA | 21 | 917-918 | T63442D | 23 | 949-950 | ||
T567X4A | 21 | 917-918 | T6091XD | 23 | 949-950 | T63442S | 21 | 922-923 | ||
T567X4D | 23 | 949-950 | T6091XS | 21 | 922-923 | T63443A | 21 | 917-918 | ||
T567X4S | 21 | 922-923 | T6092XA | 21 | 917-918 | T63443D | 23 | 949-950 | ||
T56811A | 21 | 917-918 | T6092XD | 23 | 949-950 | T63443S | 21 | 922-923 | ||
T56811D | 23 | 949-950 | T6092XS | 21 | 922-923 | T63444A | 21 | 917-918 | ||
T56811S | 21 | 922-923 | T6093XA | 21 | 917-918 | T63444D | 23 | 949-950 | ||
T56812A | 21 | 917-918 | T6093XD | 23 | 949-950 | T63444S | 21 | 922-923 | ||
T56812D | 23 | 949-950 | T6093XS | 21 | 922-923 | T63451A | 21 | 917-918 | ||
T56812S | 21 | 922-923 | T6094XA | 21 | 917-918 | T63451D | 23 | 949-950 | ||
T56813A | 21 | 917-918 | T6094XD | 23 | 949-950 | T63451S | 21 | 922-923 | ||
T56813D | 23 | 949-950 | T6094XS | 21 | 922-923 | T63452A | 21 | 917-918 | ||
T56813S | 21 | 922-923 | T6101XA | 21 | 917-918 | T63452D | 23 | 949-950 | ||
T56814A | 21 | 917-918 | T6101XD | 23 | 949-950 | T63452S | 21 | 922-923 | ||
T56814D | 23 | 949-950 | T6101XS | 21 | 922-923 | T63453A | 21 | 917-918 | ||
T56814S | 21 | 922-923 | T6102XA | 21 | 917-918 | T63453D | 23 | 949-950 | ||
T56821A | 21 | 917-918 | T6102XD | 23 | 949-950 | T63453S | 21 | 922-923 | ||
T56821D | 23 | 949-950 | T6102XS | 21 | 922-923 | T63454A | 21 | 917-918 | ||
T56821S | 21 | 922-923 | T6103XA | 21 | 917-918 | T63454D | 23 | 949-950 | ||
T56822A | 21 | 917-918 | T6103XD | 23 | 949-950 | T63454S | 21 | 922-923 | ||
T56822D | 23 | 949-950 | T6103XS | 21 | 922-923 | T63461A | 21 | 917-918 | ||
T56822S | 21 | 922-923 | T6104XA | 21 | 917-918 | T63461D | 23 | 949-950 | ||
T56823A | 21 | 917-918 | T6104XD | 23 | 949-950 | T63461S | 21 | 922-923 | ||
T56823D | 23 | 949-950 | T6104XS | 21 | 922-923 | T63462A | 21 | 917-918 | ||
T56823S | 21 | 922-923 | T6111XA | 21 | 917-918 | T63462D | 23 | 949-950 | ||
T56824A | 21 | 917-918 | T6111XD | 23 | 949-950 | T63462S | 21 | 922-923 | ||
T56824D | 23 | 949-950 | T6111XS | 21 | 922-923 | T63463A | 21 | 917-918 | ||
T56824S | 21 | 922-923 | T6112XA | 21 | 917-918 | T63463D | 23 | 949-950 | ||
T56891A | 21 | 917-918 | T6112XD | 23 | 949-950 | T63463S | 21 | 922-923 | ||
T56891D | 23 | 949-950 | T6112XS | 21 | 922-923 | T63464A | 21 | 917-918 | ||
T56891S | 21 | 922-923 | T6113XA | 21 | 917-918 | T63464D | 23 | 949-950 | ||
T56892A | 21 | 917-918 | T6113XD | 23 | 949-950 | T63464S | 21 | 922-923 | ||
T56892D | 23 | 949-950 | T6113XS | 21 | 922-923 | T63481A | 21 | 917-918 | ||
T56892S | 21 | 922-923 | T6114XA | 21 | 917-918 | T63481D | 23 | 949-950 | ||
T56893A | 21 | 917-918 | T6114XD | 23 | 949-950 | T63481S | 21 | 922-923 | ||
