ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 42 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S56191S | 21 | 913-914 | S56929A | 08 | 564-566 | S59219D | 08 | 559-561 | ||
| S56192A | 21 | 913-914 | S56929A | 24 | 955-965 | S59219G | 08 | 559-561 | ||
| S56192A | 24 | 955-965 | S56929D | 23 | 949-950 | S59219K | 08 | 564-566 | ||
| S56192D | 23 | 949-950 | S56929S | 09 | 604-605 | S59219P | 08 | 564-566 | ||
| S56192S | 21 | 913-914 | S56991A | 21 | 913-914 | S59219S | 08 | 559-561 | ||
| S56193A | 21 | 913-914 | S56991A | 24 | 955-965 | S59221A | 08 | 562-563 | ||
| S56193A | 24 | 955-965 | S56991D | 23 | 949-950 | S59221A | 24 | 955-965 | ||
| S56193D | 23 | 949-950 | S56991S | 21 | 913-914 | S59221D | 08 | 559-561 | ||
| S56193S | 21 | 913-914 | S56992A | 21 | 913-914 | S59221G | 08 | 559-561 | ||
| S56194A | 21 | 913-914 | S56992A | 24 | 955-965 | S59221K | 08 | 564-566 | ||
| S56194A | 24 | 955-965 | S56992D | 23 | 949-950 | S59221P | 08 | 564-566 | ||
| S56194D | 23 | 949-950 | S56992S | 21 | 913-914 | S59221S | 08 | 559-561 | ||
| S56194S | 21 | 913-914 | S56999A | 21 | 913-914 | S59222A | 08 | 562-563 | ||
| S56195A | 21 | 913-914 | S56999A | 24 | 955-965 | S59222A | 24 | 955-965 | ||
| S56195A | 24 | 955-965 | S56999D | 23 | 949-950 | S59222D | 08 | 559-561 | ||
| S56195D | 23 | 949-950 | S56999S | 21 | 913-914 | S59222G | 08 | 559-561 | ||
| S56195S | 21 | 913-914 | S5700XA | 21 | 913-914 | S59222K | 08 | 564-566 | ||
| S56196A | 21 | 913-914 | S5700XA | 24 | 955-965 | S59222P | 08 | 564-566 | ||
| S56196A | 24 | 955-965 | S5700XD | 23 | 949-950 | S59222S | 08 | 559-561 | ||
| S56196D | 23 | 949-950 | S5700XS | 09 | 604-605 | S59229A | 08 | 562-563 | ||
| S56196S | 21 | 913-914 | S5701XA | 21 | 913-914 | S59229A | 24 | 955-965 | ||
| S56197A | 21 | 913-914 | S5701XA | 24 | 955-965 | S59229D | 08 | 559-561 | ||
| S56197A | 24 | 955-965 | S5701XD | 23 | 949-950 | S59229G | 08 | 559-561 | ||
| S56197D | 23 | 949-950 | S5701XS | 09 | 604-605 | S59229K | 08 | 564-566 | ||
| S56197S | 21 | 913-914 | S5702XA | 21 | 913-914 | S59229P | 08 | 564-566 | ||
| S56198A | 21 | 913-914 | S5702XA | 24 | 955-965 | S59229S | 08 | 559-561 | ||
| S56198A | 24 | 955-965 | S5702XD | 23 | 949-950 | S59231A | 08 | 562-563 | ||
| S56198D | 23 | 949-950 | S5702XS | 09 | 604-605 | S59231A | 24 | 955-965 | ||
| S56198S | 21 | 913-914 | S5780XA | 21 | 913-914 | S59231D | 08 | 559-561 | ||
| S56199A | 21 | 913-914 | S5780XA | 24 | 955-965 | S59231G | 08 | 559-561 | ||
| S56199A | 24 | 955-965 | S5780XD | 23 | 949-950 | S59231K | 08 | 564-566 | ||
| S56199D | 23 | 949-950 | S5780XS | 09 | 604-605 | S59231P | 08 | 564-566 | ||
| S56199S | 21 | 913-914 | S5781XA | 21 | 913-914 | S59231S | 08 | 559-561 | ||
| S56201A | 21 | 913-914 | S5781XA | 24 | 955-965 | S59232A | 08 | 562-563 | ||
| S56201A | 24 | 955-965 | S5781XD | 23 | 949-950 | S59232A | 24 | 955-965 | ||
| S56201D | 23 | 949-950 | S5781XS | 09 | 604-605 | S59232D | 08 | 559-561 | ||
| S56201S | 21 | 913-914 | S5782XA | 21 | 913-914 | S59232G | 08 | 559-561 | ||
| S56202A | 21 | 913-914 | S5782XA | 24 | 955-965 | S59232K | 08 | 564-566 | ||
