ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual
![Previous Page [Alt-p]](bakpg.png){kind=small}
![Up a level [Alt-u]](uptop.png){kind=small}
![Next Page [Alt-n]](fwdpg.png){kind=small}
ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual |
||||
| Skip to content | |
|
|
| Diagnosis Code/MDC/MS-DRG Index |
| Page 41 of 70 |
| A000 B400 C771 C84Z9 D490 E113319 F15188 G930 H2143 H52512 I479 I7401 K08411 L101 M02049 M1A1291 M4104 M66822 M84451D M87332 N6019 O2652 O361915 O43811 O92113 Q512 R791 S02400A S06375A S1244XS S21022D S25302A S31611D S32591K S37092A S42135B S42462B S46909A S52099H S52301K S52562N S56191S S60417A S62001D S62329B S62668A S63682S S66821S S72042A S72322M S72451B S7722XS S82092Q S82255B S8264XD S8410XS S89399D S92055S S92504G S96919A T2039XD T23309D T2652XD T3991XA T45521D T50B13D T63303D T81519D T85510S Z7389 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S52562N | 08 | 564-566 | S5290XN | 08 | 564-566 | S5402XD | 23 | 949-950 | ||
| S52562P | 08 | 564-566 | S5290XP | 08 | 564-566 | S5402XS | 01 | 091-093 | ||
| S52562Q | 08 | 564-566 | S5290XQ | 08 | 564-566 | S5410XA | 01 | 073-074 | ||
| S52562R | 08 | 564-566 | S5290XR | 08 | 564-566 | S5410XA | 24 | 955-965 | ||
| S52562S | 08 | 559-561 | S5290XS | 08 | 559-561 | S5410XD | 23 | 949-950 | ||
| S52569A | 08 | 562-563 | S5291XA | 08 | 562-563 | S5410XS | 01 | 091-093 | ||
| S52569A | 24 | 955-965 | S5291XA | 24 | 955-965 | S5411XA | 01 | 073-074 | ||
| S52569B | 08 | 562-563 | S5291XB | 08 | 562-563 | S5411XA | 24 | 955-965 | ||
| S52569B | 24 | 955-965 | S5291XB | 24 | 955-965 | S5411XD | 23 | 949-950 | ||
| S52569C | 08 | 562-563 | S5291XC | 08 | 562-563 | S5411XS | 01 | 091-093 | ||
| S52569C | 24 | 955-965 | S5291XC | 24 | 955-965 | S5412XA | 01 | 073-074 | ||
| S52569D | 08 | 559-561 | S5291XD | 08 | 559-561 | S5412XA | 24 | 955-965 | ||
| S52569E | 08 | 559-561 | S5291XE | 08 | 559-561 | S5412XD | 23 | 949-950 | ||
| S52569F | 08 | 559-561 | S5291XF | 08 | 559-561 | S5412XS | 01 | 091-093 | ||
| S52569G | 08 | 559-561 | S5291XG | 08 | 559-561 | S5420XA | 01 | 073-074 | ||
| S52569H | 08 | 559-561 | S5291XH | 08 | 559-561 | S5420XA | 24 | 955-965 | ||
| S52569J | 08 | 559-561 | S5291XJ | 08 | 559-561 | S5420XD | 23 | 949-950 | ||
| S52569K | 08 | 564-566 | S5291XK | 08 | 564-566 | S5420XS | 01 | 091-093 | ||
| S52569M | 08 | 564-566 | S5291XM | 08 | 564-566 | S5421XA | 01 | 073-074 | ||
| S52569N | 08 | 564-566 | S5291XN | 08 | 564-566 | S5421XA | 24 | 955-965 | ||
| S52569P | 08 | 564-566 | S5291XP | 08 | 564-566 | S5421XD | 23 | 949-950 | ||
| S52569Q | 08 | 564-566 | S5291XQ | 08 | 564-566 | S5421XS | 01 | 091-093 | ||
| S52569R | 08 | 564-566 | S5291XR | 08 | 564-566 | S5422XA | 01 | 073-074 | ||
| S52569S | 08 | 559-561 | S5291XS | 08 | 559-561 | S5422XA | 24 | 955-965 | ||
| S52571A | 08 | 562-563 | S5292XA | 08 | 562-563 | S5422XD | 23 | 949-950 | ||
| S52571A | 24 | 955-965 | S5292XA | 24 | 955-965 | S5422XS | 01 | 091-093 | ||
| S52571B | 08 | 562-563 | S5292XB | 08 | 562-563 | S5430XA | 01 | 073-074 | ||
| S52571B | 24 | 955-965 | S5292XB | 24 | 955-965 | S5430XA | 24 | 955-965 | ||
| S52571C | 08 | 562-563 | S5292XC | 08 | 562-563 | S5430XD | 23 | 949-950 | ||
| S52571C | 24 | 955-965 | S5292XC | 24 | 955-965 | S5430XS | 01 | 091-093 | ||
| S52571D | 08 | 559-561 | S5292XD | 08 | 559-561 | S5431XA | 01 | 073-074 | ||
| S52571E | 08 | 559-561 | S5292XE | 08 | 559-561 | S5431XA | 24 | 955-965 | ||
| S52571F | 08 | 559-561 | S5292XF | 08 | 559-561 | S5431XD | 23 | 949-950 | ||
| S52571G | 08 | 559-561 | S5292XG | 08 | 559-561 | S5431XS | 01 | 091-093 | ||
| S52571H | 08 | 559-561 | S5292XH | 08 | 559-561 | S5432XA | 01 | 073-074 | ||
| S52571J | 08 | 559-561 | S5292XJ | 08 | 559-561 | S5432XA | 24 | 955-965 | ||
| S52571K | 08 | 564-566 | S5292XK | 08 | 564-566 | S5432XD | 23 | 949-950 | ||
| S52571M | 08 | 564-566 | S5292XM | 08 | 564-566 | S5432XS | 01 | 091-093 | ||
| S52571N | 08 | 564-566 | S5292XN | 08 | 564-566 | S548X1A | 01 | 073-074 | ||
| S52571P | 08 | 564-566 | S5292XP | 08 | 564-566 | S548X1A | 24 | 955-965 | ||