T56893D | 23 | 949-950 | T6114XS | 21 | 922-923 | T63482A | 21 | 917-918 | ||
T56893S | 21 | 922-923 | T61771A | 21 | 917-918 | T63482D | 23 | 949-950 | ||
T56894A | 21 | 917-918 | T61771D | 23 | 949-950 | T63482S | 21 | 922-923 | ||
T56894D | 23 | 949-950 | T61771S | 21 | 922-923 | T63483A | 21 | 917-918 | ||
T56894S | 21 | 922-923 | T61772A | 21 | 917-918 | T63483D | 23 | 949-950 | ||
T5691XA | 21 | 917-918 | T61772D | 23 | 949-950 | T63483S | 21 | 922-923 | ||
T5691XD | 23 | 949-950 | T61772S | 21 | 922-923 | T63484A | 21 | 917-918 | ||
T5691XS | 21 | 922-923 | T61773A | 21 | 917-918 | T63484D | 23 | 949-950 | ||
T5692XA | 21 | 917-918 | T61773D | 23 | 949-950 | T63484S | 21 | 922-923 | ||
T5692XD | 23 | 949-950 | T61773S | 21 | 922-923 | T63511A | 21 | 917-918 | ||
T5692XS | 21 | 922-923 | T61774A | 21 | 917-918 | T63511D | 23 | 949-950 | ||
T5693XA | 21 | 917-918 | T61774D | 23 | 949-950 | T63511S | 21 | 922-923 | ||
T5693XD | 23 | 949-950 | T61774S | 21 | 922-923 | T63512A | 21 | 917-918 | ||
T5693XS | 21 | 922-923 | T61781A | 21 | 917-918 | T63512D | 23 | 949-950 | ||
T5694XA | 21 | 917-918 | T61781D | 23 | 949-950 | T63512S | 21 | 922-923 | ||
T5694XD | 23 | 949-950 | T61781S | 21 | 922-923 | T63513A | 21 | 917-918 | ||
T5694XS | 21 | 922-923 | T61782A | 21 | 917-918 | T63513D | 23 | 949-950 | ||
T570X1A | 21 | 917-918 | T61782D | 23 | 949-950 | T63513S | 21 | 922-923 | ||
T570X1D | 23 | 949-950 | T61782S | 21 | 922-923 | T63514A | 21 | 917-918 | ||
T570X1S | 21 | 922-923 | T61783A | 21 | 917-918 | T63514D | 23 | 949-950 | ||
T570X2A | 21 | 917-918 | T61783D | 23 | 949-950 | T63514S | 21 | 922-923 | ||
T570X2D | 23 | 949-950 | T61783S | 21 | 922-923 | T63591A | 21 | 917-918 | ||
T570X2S | 21 | 922-923 | T61784A | 21 | 917-918 | T63591D | 23 | 949-950 | ||
T570X3A | 21 | 917-918 | T61784D | 23 | 949-950 | T63591S | 21 | 922-923 | ||
T570X3D | 23 | 949-950 | T61784S | 21 | 922-923 | T63592A | 21 | 917-918 | ||
T570X3S | 21 | 922-923 | T618X1A | 21 | 917-918 | T63592D | 23 | 949-950 | ||
T570X4A | 21 | 917-918 | T618X1D | 23 | 949-950 | T63592S | 21 | 922-923 | ||
T570X4D | 23 | 949-950 | T618X1S | 21 | 922-923 | T63593A | 21 | 917-918 | ||
T570X4S | 21 | 922-923 | T618X2A | 21 | 917-918 | T63593D | 23 | 949-950 | ||
T571X1A | 21 | 917-918 | T618X2D | 23 | 949-950 | T63593S | 21 | 922-923 | ||
T571X1D | 23 | 949-950 | T618X2S | 21 | 922-923 | T63594A | 21 | 917-918 | ||
T571X1S | 21 | 922-923 | T618X3A | 21 | 917-918 | T63594D | 23 | 949-950 | ||
T571X2A | 21 | 917-918 | T618X3D | 23 | 949-950 | T63594S | 21 | 922-923 | ||
T571X2D | 23 | 949-950 | T618X3S | 21 | 922-923 | T63611A | 21 | 917-918 | ||
T571X2S | 21 | 922-923 | T618X4A | 21 | 917-918 | T63611D | 23 | 949-950 | ||