| S56202A | 24 | 955-965 | S5782XD | 23 | 949-950 | S59232P | 08 | 564-566 | ||
| S56202D | 23 | 949-950 | S5782XS | 09 | 604-605 | S59232S | 08 | 559-561 | ||
| S56202S | 21 | 913-914 | S58011A | 21 | 913-914 | S59239A | 08 | 562-563 | ||
| S56209A | 21 | 913-914 | S58011A | 24 | 955-965 | S59239A | 24 | 955-965 | ||
| S56209A | 24 | 955-965 | S58011D | 23 | 949-950 | S59239D | 08 | 559-561 | ||
| S56209D | 23 | 949-950 | S58011S | 08 | 559-561 | S59239G | 08 | 559-561 | ||
| S56209S | 21 | 913-914 | S58012A | 21 | 913-914 | S59239K | 08 | 564-566 | ||
| S56211A | 08 | 562-563 | S58012A | 24 | 955-965 | S59239P | 08 | 564-566 | ||
| S56211A | 24 | 955-965 | S58012D | 23 | 949-950 | S59239S | 08 | 559-561 | ||
| S56211D | 23 | 949-950 | S58012S | 08 | 559-561 | S59241A | 08 | 562-563 | ||
| S56211S | 08 | 562-563 | S58019A | 21 | 913-914 | S59241A | 24 | 955-965 | ||
| S56212A | 08 | 562-563 | S58019A | 24 | 955-965 | S59241D | 08 | 559-561 | ||
| S56212A | 24 | 955-965 | S58019D | 23 | 949-950 | S59241G | 08 | 559-561 | ||
| S56212D | 23 | 949-950 | S58019S | 08 | 559-561 | S59241K | 08 | 564-566 | ||
| S56212S | 08 | 562-563 | S58021A | 21 | 913-914 | S59241P | 08 | 564-566 | ||
| S56219A | 08 | 562-563 | S58021A | 24 | 955-965 | S59241S | 08 | 559-561 | ||
| S56219A | 24 | 955-965 | S58021D | 23 | 949-950 | S59242A | 08 | 562-563 | ||
| S56219D | 23 | 949-950 | S58021S | 08 | 559-561 | S59242A | 24 | 955-965 | ||
| S56219S | 08 | 562-563 | S58022A | 21 | 913-914 | S59242D | 08 | 559-561 | ||
| S56221A | 08 | 564-566 | S58022A | 24 | 955-965 | S59242G | 08 | 559-561 | ||
| S56221A | 24 | 955-965 | S58022D | 23 | 949-950 | S59242K | 08 | 564-566 | ||
| S56221D | 23 | 949-950 | S58022S | 08 | 559-561 | S59242P | 08 | 564-566 | ||
| S56221S | 09 | 604-605 | S58029A | 21 | 913-914 | S59242S | 08 | 559-561 | ||
| S56222A | 08 | 564-566 | S58029A | 24 | 955-965 | S59249A | 08 | 562-563 | ||
| S56222A | 24 | 955-965 | S58029D | 23 | 949-950 | S59249A | 24 | 955-965 | ||
| S56222D | 23 | 949-950 | S58029S | 08 | 559-561 | S59249D | 08 | 559-561 | ||
| S56222S | 09 | 604-605 | S58111A | 21 | 913-914 | S59249G | 08 | 559-561 | ||
| S56229A | 08 | 564-566 | S58111A | 24 | 955-965 | S59249K | 08 | 564-566 | ||
| S56229A | 24 | 955-965 | S58111D | 23 | 949-950 | S59249P | 08 | 564-566 | ||
| S56229D | 23 | 949-950 | S58111S | 08 | 559-561 | S59249S | 08 | 559-561 | ||
| S56229S | 09 | 604-605 | S58112A | 21 | 913-914 | S59291A | 08 | 562-563 | ||
| S56291A | 21 | 913-914 | S58112A | 24 | 955-965 | S59291A | 24 | 955-965 | ||
| S56291A | 24 | 955-965 | S58112D | 23 | 949-950 | S59291D | 08 | 559-561 | ||
| S56291D | 23 | 949-950 | S58112S | 08 | 559-561 | S59291G | 08 | 559-561 | ||
| S56291S | 21 | 913-914 | S58119A | 21 | 913-914 | S59291K | 08 | 564-566 | ||
| S56292A | 21 | 913-914 | S58119A | 24 | 955-965 | S59291P | 08 | 564-566 | ||
| S56292A | 24 | 955-965 | S58119D | 23 | 949-950 | S59291S | 08 | 559-561 | ||
| S56292D | 23 | 949-950 | S58119S | 08 | 559-561 | S59292A | 08 | 562-563 | ||