| S52571Q | 08 | 564-566 | S5292XQ | 08 | 564-566 | S548X1D | 23 | 949-950 | ||
| S52571R | 08 | 564-566 | S5292XR | 08 | 564-566 | S548X1S | 01 | 091-093 | ||
| S52571S | 08 | 559-561 | S5292XS | 08 | 559-561 | S548X2A | 01 | 073-074 | ||
| S52572A | 08 | 562-563 | S53001A | 08 | 562-563 | S548X2A | 24 | 955-965 | ||
| S52572A | 24 | 955-965 | S53001A | 24 | 955-965 | S548X2D | 23 | 949-950 | ||
| S52572B | 08 | 562-563 | S53001D | 23 | 949-950 | S548X2S | 01 | 091-093 | ||
| S52572B | 24 | 955-965 | S53001S | 08 | 562-563 | S548X9A | 01 | 073-074 | ||
| S52572C | 08 | 562-563 | S53002A | 08 | 562-563 | S548X9A | 24 | 955-965 | ||
| S52572C | 24 | 955-965 | S53002A | 24 | 955-965 | S548X9D | 23 | 949-950 | ||
| S52572D | 08 | 559-561 | S53002D | 23 | 949-950 | S548X9S | 01 | 091-093 | ||
| S52572E | 08 | 559-561 | S53002S | 08 | 562-563 | S5490XA | 01 | 073-074 | ||
| S52572F | 08 | 559-561 | S53003A | 08 | 562-563 | S5490XA | 24 | 955-965 | ||
| S52572G | 08 | 559-561 | S53003A | 24 | 955-965 | S5490XD | 23 | 949-950 | ||
| S52572H | 08 | 559-561 | S53003D | 23 | 949-950 | S5490XS | 01 | 091-093 | ||
| S52572J | 08 | 559-561 | S53003S | 08 | 562-563 | S5491XA | 01 | 073-074 | ||
| S52572K | 08 | 564-566 | S53004A | 08 | 562-563 | S5491XA | 24 | 955-965 | ||
| S52572M | 08 | 564-566 | S53004A | 24 | 955-965 | S5491XD | 23 | 949-950 | ||
| S52572N | 08 | 564-566 | S53004D | 23 | 949-950 | S5491XS | 01 | 091-093 | ||
| S52572P | 08 | 564-566 | S53004S | 08 | 562-563 | S5492XA | 01 | 073-074 | ||
| S52572Q | 08 | 564-566 | S53005A | 08 | 562-563 | S5492XA | 24 | 955-965 | ||
| S52572R | 08 | 564-566 | S53005A | 24 | 955-965 | S5492XD | 23 | 949-950 | ||
| S52572S | 08 | 559-561 | S53005D | 23 | 949-950 | S5492XS | 01 | 091-093 | ||
| S52579A | 08 | 562-563 | S53005S | 08 | 562-563 | S55001A | 21 | 913-914 | ||
| S52579A | 24 | 955-965 | S53006A | 08 | 562-563 | S55001A | 24 | 955-965 | ||
| S52579B | 08 | 562-563 | S53006A | 24 | 955-965 | S55001D | 23 | 949-950 | ||
| S52579B | 24 | 955-965 | S53006D | 23 | 949-950 | S55001S | 05 | 299-301 | ||
| S52579C | 08 | 562-563 | S53006S | 08 | 562-563 | S55002A | 21 | 913-914 | ||
| S52579C | 24 | 955-965 | S53011A | 08 | 562-563 | S55002A | 24 | 955-965 | ||
| S52579D | 08 | 559-561 | S53011A | 24 | 955-965 | S55002D | 23 | 949-950 | ||
| S52579E | 08 | 559-561 | S53011D | 23 | 949-950 | S55002S | 05 | 299-301 | ||
| S52579F | 08 | 559-561 | S53011S | 08 | 562-563 | S55009A | 21 | 913-914 | ||
| S52579G | 08 | 559-561 | S53012A | 08 | 562-563 | S55009A | 24 | 955-965 | ||
| S52579H | 08 | 559-561 | S53012A | 24 | 955-965 | S55009D | 23 | 949-950 | ||
| S52579J | 08 | 559-561 | S53012D | 23 | 949-950 | S55009S | 05 | 299-301 | ||
| S52579K | 08 | 564-566 | S53012S | 08 | 562-563 | S55011A | 21 | 913-914 | ||
| S52579M | 08 | 564-566 | S53013A | 08 | 562-563 | S55011A | 24 | 955-965 | ||
| S52579N | 08 | 564-566 | S53013A | 24 | 955-965 | S55011D | 23 | 949-950 | ||
| S52579P | 08 | 564-566 | S53013D | 23 | 949-950 | S55011S | 05 | 299-301 | ||
| S52579Q | 08 | 564-566 | S53013S | 08 | 562-563 | S55012A | 21 | 913-914 | ||
| S52579R | 08 | 564-566 | S53014A | 08 | 562-563 | S55012A | 24 | 955-965 | ||
| S52579S | 08 | 559-561 | S53014A | 24 | 955-965 | S55012D | 23 | 949-950 | ||
| S52591A | 08 | 562-563 | S53014D | 23 | 949-950 | S55012S | 05 | 299-301 | ||
| S52591A | 24 | 955-965 | S53014S | 08 | 562-563 | S55019A | 21 | 913-914 | ||
| S52591B | 08 | 562-563 | S53015A | 08 | 562-563 | S55019A | 24 | 955-965 | ||
| S52591B | 24 | 955-965 | S53015A | 24 | 955-965 | S55019D | 23 | 949-950 | ||
| S52591C | 08 | 562-563 | S53015D | 23 | 949-950 | S55019S | 05 | 299-301 | ||
| S52591C | 24 | 955-965 | S53015S | 08 | 562-563 | S55091A | 21 | 913-914 | ||
| S52591D | 08 | 559-561 | S53016A | 08 | 562-563 | S55091A | 24 | 955-965 | ||
| S52591E | 08 | 559-561 | S53016A | 24 | 955-965 | S55091D | 23 | 949-950 | ||
| S52591F | 08 | 559-561 | S53016D | 23 | 949-950 | S55091S | 05 | 299-301 | ||
| S52591G | 08 | 559-561 | S53016S | 08 | 562-563 | S55092A | 21 | 913-914 | ||
| S52591H | 08 | 559-561 | S53021A | 08 | 562-563 | S55092A | 24 | 955-965 | ||