T571X3A | 21 | 917-918 | T618X4D | 23 | 949-950 | T63611S | 21 | 922-923 | ||
T571X3D | 23 | 949-950 | T618X4S | 21 | 922-923 | T63612A | 21 | 917-918 | ||
T571X3S | 21 | 922-923 | T6191XA | 21 | 917-918 | T63612D | 23 | 949-950 | ||
T571X4A | 21 | 917-918 | T6191XD | 23 | 949-950 | T63612S | 21 | 922-923 | ||
T571X4D | 23 | 949-950 | T6191XS | 21 | 922-923 | T63613A | 21 | 917-918 | ||
T571X4S | 21 | 922-923 | T6192XA | 21 | 917-918 | T63613D | 23 | 949-950 | ||
T572X1A | 21 | 917-918 | T6192XD | 23 | 949-950 | T63613S | 21 | 922-923 | ||
T572X1D | 23 | 949-950 | T6192XS | 21 | 922-923 | T63614A | 21 | 917-918 | ||
T572X1S | 21 | 922-923 | T6193XA | 21 | 917-918 | T63614D | 23 | 949-950 | ||
T572X2A | 21 | 917-918 | T6193XD | 23 | 949-950 | T63614S | 21 | 922-923 | ||
T572X2D | 23 | 949-950 | T6193XS | 21 | 922-923 | T63621A | 21 | 917-918 | ||
T572X2S | 21 | 922-923 | T6194XA | 21 | 917-918 | T63621D | 23 | 949-950 | ||
T572X3A | 21 | 917-918 | T6194XD | 23 | 949-950 | T63621S | 21 | 922-923 | ||
T572X3D | 23 | 949-950 | T6194XS | 21 | 922-923 | T63622A | 21 | 917-918 | ||
T572X3S | 21 | 922-923 | T620X1A | 21 | 917-918 | T63622D | 23 | 949-950 | ||
T572X4A | 21 | 917-918 | T620X1D | 23 | 949-950 | T63622S | 21 | 922-923 | ||
T572X4D | 23 | 949-950 | T620X1S | 21 | 922-923 | T63623A | 21 | 917-918 | ||
T572X4S | 21 | 922-923 | T620X2A | 21 | 917-918 | T63623D | 23 | 949-950 | ||
T573X1A | 21 | 917-918 | T620X2D | 23 | 949-950 | T63623S | 21 | 922-923 | ||
T573X1D | 23 | 949-950 | T620X2S | 21 | 922-923 | T63624A | 21 | 917-918 | ||
T573X1S | 21 | 922-923 | T620X3A | 21 | 917-918 | T63624D | 23 | 949-950 | ||
T573X2A | 21 | 917-918 | T620X3D | 23 | 949-950 | T63624S | 21 | 922-923 | ||
T573X2D | 23 | 949-950 | T620X3S | 21 | 922-923 | T63631A | 21 | 917-918 | ||
T573X2S | 21 | 922-923 | T620X4A | 21 | 917-918 | T63631D | 23 | 949-950 | ||
T573X3A | 21 | 917-918 | T620X4D | 23 | 949-950 | T63631S | 21 | 922-923 | ||
T573X3D | 23 | 949-950 | T620X4S | 21 | 922-923 | T63632A | 21 | 917-918 | ||
T573X3S | 21 | 922-923 | T621X1A | 21 | 917-918 | T63632D | 23 | 949-950 | ||
T573X4A | 21 | 917-918 | T621X1D | 23 | 949-950 | T63632S | 21 | 922-923 | ||
T573X4D | 23 | 949-950 | T621X1S | 21 | 922-923 | T63633A | 21 | 917-918 | ||
T573X4S | 21 | 922-923 | T621X2A | 21 | 917-918 | T63633D | 23 | 949-950 | ||
T578X1A | 21 | 917-918 | T621X2D | 23 | 949-950 | T63633S | 21 | 922-923 | ||
T578X1D | 23 | 949-950 | T621X2S | 21 | 922-923 | T63634A | 21 | 917-918 | ||
T578X1S | 21 | 922-923 | T621X3A | 21 | 917-918 | T63634D | 23 | 949-950 | ||
T578X2A | 21 | 917-918 | T621X3D | 23 | 949-950 | T63634S | 21 | 922-923 | ||