| S56292S | 21 | 913-914 | S58121A | 21 | 913-914 | S59292A | 24 | 955-965 | ||
| S56299A | 21 | 913-914 | S58121A | 24 | 955-965 | S59292D | 08 | 559-561 | ||
| S56299A | 24 | 955-965 | S58121D | 23 | 949-950 | S59292G | 08 | 559-561 | ||
| S56299D | 23 | 949-950 | S58121S | 08 | 559-561 | S59292K | 08 | 564-566 | ||
| S56299S | 21 | 913-914 | S58122A | 21 | 913-914 | S59292P | 08 | 564-566 | ||
| S56301A | 21 | 913-914 | S58122A | 24 | 955-965 | S59292S | 08 | 559-561 | ||
| S56301A | 24 | 955-965 | S58122D | 23 | 949-950 | S59299A | 08 | 562-563 | ||
| S56301D | 23 | 949-950 | S58122S | 08 | 559-561 | S59299A | 24 | 955-965 | ||
| S56301S | 21 | 913-914 | S58129A | 21 | 913-914 | S59299D | 08 | 559-561 | ||
| S56302A | 21 | 913-914 | S58129A | 24 | 955-965 | S59299G | 08 | 559-561 | ||
| S56302A | 24 | 955-965 | S58129D | 23 | 949-950 | S59299K | 08 | 564-566 | ||
| S56302D | 23 | 949-950 | S58129S | 08 | 559-561 | S59299P | 08 | 564-566 | ||
| S56302S | 21 | 913-914 | S58911A | 21 | 913-914 | S59299S | 08 | 559-561 | ||
| S56309A | 21 | 913-914 | S58911A | 24 | 955-965 | S59801A | 21 | 913-914 | ||
| S56309A | 24 | 955-965 | S58911D | 23 | 949-950 | S59801A | 24 | 955-965 | ||
| S56309D | 23 | 949-950 | S58911S | 08 | 559-561 | S59801D | 23 | 949-950 | ||
| S56309S | 21 | 913-914 | S58912A | 21 | 913-914 | S59801S | 21 | 913-914 | ||
| S56311A | 08 | 562-563 | S58912A | 24 | 955-965 | S59802A | 21 | 913-914 | ||
| S56311A | 24 | 955-965 | S58912D | 23 | 949-950 | S59802A | 24 | 955-965 | ||
| S56311D | 23 | 949-950 | S58912S | 08 | 559-561 | S59802D | 23 | 949-950 | ||
| S56311S | 08 | 562-563 | S58919A | 21 | 913-914 | S59802S | 21 | 913-914 | ||
| S56312A | 08 | 562-563 | S58919A | 24 | 955-965 | S59809A | 21 | 913-914 | ||
| S56312A | 24 | 955-965 | S58919D | 23 | 949-950 | S59809A | 24 | 955-965 | ||
| S56312D | 23 | 949-950 | S58919S | 08 | 559-561 | S59809D | 23 | 949-950 | ||
| S56312S | 08 | 562-563 | S58921A | 21 | 913-914 | S59809S | 21 | 913-914 | ||
| S56319A | 08 | 562-563 | S58921A | 24 | 955-965 | S59811A | 21 | 913-914 | ||
| S56319A | 24 | 955-965 | S58921D | 23 | 949-950 | S59811A | 24 | 955-965 | ||
| S56319D | 23 | 949-950 | S58921S | 08 | 559-561 | S59811D | 23 | 949-950 | ||
| S56319S | 08 | 562-563 | S58922A | 21 | 913-914 | S59811S | 21 | 913-914 | ||
| S56321A | 08 | 564-566 | S58922A | 24 | 955-965 | S59812A | 21 | 913-914 | ||
| S56321A | 24 | 955-965 | S58922D | 23 | 949-950 | S59812A | 24 | 955-965 | ||
| S56321D | 23 | 949-950 | S58922S | 08 | 559-561 | S59812D | 23 | 949-950 | ||
| S56321S | 09 | 604-605 | S58929A | 21 | 913-914 | S59812S | 21 | 913-914 | ||
| S56322A | 08 | 564-566 | S58929A | 24 | 955-965 | S59819A | 21 | 913-914 | ||
| S56322A | 24 | 955-965 | S58929D | 23 | 949-950 | S59819A | 24 | 955-965 | ||
| S56322D | 23 | 949-950 | S58929S | 08 | 559-561 | S59819D | 23 | 949-950 | ||
| S56322S | 09 | 604-605 | S59001A | 08 | 562-563 | S59819S | 21 | 913-914 | ||
| S56329A | 08 | 564-566 | S59001A | 24 | 955-965 | S59901A | 21 | 913-914 | ||
| S56329A | 24 | 955-965 | S59001D | 08 | 559-561 | S59901A | 24 | 955-965 | ||