| S52591J | 08 | 559-561 | S53021A | 24 | 955-965 | S55092D | 23 | 949-950 | ||
| S52591K | 08 | 564-566 | S53021D | 23 | 949-950 | S55092S | 05 | 299-301 | ||
| S52591M | 08 | 564-566 | S53021S | 08 | 562-563 | S55099A | 21 | 913-914 | ||
| S52591N | 08 | 564-566 | S53022A | 08 | 562-563 | S55099A | 24 | 955-965 | ||
| S52591P | 08 | 564-566 | S53022A | 24 | 955-965 | S55099D | 23 | 949-950 | ||
| S52591Q | 08 | 564-566 | S53022D | 23 | 949-950 | S55099S | 05 | 299-301 | ||
| S52591R | 08 | 564-566 | S53022S | 08 | 562-563 | S55101A | 21 | 913-914 | ||
| S52591S | 08 | 559-561 | S53023A | 08 | 562-563 | S55101A | 24 | 955-965 | ||
| S52592A | 08 | 562-563 | S53023A | 24 | 955-965 | S55101D | 23 | 949-950 | ||
| S52592A | 24 | 955-965 | S53023D | 23 | 949-950 | S55101S | 05 | 299-301 | ||
| S52592B | 08 | 562-563 | S53023S | 08 | 562-563 | S55102A | 21 | 913-914 | ||
| S52592B | 24 | 955-965 | S53024A | 08 | 562-563 | S55102A | 24 | 955-965 | ||
| S52592C | 08 | 562-563 | S53024A | 24 | 955-965 | S55102D | 23 | 949-950 | ||
| S52592C | 24 | 955-965 | S53024D | 23 | 949-950 | S55102S | 05 | 299-301 | ||
| S52592D | 08 | 559-561 | S53024S | 08 | 562-563 | S55109A | 21 | 913-914 | ||
| S52592E | 08 | 559-561 | S53025A | 08 | 562-563 | S55109A | 24 | 955-965 | ||
| S52592F | 08 | 559-561 | S53025A | 24 | 955-965 | S55109D | 23 | 949-950 | ||
| S52592G | 08 | 559-561 | S53025D | 23 | 949-950 | S55109S | 05 | 299-301 | ||
| S52592H | 08 | 559-561 | S53025S | 08 | 562-563 | S55111A | 21 | 913-914 | ||
| S52592J | 08 | 559-561 | S53026A | 08 | 562-563 | S55111A | 24 | 955-965 | ||
| S52592K | 08 | 564-566 | S53026A | 24 | 955-965 | S55111D | 23 | 949-950 | ||
| S52592M | 08 | 564-566 | S53026D | 23 | 949-950 | S55111S | 05 | 299-301 | ||
| S52592N | 08 | 564-566 | S53026S | 08 | 562-563 | S55112A | 21 | 913-914 | ||
| S52592P | 08 | 564-566 | S53031A | 08 | 562-563 | S55112A | 24 | 955-965 | ||
| S52592Q | 08 | 564-566 | S53031A | 24 | 955-965 | S55112D | 23 | 949-950 | ||
| S52592R | 08 | 564-566 | S53031D | 23 | 949-950 | S55112S | 05 | 299-301 | ||
| S52592S | 08 | 559-561 | S53031S | 08 | 562-563 | S55119A | 21 | 913-914 | ||
| S52599A | 08 | 562-563 | S53032A | 08 | 562-563 | S55119A | 24 | 955-965 | ||
| S52599A | 24 | 955-965 | S53032A | 24 | 955-965 | S55119D | 23 | 949-950 | ||
| S52599B | 08 | 562-563 | S53032D | 23 | 949-950 | S55119S | 05 | 299-301 | ||
| S52599B | 24 | 955-965 | S53032S | 08 | 562-563 | S55191A | 21 | 913-914 | ||
| S52599C | 08 | 562-563 | S53033A | 08 | 562-563 | S55191A | 24 | 955-965 | ||
| S52599C | 24 | 955-965 | S53033A | 24 | 955-965 | S55191D | 23 | 949-950 | ||
| S52599D | 08 | 559-561 | S53033D | 23 | 949-950 | S55191S | 05 | 299-301 | ||
| S52599E | 08 | 559-561 | S53033S | 08 | 562-563 | S55192A | 21 | 913-914 | ||
| S52599F | 08 | 559-561 | S53091A | 08 | 562-563 | S55192A | 24 | 955-965 | ||
| S52599G | 08 | 559-561 | S53091A | 24 | 955-965 | S55192D | 23 | 949-950 | ||
| S52599H | 08 | 559-561 | S53091D | 23 | 949-950 | S55192S | 05 | 299-301 | ||
| S52599J | 08 | 559-561 | S53091S | 08 | 562-563 | S55199A | 21 | 913-914 | ||
| S52599K | 08 | 564-566 | S53092A | 08 | 562-563 | S55199A | 24 | 955-965 | ||
| S52599M | 08 | 564-566 | S53092A | 24 | 955-965 | S55199D | 23 | 949-950 | ||
| S52599N | 08 | 564-566 | S53092D | 23 | 949-950 | S55199S | 05 | 299-301 | ||
| S52599P | 08 | 564-566 | S53092S | 08 | 562-563 | S55201A | 21 | 913-914 | ||
| S52599Q | 08 | 564-566 | S53093A | 08 | 562-563 | S55201A | 24 | 955-965 | ||
| S52599R | 08 | 564-566 | S53093A | 24 | 955-965 | S55201D | 23 | 949-950 | ||
| S52599S | 08 | 559-561 | S53093D | 23 | 949-950 | S55201S | 05 | 299-301 | ||
| S52601A | 08 | 562-563 | S53093S | 08 | 562-563 | S55202A | 21 | 913-914 | ||
| S52601A | 24 | 955-965 | S53094A | 08 | 562-563 | S55202A | 24 | 955-965 | ||
| S52601B | 08 | 562-563 | S53094A | 24 | 955-965 | S55202D | 23 | 949-950 | ||
| S52601B | 24 | 955-965 | S53094D | 23 | 949-950 | S55202S | 05 | 299-301 | ||
| S52601C | 08 | 562-563 | S53094S | 08 | 562-563 | S55209A | 21 | 913-914 | ||
| S52601C | 24 | 955-965 | S53095A | 08 | 562-563 | S55209A | 24 | 955-965 | ||