T578X2D | 23 | 949-950 | T621X3S | 21 | 922-923 | T63691A | 21 | 917-918 | ||
T578X2S | 21 | 922-923 | T621X4A | 21 | 917-918 | T63691D | 23 | 949-950 | ||
T578X3A | 21 | 917-918 | T621X4D | 23 | 949-950 | T63691S | 21 | 922-923 | ||
T578X3D | 23 | 949-950 | T621X4S | 21 | 922-923 | T63692A | 21 | 917-918 | ||
T578X3S | 21 | 922-923 | T622X1A | 21 | 917-918 | T63692D | 23 | 949-950 | ||
T578X4A | 21 | 917-918 | T622X1D | 23 | 949-950 | T63692S | 21 | 922-923 | ||
T578X4D | 23 | 949-950 | T622X1S | 21 | 922-923 | T63693A | 21 | 917-918 | ||
T578X4S | 21 | 922-923 | T622X2A | 21 | 917-918 | T63693D | 23 | 949-950 | ||
T5791XA | 21 | 917-918 | T622X2D | 23 | 949-950 | T63693S | 21 | 922-923 | ||
T5791XD | 23 | 949-950 | T622X2S | 21 | 922-923 | T63694A | 21 | 917-918 | ||
T5791XS | 21 | 922-923 | T622X3A | 21 | 917-918 | T63694D | 23 | 949-950 | ||
T5792XA | 21 | 917-918 | T622X3D | 23 | 949-950 | T63694S | 21 | 922-923 | ||
T5792XD | 23 | 949-950 | T622X3S | 21 | 922-923 | T63711A | 21 | 917-918 | ||
T5792XS | 21 | 922-923 | T622X4A | 21 | 917-918 | T63711D | 23 | 949-950 | ||
T5793XA | 21 | 917-918 | T622X4D | 23 | 949-950 | T63711S | 21 | 922-923 | ||
T5793XD | 23 | 949-950 | T622X4S | 21 | 922-923 | T63712A | 21 | 917-918 | ||
T5793XS | 21 | 922-923 | T628X1A | 21 | 917-918 | T63712D | 23 | 949-950 | ||
T5794XA | 21 | 917-918 | T628X1D | 23 | 949-950 | T63712S | 21 | 922-923 | ||
T5794XD | 23 | 949-950 | T628X1S | 21 | 922-923 | T63713A | 21 | 917-918 | ||
T5794XS | 21 | 922-923 | T628X2A | 21 | 917-918 | T63713D | 23 | 949-950 | ||
T5801XA | 21 | 917-918 | T628X2D | 23 | 949-950 | T63713S | 21 | 922-923 | ||
T5801XD | 23 | 949-950 | T628X2S | 21 | 922-923 | T63714A | 21 | 917-918 | ||
T5801XS | 21 | 922-923 | T628X3A | 21 | 917-918 | T63714D | 23 | 949-950 | ||
T5802XA | 21 | 917-918 | T628X3D | 23 | 949-950 | T63714S | 21 | 922-923 | ||
T5802XD | 23 | 949-950 | T628X3S | 21 | 922-923 | T63791A | 21 | 917-918 | ||
T5802XS | 21 | 922-923 | T628X4A | 21 | 917-918 | T63791D | 23 | 949-950 | ||
T5803XA | 21 | 917-918 | T628X4D | 23 | 949-950 | T63791S | 21 | 922-923 | ||
T5803XD | 23 | 949-950 | T628X4S | 21 | 922-923 | T63792A | 21 | 917-918 | ||
T5803XS | 21 | 922-923 | T6291XA | 21 | 917-918 | T63792D | 23 | 949-950 | ||
T5804XA | 21 | 917-918 | T6291XD | 23 | 949-950 | T63792S | 21 | 922-923 | ||
T5804XD | 23 | 949-950 | T6291XS | 21 | 922-923 | T63793A | 21 | 917-918 | ||
T5804XS | 21 | 922-923 | T6292XA | 21 | 917-918 | T63793D | 23 | 949-950 | ||
T5811XA | 21 | 917-918 | T6292XD | 23 | 949-950 | T63793S | 21 | 922-923 | ||
T5811XD | 23 | 949-950 | T6292XS | 21 | 922-923 | T63794A | 21 | 917-918 | ||
T5811XS | 21 | 922-923 | T6293XA | 21 | 917-918 | T63794D | 23 | 949-950 | ||