| S52601D | 08 | 559-561 | S53095A | 24 | 955-965 | S55209D | 23 | 949-950 | ||
| S52601E | 08 | 559-561 | S53095D | 23 | 949-950 | S55209S | 05 | 299-301 | ||
| S52601F | 08 | 559-561 | S53095S | 08 | 562-563 | S55211A | 21 | 913-914 | ||
| S52601G | 08 | 559-561 | S53096A | 08 | 562-563 | S55211A | 24 | 955-965 | ||
| S52601H | 08 | 559-561 | S53096A | 24 | 955-965 | S55211D | 23 | 949-950 | ||
| S52601J | 08 | 559-561 | S53096D | 23 | 949-950 | S55211S | 05 | 299-301 | ||
| S52601K | 08 | 564-566 | S53096S | 08 | 562-563 | S55212A | 21 | 913-914 | ||
| S52601M | 08 | 564-566 | S53101A | 08 | 562-563 | S55212A | 24 | 955-965 | ||
| S52601N | 08 | 564-566 | S53101A | 24 | 955-965 | S55212D | 23 | 949-950 | ||
| S52601P | 08 | 564-566 | S53101D | 23 | 949-950 | S55212S | 05 | 299-301 | ||
| S52601Q | 08 | 564-566 | S53101S | 08 | 562-563 | S55219A | 21 | 913-914 | ||
| S52601R | 08 | 564-566 | S53102A | 08 | 562-563 | S55219A | 24 | 955-965 | ||
| S52601S | 08 | 559-561 | S53102A | 24 | 955-965 | S55219D | 23 | 949-950 | ||
| S52602A | 08 | 562-563 | S53102D | 23 | 949-950 | S55219S | 05 | 299-301 | ||
| S52602A | 24 | 955-965 | S53102S | 08 | 562-563 | S55291A | 21 | 913-914 | ||
| S52602B | 08 | 562-563 | S53103A | 08 | 562-563 | S55291A | 24 | 955-965 | ||
| S52602B | 24 | 955-965 | S53103A | 24 | 955-965 | S55291D | 23 | 949-950 | ||
| S52602C | 08 | 562-563 | S53103D | 23 | 949-950 | S55291S | 05 | 299-301 | ||
| S52602C | 24 | 955-965 | S53103S | 08 | 562-563 | S55292A | 21 | 913-914 | ||
| S52602D | 08 | 559-561 | S53104A | 08 | 562-563 | S55292A | 24 | 955-965 | ||
| S52602E | 08 | 559-561 | S53104A | 24 | 955-965 | S55292D | 23 | 949-950 | ||
| S52602F | 08 | 559-561 | S53104D | 23 | 949-950 | S55292S | 05 | 299-301 | ||
| S52602G | 08 | 559-561 | S53104S | 08 | 562-563 | S55299A | 21 | 913-914 | ||
| S52602H | 08 | 559-561 | S53105A | 08 | 562-563 | S55299A | 24 | 955-965 | ||
| S52602J | 08 | 559-561 | S53105A | 24 | 955-965 | S55299D | 23 | 949-950 | ||
| S52602K | 08 | 564-566 | S53105D | 23 | 949-950 | S55299S | 05 | 299-301 | ||
| S52602M | 08 | 564-566 | S53105S | 08 | 562-563 | S55801A | 21 | 913-914 | ||
| S52602N | 08 | 564-566 | S53106A | 08 | 562-563 | S55801A | 24 | 955-965 | ||
| S52602P | 08 | 564-566 | S53106A | 24 | 955-965 | S55801D | 23 | 949-950 | ||
| S52602Q | 08 | 564-566 | S53106D | 23 | 949-950 | S55801S | 05 | 299-301 | ||
| S52602R | 08 | 564-566 | S53106S | 08 | 562-563 | S55802A | 21 | 913-914 | ||
| S52602S | 08 | 559-561 | S53111A | 08 | 562-563 | S55802A | 24 | 955-965 | ||
| S52609A | 08 | 562-563 | S53111A | 24 | 955-965 | S55802D | 23 | 949-950 | ||
| S52609A | 24 | 955-965 | S53111D | 23 | 949-950 | S55802S | 05 | 299-301 | ||
| S52609B | 08 | 562-563 | S53111S | 08 | 562-563 | S55809A | 21 | 913-914 | ||
| S52609B | 24 | 955-965 | S53112A | 08 | 562-563 | S55809A | 24 | 955-965 | ||
| S52609C | 08 | 562-563 | S53112A | 24 | 955-965 | S55809D | 23 | 949-950 | ||
| S52609C | 24 | 955-965 | S53112D | 23 | 949-950 | S55809S | 05 | 299-301 | ||
| S52609D | 08 | 559-561 | S53112S | 08 | 562-563 | S55811A | 21 | 913-914 | ||
| S52609E | 08 | 559-561 | S53113A | 08 | 562-563 | S55811A | 24 | 955-965 | ||
| S52609F | 08 | 559-561 | S53113A | 24 | 955-965 | S55811D | 23 | 949-950 | ||
| S52609G | 08 | 559-561 | S53113D | 23 | 949-950 | S55811S | 05 | 299-301 | ||
| S52609H | 08 | 559-561 | S53113S | 08 | 562-563 | S55812A | 21 | 913-914 | ||
| S52609J | 08 | 559-561 | S53114A | 08 | 562-563 | S55812A | 24 | 955-965 | ||
| S52609K | 08 | 564-566 | S53114A | 24 | 955-965 | S55812D | 23 | 949-950 | ||
| S52609M | 08 | 564-566 | S53114D | 23 | 949-950 | S55812S | 05 | 299-301 | ||
| S52609N | 08 | 564-566 | S53114S | 08 | 562-563 | S55819A | 21 | 913-914 | ||
| S52609P | 08 | 564-566 | S53115A | 08 | 562-563 | S55819A | 24 | 955-965 | ||
| S52609Q | 08 | 564-566 | S53115A | 24 | 955-965 | S55819D | 23 | 949-950 | ||
| S52609R | 08 | 564-566 | S53115D | 23 | 949-950 | S55819S | 05 | 299-301 | ||
| S52609S | 08 | 559-561 | S53115S | 08 | 562-563 | S55891A | 21 | 913-914 | ||
| S52611A | 08 | 562-563 | S53116A | 08 | 562-563 | S55891A | 24 | 955-965 | ||
| S52611A | 24 | 955-965 | S53116A | 24 | 955-965 | S55891D | 23 | 949-950 | ||
| S52611B | 08 | 562-563 | S53116D | 23 | 949-950 | S55891S | 05 | 299-301 | ||
| S52611B | 24 | 955-965 | S53116S | 08 | 562-563 | S55892A | 21 | 913-914 | ||
| S52611C | 08 | 562-563 | S53121A | 08 | 562-563 | S55892A | 24 | 955-965 | ||
| S52611C | 24 | 955-965 | S53121A | 24 | 955-965 | S55892D | 23 | 949-950 | ||
| S52611D | 08 | 559-561 | S53121D | 23 | 949-950 | S55892S | 05 | 299-301 | ||
| S52611E | 08 | 559-561 | S53121S | 08 | 562-563 | S55899A | 21 | 913-914 | ||
| S52611F | 08 | 559-561 | S53122A | 08 | 562-563 | S55899A | 24 | 955-965 | ||
| S52611G | 08 | 559-561 | S53122A | 24 | 955-965 | S55899D | 23 | 949-950 | ||
| S52611H | 08 | 559-561 | S53122D | 23 | 949-950 | S55899S | 05 | 299-301 | ||
| S52611J | 08 | 559-561 | S53122S | 08 | 562-563 | S55901A | 21 | 913-914 | ||
| S52611K | 08 | 564-566 | S53123A | 08 | 562-563 | S55901A | 24 | 955-965 | ||
| S52611M | 08 | 564-566 | S53123A | 24 | 955-965 | S55901D | 23 | 949-950 | ||
| S52611N | 08 | 564-566 | S53123D | 23 | 949-950 | S55901S | 05 | 299-301 | ||
| S52611P | 08 | 564-566 | S53123S | 08 | 562-563 | S55902A | 21 | 913-914 | ||
| S52611Q | 08 | 564-566 | S53124A | 08 | 562-563 | S55902A | 24 | 955-965 | ||
| S52611R | 08 | 564-566 | S53124A | 24 | 955-965 | S55902D | 23 | 949-950 | ||
| S52611S | 08 | 559-561 | S53124D | 23 | 949-950 | S55902S | 05 | 299-301 | ||
| S52612A | 08 | 562-563 | S53124S | 08 | 562-563 | S55909A | 21 | 913-914 | ||
| S52612A | 24 | 955-965 | S53125A | 08 | 562-563 | S55909A | 24 | 955-965 | ||
| S52612B | 08 | 562-563 | S53125A | 24 | 955-965 | S55909D | 23 | 949-950 | ||
| S52612B | 24 | 955-965 | S53125D | 23 | 949-950 | S55909S | 05 | 299-301 | ||
| S52612C | 08 | 562-563 | S53125S | 08 | 562-563 | S55911A | 21 | 913-914 | ||
| S52612C | 24 | 955-965 | S53126A | 08 | 562-563 | S55911A | 24 | 955-965 | ||
| S52612D | 08 | 559-561 | S53126A | 24 | 955-965 | S55911D | 23 | 949-950 | ||
| S52612E | 08 | 559-561 | S53126D | 23 | 949-950 | S55911S | 05 | 299-301 | ||
| S52612F | 08 | 559-561 | S53126S | 08 | 562-563 | S55912A | 21 | 913-914 | ||
| S52612G | 08 | 559-561 | S53131A | 08 | 562-563 | S55912A | 24 | 955-965 | ||
| S52612H | 08 | 559-561 | S53131A | 24 | 955-965 | S55912D | 23 | 949-950 | ||
| S52612J | 08 | 559-561 | S53131D | 23 | 949-950 | S55912S | 05 | 299-301 | ||
| S52612K | 08 | 564-566 | S53131S | 08 | 562-563 | S55919A | 21 | 913-914 | ||
| S52612M | 08 | 564-566 | S53132A | 08 | 562-563 | S55919A | 24 | 955-965 | ||
| S52612N | 08 | 564-566 | S53132A | 24 | 955-965 | S55919D | 23 | 949-950 | ||
| S52612P | 08 | 564-566 | S53132D | 23 | 949-950 | S55919S | 05 | 299-301 | ||
| S52612Q | 08 | 564-566 | S53132S | 08 | 562-563 | S55991A | 21 | 913-914 | ||
| S52612R | 08 | 564-566 | S53133A | 08 | 562-563 | S55991A | 24 | 955-965 | ||
| S52612S | 08 | 559-561 | S53133A | 24 | 955-965 | S55991D | 23 | 949-950 | ||
| S52613A | 08 | 562-563 | S53133D | 23 | 949-950 | S55991S | 05 | 299-301 | ||
| S52613A | 24 | 955-965 | S53133S | 08 | 562-563 | S55992A | 21 | 913-914 | ||
| S52613B | 08 | 562-563 | S53134A | 08 | 562-563 | S55992A | 24 | 955-965 | ||
| S52613B | 24 | 955-965 | S53134A | 24 | 955-965 | S55992D | 23 | 949-950 | ||
| S52613C | 08 | 562-563 | S53134D | 23 | 949-950 | S55992S | 05 | 299-301 | ||
| S52613C | 24 | 955-965 | S53134S | 08 | 562-563 | S55999A | 21 | 913-914 | ||
| S52613D | 08 | 559-561 | S53135A | 08 | 562-563 | S55999A | 24 | 955-965 | ||
| S52613E | 08 | 559-561 | S53135A | 24 | 955-965 | S55999D | 23 | 949-950 | ||
| S52613F | 08 | 559-561 | S53135D | 23 | 949-950 | S55999S | 05 | 299-301 | ||
| S52613G | 08 | 559-561 | S53135S | 08 | 562-563 | S56001A | 21 | 913-914 | ||
| S52613H | 08 | 559-561 | S53136A | 08 | 562-563 | S56001A | 24 | 955-965 | ||
| S52613J | 08 | 559-561 | S53136A | 24 | 955-965 | S56001D | 23 | 949-950 | ||
| S52613K | 08 | 564-566 | S53136D | 23 | 949-950 | S56001S | 21 | 913-914 | ||
| S52613M | 08 | 564-566 | S53136S | 08 | 562-563 | S56002A | 21 | 913-914 | ||