T5812XA | 21 | 917-918 | T6293XD | 23 | 949-950 | T63794S | 21 | 922-923 | ||
T5812XD | 23 | 949-950 | T6293XS | 21 | 922-923 | T63811A | 21 | 917-918 | ||
T5812XS | 21 | 922-923 | T6294XA | 21 | 917-918 | T63811D | 23 | 949-950 | ||
T5813XA | 21 | 917-918 | T6294XD | 23 | 949-950 | T63811S | 21 | 922-923 | ||
T5813XD | 23 | 949-950 | T6294XS | 21 | 922-923 | T63812A | 21 | 917-918 | ||
T5813XS | 21 | 922-923 | T63001A | 21 | 917-918 | T63812D | 23 | 949-950 | ||
T5814XA | 21 | 917-918 | T63001D | 23 | 949-950 | T63812S | 21 | 922-923 | ||
T5814XD | 23 | 949-950 | T63001S | 21 | 922-923 | T63813A | 21 | 917-918 | ||
T5814XS | 21 | 922-923 | T63002A | 21 | 917-918 | T63813D | 23 | 949-950 | ||
T582X1A | 21 | 917-918 | T63002D | 23 | 949-950 | T63813S | 21 | 922-923 | ||
T582X1D | 23 | 949-950 | T63002S | 21 | 922-923 | T63814A | 21 | 917-918 | ||
T582X1S | 21 | 922-923 | T63003A | 21 | 917-918 | T63814D | 23 | 949-950 | ||
T582X2A | 21 | 917-918 | T63003D | 23 | 949-950 | T63814S | 21 | 922-923 | ||
T582X2D | 23 | 949-950 | T63003S | 21 | 922-923 | T63821A | 21 | 917-918 | ||
T582X2S | 21 | 922-923 | T63004A | 21 | 917-918 | T63821D | 23 | 949-950 | ||
T582X3A | 21 | 917-918 | T63004D | 23 | 949-950 | T63821S | 21 | 922-923 | ||
T582X3D | 23 | 949-950 | T63004S | 21 | 922-923 | T63822A | 21 | 917-918 | ||
T582X3S | 21 | 922-923 | T63011A | 21 | 917-918 | T63822D | 23 | 949-950 | ||
T582X4A | 21 | 917-918 | T63011D | 23 | 949-950 | T63822S | 21 | 922-923 | ||
T582X4D | 23 | 949-950 | T63011S | 21 | 922-923 | T63823A | 21 | 917-918 | ||
T582X4S | 21 | 922-923 | T63012A | 21 | 917-918 | T63823D | 23 | 949-950 | ||
T588X1A | 21 | 917-918 | T63012D | 23 | 949-950 | T63823S | 21 | 922-923 | ||
T588X1D | 23 | 949-950 | T63012S | 21 | 922-923 | T63824A | 21 | 917-918 | ||
T588X1S | 21 | 922-923 | T63013A | 21 | 917-918 | T63824D | 23 | 949-950 | ||
T588X2A | 21 | 917-918 | T63013D | 23 | 949-950 | T63824S | 21 | 922-923 | ||
T588X2D | 23 | 949-950 | T63013S | 21 | 922-923 | T63831A | 21 | 917-918 | ||
T588X2S | 21 | 922-923 | T63014A | 21 | 917-918 | T63831D | 23 | 949-950 | ||
T588X3A | 21 | 917-918 | T63014D | 23 | 949-950 | T63831S | 21 | 922-923 | ||
T588X3D | 23 | 949-950 | T63014S | 21 | 922-923 | T63832A | 21 | 917-918 | ||
T588X3S | 21 | 922-923 | T63021A | 21 | 917-918 | T63832D | 23 | 949-950 | ||
T588X4A | 21 | 917-918 | T63021D | 23 | 949-950 | T63832S | 21 | 922-923 | ||
T588X4D | 23 | 949-950 | T63021S | 21 | 922-923 | T63833A | 21 | 917-918 | ||
T588X4S | 21 | 922-923 | T63022A | 21 | 917-918 | T63833D | 23 | 949-950 | ||
T5891XA | 21 | 917-918 | T63022D | 23 | 949-950 | T63833S | 21 | 922-923 | ||
T5891XD | 23 | 949-950 | T63022S | 21 | 922-923 | T63834A | 21 | 917-918 | ||