| S52613N | 08 | 564-566 | S53141A | 08 | 562-563 | S56002A | 24 | 955-965 | ||
| S52613P | 08 | 564-566 | S53141A | 24 | 955-965 | S56002D | 23 | 949-950 | ||
| S52613Q | 08 | 564-566 | S53141D | 23 | 949-950 | S56002S | 21 | 913-914 | ||
| S52613R | 08 | 564-566 | S53141S | 08 | 562-563 | S56009A | 21 | 913-914 | ||
| S52613S | 08 | 559-561 | S53142A | 08 | 562-563 | S56009A | 24 | 955-965 | ||
| S52614A | 08 | 562-563 | S53142A | 24 | 955-965 | S56009D | 23 | 949-950 | ||
| S52614A | 24 | 955-965 | S53142D | 23 | 949-950 | S56009S | 21 | 913-914 | ||
| S52614B | 08 | 562-563 | S53142S | 08 | 562-563 | S56011A | 08 | 562-563 | ||
| S52614B | 24 | 955-965 | S53143A | 08 | 562-563 | S56011A | 24 | 955-965 | ||
| S52614C | 08 | 562-563 | S53143A | 24 | 955-965 | S56011D | 23 | 949-950 | ||
| S52614C | 24 | 955-965 | S53143D | 23 | 949-950 | S56011S | 08 | 562-563 | ||
| S52614D | 08 | 559-561 | S53143S | 08 | 562-563 | S56012A | 08 | 562-563 | ||
| S52614E | 08 | 559-561 | S53144A | 08 | 562-563 | S56012A | 24 | 955-965 | ||
| S52614F | 08 | 559-561 | S53144A | 24 | 955-965 | S56012D | 23 | 949-950 | ||
| S52614G | 08 | 559-561 | S53144D | 23 | 949-950 | S56012S | 08 | 562-563 | ||
| S52614H | 08 | 559-561 | S53144S | 08 | 562-563 | S56019A | 08 | 562-563 | ||
| S52614J | 08 | 559-561 | S53145A | 08 | 562-563 | S56019A | 24 | 955-965 | ||
| S52614K | 08 | 564-566 | S53145A | 24 | 955-965 | S56019D | 23 | 949-950 | ||
| S52614M | 08 | 564-566 | S53145D | 23 | 949-950 | S56019S | 08 | 562-563 | ||
| S52614N | 08 | 564-566 | S53145S | 08 | 562-563 | S56021A | 08 | 564-566 | ||
| S52614P | 08 | 564-566 | S53146A | 08 | 562-563 | S56021A | 24 | 955-965 | ||
| S52614Q | 08 | 564-566 | S53146A | 24 | 955-965 | S56021D | 23 | 949-950 | ||
| S52614R | 08 | 564-566 | S53146D | 23 | 949-950 | S56021S | 09 | 604-605 | ||
| S52614S | 08 | 559-561 | S53146S | 08 | 562-563 | S56022A | 08 | 564-566 | ||
| S52615A | 08 | 562-563 | S53191A | 08 | 562-563 | S56022A | 24 | 955-965 | ||
| S52615A | 24 | 955-965 | S53191A | 24 | 955-965 | S56022D | 23 | 949-950 | ||
| S52615B | 08 | 562-563 | S53191D | 23 | 949-950 | S56022S | 09 | 604-605 | ||
| S52615B | 24 | 955-965 | S53191S | 08 | 562-563 | S56029A | 08 | 564-566 | ||
| S52615C | 08 | 562-563 | S53192A | 08 | 562-563 | S56029A | 24 | 955-965 | ||
| S52615C | 24 | 955-965 | S53192A | 24 | 955-965 | S56029D | 23 | 949-950 | ||
| S52615D | 08 | 559-561 | S53192D | 23 | 949-950 | S56029S | 09 | 604-605 | ||
| S52615E | 08 | 559-561 | S53192S | 08 | 562-563 | S56091A | 21 | 913-914 | ||
| S52615F | 08 | 559-561 | S53193A | 08 | 562-563 | S56091A | 24 | 955-965 | ||
| S52615G | 08 | 559-561 | S53193A | 24 | 955-965 | S56091D | 23 | 949-950 | ||
| S52615H | 08 | 559-561 | S53193D | 23 | 949-950 | S56091S | 21 | 913-914 | ||
| S52615J | 08 | 559-561 | S53193S | 08 | 562-563 | S56092A | 21 | 913-914 | ||
| S52615K | 08 | 564-566 | S53194A | 08 | 562-563 | S56092A | 24 | 955-965 | ||
| S52615M | 08 | 564-566 | S53194A | 24 | 955-965 | S56092D | 23 | 949-950 | ||
| S52615N | 08 | 564-566 | S53194D | 23 | 949-950 | S56092S | 21 | 913-914 | ||
| S52615P | 08 | 564-566 | S53194S | 08 | 562-563 | S56099A | 21 | 913-914 | ||
| S52615Q | 08 | 564-566 | S53195A | 08 | 562-563 | S56099A | 24 | 955-965 | ||
| S52615R | 08 | 564-566 | S53195A | 24 | 955-965 | S56099D | 23 | 949-950 | ||
| S52615S | 08 | 559-561 | S53195D | 23 | 949-950 | S56099S | 21 | 913-914 | ||
| S52616A | 08 | 562-563 | S53195S | 08 | 562-563 | S56101A | 21 | 913-914 | ||
| S52616A | 24 | 955-965 | S53196A | 08 | 562-563 | S56101A | 24 | 955-965 | ||
| S52616B | 08 | 562-563 | S53196A | 24 | 955-965 | S56101D | 23 | 949-950 | ||
| S52616B | 24 | 955-965 | S53196D | 23 | 949-950 | S56101S | 21 | 913-914 | ||
| S52616C | 08 | 562-563 | S53196S | 08 | 562-563 | S56102A | 21 | 913-914 | ||
| S52616C | 24 | 955-965 | S5320XA | 08 | 562-563 | S56102A | 24 | 955-965 | ||
| S52616D | 08 | 559-561 | S5320XA | 24 | 955-965 | S56102D | 23 | 949-950 | ||
| S52616E | 08 | 559-561 | S5320XD | 23 | 949-950 | S56102S | 21 | 913-914 | ||
| S52616F | 08 | 559-561 | S5320XS | 08 | 562-563 | S56103A | 21 | 913-914 | ||
| S52616G | 08 | 559-561 | S5321XA | 08 | 562-563 | S56103A | 24 | 955-965 | ||
| S52616H | 08 | 559-561 | S5321XA | 24 | 955-965 | S56103D | 23 | 949-950 | ||
| S52616J | 08 | 559-561 | S5321XD | 23 | 949-950 | S56103S | 21 | 913-914 | ||
| S52616K | 08 | 564-566 | S5321XS | 08 | 562-563 | S56104A | 21 | 913-914 | ||
| S52616M | 08 | 564-566 | S5322XA | 08 | 562-563 | S56104A | 24 | 955-965 | ||
| S52616N | 08 | 564-566 | S5322XA | 24 | 955-965 | S56104D | 23 | 949-950 | ||
| S52616P | 08 | 564-566 | S5322XD | 23 | 949-950 | S56104S | 21 | 913-914 | ||
| S52616Q | 08 | 564-566 | S5322XS | 08 | 562-563 | S56105A | 21 | 913-914 | ||
| S52616R | 08 | 564-566 | S5330XA | 08 | 562-563 | S56105A | 24 | 955-965 | ||
| S52616S | 08 | 559-561 | S5330XA | 24 | 955-965 | S56105D | 23 | 949-950 | ||
| S52621A | 08 | 562-563 | S5330XD | 23 | 949-950 | S56105S | 21 | 913-914 | ||
| S52621A | 24 | 955-965 | S5330XS | 08 | 562-563 | S56106A | 21 | 913-914 | ||
| S52621D | 08 | 559-561 | S5331XA | 08 | 562-563 | S56106A | 24 | 955-965 | ||
| S52621G | 08 | 559-561 | S5331XA | 24 | 955-965 | S56106D | 23 | 949-950 | ||
| S52621K | 08 | 564-566 | S5331XD | 23 | 949-950 | S56106S | 21 | 913-914 | ||
| S52621P | 08 | 564-566 | S5331XS | 08 | 562-563 | S56107A | 21 | 913-914 | ||
| S52621S | 08 | 559-561 | S5332XA | 08 | 562-563 | S56107A | 24 | 955-965 | ||
| S52622A | 08 | 562-563 | S5332XA | 24 | 955-965 | S56107D | 23 | 949-950 | ||
| S52622A | 24 | 955-965 | S5332XD | 23 | 949-950 | S56107S | 21 | 913-914 | ||
| S52622D | 08 | 559-561 | S5332XS | 08 | 562-563 | S56108A | 21 | 913-914 | ||
| S52622G | 08 | 559-561 | S53401A | 08 | 562-563 | S56108A | 24 | 955-965 | ||
| S52622K | 08 | 564-566 | S53401A | 24 | 955-965 | S56108D | 23 | 949-950 | ||
| S52622P | 08 | 564-566 | S53401D | 23 | 949-950 | S56108S | 21 | 913-914 | ||
| S52622S | 08 | 559-561 | S53401S | 08 | 562-563 | S56109A | 21 | 913-914 | ||
| S52629A | 08 | 562-563 | S53402A | 08 | 562-563 | S56109A | 24 | 955-965 | ||
| S52629A | 24 | 955-965 | S53402A | 24 | 955-965 | S56109D | 23 | 949-950 | ||
| S52629D | 08 | 559-561 | S53402D | 23 | 949-950 | S56109S | 21 | 913-914 | ||
| S52629G | 08 | 559-561 | S53402S | 08 | 562-563 | S56111A | 08 | 562-563 | ||
| S52629K | 08 | 564-566 | S53409A | 08 | 562-563 | S56111A | 24 | 955-965 | ||
| S52629P | 08 | 564-566 | S53409A | 24 | 955-965 | S56111D | 23 | 949-950 | ||
| S52629S | 08 | 559-561 | S53409D | 23 | 949-950 | S56111S | 08 | 562-563 | ||
| S52691A | 08 | 562-563 | S53409S | 08 | 562-563 | S56112A | 08 | 562-563 | ||
| S52691A | 24 | 955-965 | S53411A | 08 | 562-563 | S56112A | 24 | 955-965 | ||
| S52691B | 08 | 562-563 | S53411A | 24 | 955-965 | S56112D | 23 | 949-950 | ||
| S52691B | 24 | 955-965 | S53411D | 23 | 949-950 | S56112S | 08 | 562-563 | ||
| S52691C | 08 | 562-563 | S53411S | 08 | 562-563 | S56113A | 08 | 562-563 | ||
| S52691C | 24 | 955-965 | S53412A | 08 | 562-563 | S56113A | 24 | 955-965 | ||
| S52691D | 08 | 559-561 | S53412A | 24 | 955-965 | S56113D | 23 | 949-950 | ||
| S52691E | 08 | 559-561 | S53412D | 23 | 949-950 | S56113S | 08 | 562-563 | ||
| S52691F | 08 | 559-561 | S53412S | 08 | 562-563 | S56114A | 08 | 562-563 | ||
| S52691G | 08 | 559-561 | S53419A | 08 | 562-563 | S56114A | 24 | 955-965 | ||
| S52691H | 08 | 559-561 | S53419A | 24 | 955-965 | S56114D | 23 | 949-950 | ||
| S52691J | 08 | 559-561 | S53419D | 23 | 949-950 | S56114S | 08 | 562-563 | ||
| S52691K | 08 | 564-566 | S53419S | 08 | 562-563 | S56115A | 08 | 562-563 | ||
| S52691M | 08 | 564-566 | S53421A | 08 | 562-563 | S56115A | 24 | 955-965 | ||
| S52691N | 08 | 564-566 | S53421A | 24 | 955-965 | S56115D | 23 | 949-950 | ||
| S52691P | 08 | 564-566 | S53421D | 23 | 949-950 | S56115S | 08 | 562-563 | ||
| S52691Q | 08 | 564-566 | S53421S | 08 | 562-563 | S56116A | 08 | 562-563 | ||
| S52691R | 08 | 564-566 | S53422A | 08 | 562-563 | S56116A | 24 | 955-965 | ||
| S52691S | 08 | 559-561 | S53422A | 24 | 955-965 | S56116D | 23 | 949-950 | ||
| S52692A | 08 | 562-563 | S53422D | 23 | 949-950 | S56116S | 08 | 562-563 | ||
| S52692A | 24 | 955-965 | S53422S | 08 | 562-563 | S56117A | 08 | 562-563 | ||