T5891XS | 21 | 922-923 | T63023A | 21 | 917-918 | T63834D | 23 | 949-950 | ||
T5892XA | 21 | 917-918 | T63023D | 23 | 949-950 | T63834S | 21 | 922-923 | ||
T5892XD | 23 | 949-950 | T63023S | 21 | 922-923 | T63891A | 21 | 917-918 | ||
T5892XS | 21 | 922-923 | T63024A | 21 | 917-918 | T63891D | 23 | 949-950 | ||
T5893XA | 21 | 917-918 | T63024D | 23 | 949-950 | T63891S | 21 | 922-923 | ||
T5893XD | 23 | 949-950 | T63024S | 21 | 922-923 | T63892A | 21 | 917-918 | ||
T5893XS | 21 | 922-923 | T63031A | 21 | 917-918 | T63892D | 23 | 949-950 | ||
T5894XA | 21 | 917-918 | T63031D | 23 | 949-950 | T63892S | 21 | 922-923 | ||
T5894XD | 23 | 949-950 | T63031S | 21 | 922-923 | T63893A | 21 | 917-918 | ||
T5894XS | 21 | 922-923 | T63032A | 21 | 917-918 | T63893D | 23 | 949-950 | ||
T590X1A | 21 | 917-918 | T63032D | 23 | 949-950 | T63893S | 21 | 922-923 | ||
T590X1D | 23 | 949-950 | T63032S | 21 | 922-923 | T63894A | 21 | 917-918 | ||
T590X1S | 21 | 922-923 | T63033A | 21 | 917-918 | T63894D | 23 | 949-950 | ||
T590X2A | 21 | 917-918 | T63033D | 23 | 949-950 | T63894S | 21 | 922-923 | ||
T590X2D | 23 | 949-950 | T63033S | 21 | 922-923 | T6391XA | 21 | 917-918 | ||
T590X2S | 21 | 922-923 | T63034A | 21 | 917-918 | T6391XD | 23 | 949-950 | ||
T590X3A | 21 | 917-918 | T63034D | 23 | 949-950 | T6391XS | 21 | 922-923 | ||
T590X3D | 23 | 949-950 | T63034S | 21 | 922-923 | T6392XA | 21 | 917-918 | ||
T590X3S | 21 | 922-923 | T63041A | 21 | 917-918 | T6392XD | 23 | 949-950 | ||
T590X4A | 21 | 917-918 | T63041D | 23 | 949-950 | T6392XS | 21 | 922-923 | ||
T590X4D | 23 | 949-950 | T63041S | 21 | 922-923 | T6393XA | 21 | 917-918 | ||
T590X4S | 21 | 922-923 | T63042A | 21 | 917-918 | T6393XD | 23 | 949-950 | ||
T591X1A | 21 | 917-918 | T63042D | 23 | 949-950 | T6393XS | 21 | 922-923 | ||
T591X1D | 23 | 949-950 | T63042S | 21 | 922-923 | T6394XA | 21 | 917-918 | ||
T591X1S | 21 | 922-923 | T63043A | 21 | 917-918 | T6394XD | 23 | 949-950 | ||
T591X2A | 21 | 917-918 | T63043D | 23 | 949-950 | T6394XS | 21 | 922-923 | ||
T591X2D | 23 | 949-950 | T63043S | 21 | 922-923 | T6401XA | 21 | 917-918 | ||
T591X2S | 21 | 922-923 | T63044A | 21 | 917-918 | T6401XD | 23 | 949-950 | ||
T591X3A | 21 | 917-918 | T63044D | 23 | 949-950 | T6401XS | 21 | 922-923 | ||
T591X3D | 23 | 949-950 | T63044S | 21 | 922-923 | T6402XA | 21 | 917-918 | ||
T591X3S | 21 | 922-923 | T63061A | 21 | 917-918 | T6402XD | 23 | 949-950 | ||
T591X4A | 21 | 917-918 | T63061D | 23 | 949-950 | T6402XS | 21 | 922-923 | ||
T591X4D | 23 | 949-950 | T63061S | 21 | 922-923 | T6403XA | 21 | 917-918 | ||
T591X4S | 21 | 922-923 | T63062A | 21 | 917-918 | T6403XD | 23 | 949-950 | ||
T592X1A | 21 | 917-918 | T63062D | 23 | 949-950 | T6403XS | 21 | 922-923 | ||
T592X1D | 23 | 949-950 | T63062S | 21 | 922-923 | T6404XA | 21 | 917-918 | ||
T592X1S | 21 | 922-923 | T63063A | 21 | 917-918 | T6404XD | 23 | 949-950 | ||
T592X2A | 21 | 917-918 | T63063D | 23 | 949-950 | T6404XS | 21 | 922-923 | ||
T592X2D | 23 | 949-950 | T63063S | 21 | 922-923 | T6481XA | 21 | 917-918 | ||
T592X2S | 21 | 922-923 | T63064A | 21 | 917-918 | T6481XD | 23 | 949-950 | ||
T592X3A | 21 | 917-918 | T63064D | 23 | 949-950 | T6481XS | 21 | 922-923 | ||
T592X3D | 23 | 949-950 | T63064S | 21 | 922-923 | T6482XA | 21 | 917-918 | ||
T592X3S | 21 | 922-923 | T63071A | 21 | 917-918 | T6482XD | 23 | 949-950 | ||
T592X4A | 21 | 917-918 | T63071D | 23 | 949-950 | T6482XS | 21 | 922-923 | ||
T592X4D | 23 | 949-950 | T63071S | 21 | 922-923 | T6483XA | 21 | 917-918 | ||
T592X4S | 21 | 922-923 | T63072A | 21 | 917-918 | T6483XD | 23 | 949-950 | ||
T593X1A | 21 | 917-918 | T63072D | 23 | 949-950 | T6483XS | 21 | 922-923 | ||
T593X1D | 23 | 949-950 | T63072S | 21 | 922-923 | T6484XA | 21 | 917-918 | ||
T593X1S | 21 | 922-923 | T63073A | 21 | 917-918 | T6484XD | 23 | 949-950 | ||
T593X2A | 21 | 917-918 | T63073D | 23 | 949-950 | T6484XS | 21 | 922-923 | ||
T593X2D | 23 | 949-950 | T63073S | 21 | 922-923 | T650X1A | 21 | 917-918 | ||
T593X2S | 21 | 922-923 | T63074A | 21 | 917-918 | T650X1D | 23 | 949-950 | ||
T593X3A | 21 | 917-918 | T63074D | 23 | 949-950 | T650X1S | 21 | 922-923 | ||
T593X3D | 23 | 949-950 | T63074S | 21 | 922-923 | T650X2A | 21 | 917-918 | ||
T593X3S | 21 | 922-923 | T63081A | 21 | 917-918 | T650X2D | 23 | 949-950 | ||
T593X4A | 21 | 917-918 | T63081D | 23 | 949-950 | T650X2S | 21 | 922-923 | ||
T593X4D | 23 | 949-950 | T63081S | 21 | 922-923 | T650X3A | 21 | 917-918 | ||
T593X4S | 21 | 922-923 | T63082A | 21 | 917-918 | T650X3D | 23 | 949-950 | ||
T594X1A | 21 | 917-918 | T63082D | 23 | 949-950 | T650X3S | 21 | 922-923 | ||
T594X1D | 23 | 949-950 | T63082S | 21 | 922-923 | T650X4A | 21 | 917-918 | ||
T594X1S | 21 | 922-923 | T63083A | 21 | 917-918 | T650X4D | 23 | 949-950 | ||
T594X2A | 21 | 917-918 | T63083D | 23 | 949-950 | T650X4S | 21 | 922-923 | ||
T594X2D | 23 | 949-950 | T63083S | 21 | 922-923 | T651X1A | 21 | 917-918 | ||
T594X2S | 21 | 922-923 | T63084A | 21 | 917-918 | T651X1D | 23 | 949-950 | ||
T594X3A | 21 | 917-918 | T63084D | 23 | 949-950 | T651X1S | 21 | 922-923 | ||
T594X3D | 23 | 949-950 | T63084S | 21 | 922-923 | T651X2A | 21 | 917-918 | ||
T594X3S | 21 | 922-923 | T63091A | 21 | 917-918 | T651X2D | 23 | 949-950 | ||
T594X4A | 21 | 917-918 | T63091D | 23 | 949-950 | T651X2S | 21 | 922-923 | ||
T594X4D | 23 | 949-950 | T63091S | 21 | 922-923 | T651X3A | 21 | 917-918 | ||