| S52692B | 08 | 562-563 | S53429A | 08 | 562-563 | S56117A | 24 | 955-965 | ||
| S52692B | 24 | 955-965 | S53429A | 24 | 955-965 | S56117D | 23 | 949-950 | ||
| S52692C | 08 | 562-563 | S53429D | 23 | 949-950 | S56117S | 08 | 562-563 | ||
| S52692C | 24 | 955-965 | S53429S | 08 | 562-563 | S56118A | 08 | 562-563 | ||
| S52692D | 08 | 559-561 | S53431A | 08 | 562-563 | S56118A | 24 | 955-965 | ||
| S52692E | 08 | 559-561 | S53431A | 24 | 955-965 | S56118D | 23 | 949-950 | ||
| S52692F | 08 | 559-561 | S53431D | 23 | 949-950 | S56118S | 08 | 562-563 | ||
| S52692G | 08 | 559-561 | S53431S | 08 | 562-563 | S56119A | 08 | 562-563 | ||
| S52692H | 08 | 559-561 | S53432A | 08 | 562-563 | S56119A | 24 | 955-965 | ||
| S52692J | 08 | 559-561 | S53432A | 24 | 955-965 | S56119D | 23 | 949-950 | ||
| S52692K | 08 | 564-566 | S53432D | 23 | 949-950 | S56119S | 08 | 562-563 | ||
| S52692M | 08 | 564-566 | S53432S | 08 | 562-563 | S56121A | 08 | 564-566 | ||
| S52692N | 08 | 564-566 | S53439A | 08 | 562-563 | S56121A | 24 | 955-965 | ||
| S52692P | 08 | 564-566 | S53439A | 24 | 955-965 | S56121D | 23 | 949-950 | ||
| S52692Q | 08 | 564-566 | S53439D | 23 | 949-950 | S56121S | 09 | 604-605 | ||
| S52692R | 08 | 564-566 | S53439S | 08 | 562-563 | S56122A | 08 | 564-566 | ||
| S52692S | 08 | 559-561 | S53441A | 08 | 562-563 | S56122A | 24 | 955-965 | ||
| S52699A | 08 | 562-563 | S53441A | 24 | 955-965 | S56122D | 23 | 949-950 | ||
| S52699A | 24 | 955-965 | S53441D | 23 | 949-950 | S56122S | 09 | 604-605 | ||
| S52699B | 08 | 562-563 | S53441S | 08 | 562-563 | S56123A | 08 | 564-566 | ||
| S52699B | 24 | 955-965 | S53442A | 08 | 562-563 | S56123A | 24 | 955-965 | ||
| S52699C | 08 | 562-563 | S53442A | 24 | 955-965 | S56123D | 23 | 949-950 | ||
| S52699C | 24 | 955-965 | S53442D | 23 | 949-950 | S56123S | 09 | 604-605 | ||
| S52699D | 08 | 559-561 | S53442S | 08 | 562-563 | S56124A | 08 | 564-566 | ||
| S52699E | 08 | 559-561 | S53449A | 08 | 562-563 | S56124A | 24 | 955-965 | ||
| S52699F | 08 | 559-561 | S53449A | 24 | 955-965 | S56124D | 23 | 949-950 | ||
| S52699G | 08 | 559-561 | S53449D | 23 | 949-950 | S56124S | 09 | 604-605 | ||
| S52699H | 08 | 559-561 | S53449S | 08 | 562-563 | S56125A | 08 | 564-566 | ||
| S52699J | 08 | 559-561 | S53491A | 08 | 562-563 | S56125A | 24 | 955-965 | ||
| S52699K | 08 | 564-566 | S53491A | 24 | 955-965 | S56125D | 23 | 949-950 | ||
| S52699M | 08 | 564-566 | S53491D | 23 | 949-950 | S56125S | 09 | 604-605 | ||
| S52699N | 08 | 564-566 | S53491S | 08 | 562-563 | S56126A | 08 | 564-566 | ||
| S52699P | 08 | 564-566 | S53492A | 08 | 562-563 | S56126A | 24 | 955-965 | ||
| S52699Q | 08 | 564-566 | S53492A | 24 | 955-965 | S56126D | 23 | 949-950 | ||
| S52699R | 08 | 564-566 | S53492D | 23 | 949-950 | S56126S | 09 | 604-605 | ||
| S52699S | 08 | 559-561 | S53492S | 08 | 562-563 | S56127A | 08 | 564-566 | ||
| S5290XA | 08 | 562-563 | S53499A | 08 | 562-563 | S56127A | 24 | 955-965 | ||
| S5290XA | 24 | 955-965 | S53499A | 24 | 955-965 | S56127D | 23 | 949-950 | ||
| S5290XB | 08 | 562-563 | S53499D | 23 | 949-950 | S56127S | 09 | 604-605 | ||
| S5290XB | 24 | 955-965 | S53499S | 08 | 562-563 | S56128A | 08 | 564-566 | ||
| S5290XC | 08 | 562-563 | S5400XA | 01 | 073-074 | S56128A | 24 | 955-965 | ||
| S5290XC | 24 | 955-965 | S5400XA | 24 | 955-965 | S56128D | 23 | 949-950 | ||
| S5290XD | 08 | 559-561 | S5400XD | 23 | 949-950 | S56128S | 09 | 604-605 | ||
| S5290XE | 08 | 559-561 | S5400XS | 01 | 091-093 | S56129A | 08 | 564-566 | ||
| S5290XF | 08 | 559-561 | S5401XA | 01 | 073-074 | S56129A | 24 | 955-965 | ||
| S5290XG | 08 | 559-561 | S5401XA | 24 | 955-965 | S56129D | 23 | 949-950 | ||
| S5290XH | 08 | 559-561 | S5401XD | 23 | 949-950 | S56129S | 09 | 604-605 | ||
| S5290XJ | 08 | 559-561 | S5401XS | 01 | 091-093 | S56191A | 21 | 913-914 | ||
| S5290XK | 08 | 564-566 | S5402XA | 01 | 073-074 | S56191A | 24 | 955-965 | ||
| S5290XM | 08 | 564-566 | S5402XA | 24 | 955-965 | S56191D | 23 | 949-950 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Aug 2017 11:52:25 CMS, code-revision=63, description-revision=616 |