T594X4S | 21 | 922-923 | T63092A | 21 | 917-918 | T651X3D | 23 | 949-950 | ||
T595X1A | 21 | 917-918 | T63092D | 23 | 949-950 | T651X3S | 21 | 922-923 | ||
T595X1D | 23 | 949-950 | T63092S | 21 | 922-923 | T651X4A | 21 | 917-918 | ||
T595X1S | 21 | 922-923 | T63093A | 21 | 917-918 | T651X4D | 23 | 949-950 | ||
T595X2A | 21 | 917-918 | T63093D | 23 | 949-950 | T651X4S | 21 | 922-923 | ||
T595X2D | 23 | 949-950 | T63093S | 21 | 922-923 | T65211A | 21 | 917-918 | ||
T595X2S | 21 | 922-923 | T63094A | 21 | 917-918 | T65211D | 23 | 949-950 | ||
T595X3A | 21 | 917-918 | T63094D | 23 | 949-950 | T65211S | 21 | 922-923 | ||
T595X3D | 23 | 949-950 | T63094S | 21 | 922-923 | T65212A | 21 | 917-918 | ||
T595X3S | 21 | 922-923 | T63111A | 21 | 917-918 | T65212D | 23 | 949-950 | ||
T595X4A | 21 | 917-918 | T63111D | 23 | 949-950 | T65212S | 21 | 922-923 | ||
T595X4D | 23 | 949-950 | T63111S | 21 | 922-923 | T65213A | 21 | 917-918 | ||
T595X4S | 21 | 922-923 | T63112A | 21 | 917-918 | T65213D | 23 | 949-950 | ||
T596X1A | 21 | 917-918 | T63112D | 23 | 949-950 | T65213S | 21 | 922-923 | ||
T596X1D | 23 | 949-950 | T63112S | 21 | 922-923 | T65214A | 21 | 917-918 | ||
T596X1S | 21 | 922-923 | T63113A | 21 | 917-918 | T65214D | 23 | 949-950 | ||
T596X2A | 21 | 917-918 | T63113D | 23 | 949-950 | T65214S | 21 | 922-923 | ||
T596X2D | 23 | 949-950 | T63113S | 21 | 922-923 | T65221A | 21 | 917-918 | ||
T596X2S | 21 | 922-923 | T63114A | 21 | 917-918 | T65221D | 23 | 949-950 | ||
T596X3A | 21 | 917-918 | T63114D | 23 | 949-950 | T65221S | 21 | 922-923 | ||
T596X3D | 23 | 949-950 | T63114S | 21 | 922-923 | T65222A | 21 | 917-918 | ||
T596X3S | 21 | 922-923 | T63121A | 21 | 917-918 | T65222D | 23 | 949-950 | ||
T596X4A | 21 | 917-918 | T63121D | 23 | 949-950 | T65222S | 21 | 922-923 | ||
T596X4D | 23 | 949-950 | T63121S | 21 | 922-923 | T65223A | 21 | 917-918 | ||
T596X4S | 21 | 922-923 | T63122A | 21 | 917-918 | T65223D | 23 | 949-950 | ||
T597X1A | 21 | 917-918 | T63122D | 23 | 949-950 | T65223S | 21 | 922-923 | ||
T597X1D | 23 | 949-950 | T63122S | 21 | 922-923 | T65224A | 21 | 917-918 | ||
T597X1S | 21 | 922-923 | T63123A | 21 | 917-918 | T65224D | 23 | 949-950 | ||
T597X2A | 21 | 917-918 | T63123D | 23 | 949-950 | T65224S | 21 | 922-923 | ||
T597X2D | 23 | 949-950 | T63123S | 21 | 922-923 | T65291A | 21 | 917-918 | ||
T597X2S | 21 | 922-923 | T63124A | 21 | 917-918 | T65291D | 23 | 949-950 | ||
T597X3A | 21 | 917-918 | T63124D | 23 | 949-950 | T65291S | 21 | 922-923 | ||
T597X3D | 23 | 949-950 | T63124S | 21 | 922-923 | T65292A | 21 | 917-918 |
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 13 Oct 2023 12:52:35 CMS, code-revision=349, description-revision=1375 |