| S56329D | 23 | 949-950 | S59001G | 08 | 559-561 | S59901D | 23 | 949-950 | ||
| S56329S | 09 | 604-605 | S59001K | 08 | 564-566 | S59901S | 21 | 913-914 | ||
| S56391A | 21 | 913-914 | S59001P | 08 | 564-566 | S59902A | 21 | 913-914 | ||
| S56391A | 24 | 955-965 | S59001S | 08 | 559-561 | S59902A | 24 | 955-965 | ||
| S56391D | 23 | 949-950 | S59002A | 08 | 562-563 | S59902D | 23 | 949-950 | ||
| S56391S | 21 | 913-914 | S59002A | 24 | 955-965 | S59902S | 21 | 913-914 | ||
| S56392A | 21 | 913-914 | S59002D | 08 | 559-561 | S59909A | 21 | 913-914 | ||
| S56392A | 24 | 955-965 | S59002G | 08 | 559-561 | S59909A | 24 | 955-965 | ||
| S56392D | 23 | 949-950 | S59002K | 08 | 564-566 | S59909D | 23 | 949-950 | ||
| S56392S | 21 | 913-914 | S59002P | 08 | 564-566 | S59909S | 21 | 913-914 | ||
| S56399A | 21 | 913-914 | S59002S | 08 | 559-561 | S59911A | 21 | 913-914 | ||
| S56399A | 24 | 955-965 | S59009A | 08 | 562-563 | S59911A | 24 | 955-965 | ||
| S56399D | 23 | 949-950 | S59009A | 24 | 955-965 | S59911D | 23 | 949-950 | ||
| S56399S | 21 | 913-914 | S59009D | 08 | 559-561 | S59911S | 21 | 913-914 | ||
| S56401A | 21 | 913-914 | S59009G | 08 | 559-561 | S59912A | 21 | 913-914 | ||
| S56401A | 24 | 955-965 | S59009K | 08 | 564-566 | S59912A | 24 | 955-965 | ||
| S56401D | 23 | 949-950 | S59009P | 08 | 564-566 | S59912D | 23 | 949-950 | ||
| S56401S | 21 | 913-914 | S59009S | 08 | 559-561 | S59912S | 21 | 913-914 | ||
| S56402A | 21 | 913-914 | S59011A | 08 | 562-563 | S59919A | 21 | 913-914 | ||
| S56402A | 24 | 955-965 | S59011A | 24 | 955-965 | S59919A | 24 | 955-965 | ||
| S56402D | 23 | 949-950 | S59011D | 08 | 559-561 | S59919D | 23 | 949-950 | ||
| S56402S | 21 | 913-914 | S59011G | 08 | 559-561 | S59919S | 21 | 913-914 | ||
| S56403A | 21 | 913-914 | S59011K | 08 | 564-566 | S6000XA | 09 | 604-605 | ||
| S56403A | 24 | 955-965 | S59011P | 08 | 564-566 | S6000XA | 24 | 955-965 | ||
| S56403D | 23 | 949-950 | S59011S | 08 | 559-561 | S6000XD | 23 | 949-950 | ||
| S56403S | 21 | 913-914 | S59012A | 08 | 562-563 | S6000XS | 09 | 604-605 | ||
| S56404A | 21 | 913-914 | S59012A | 24 | 955-965 | S60011A | 09 | 604-605 | ||
| S56404A | 24 | 955-965 | S59012D | 08 | 559-561 | S60011A | 24 | 955-965 | ||
| S56404D | 23 | 949-950 | S59012G | 08 | 559-561 | S60011D | 23 | 949-950 | ||
| S56404S | 21 | 913-914 | S59012K | 08 | 564-566 | S60011S | 09 | 604-605 | ||
| S56405A | 21 | 913-914 | S59012P | 08 | 564-566 | S60012A | 09 | 604-605 | ||
| S56405A | 24 | 955-965 | S59012S | 08 | 559-561 | S60012A | 24 | 955-965 | ||
| S56405D | 23 | 949-950 | S59019A | 08 | 562-563 | S60012D | 23 | 949-950 | ||
| S56405S | 21 | 913-914 | S59019A | 24 | 955-965 | S60012S | 09 | 604-605 | ||
| S56406A | 21 | 913-914 | S59019D | 08 | 559-561 | S60019A | 09 | 604-605 | ||
| S56406A | 24 | 955-965 | S59019G | 08 | 559-561 | S60019A | 24 | 955-965 | ||
| S56406D | 23 | 949-950 | S59019K | 08 | 564-566 | S60019D | 23 | 949-950 | ||
| S56406S | 21 | 913-914 | S59019P | 08 | 564-566 | S60019S | 09 | 604-605 | ||
| S56407A | 21 | 913-914 | S59019S | 08 | 559-561 | S60021A | 09 | 604-605 | ||
| S56407A | 24 | 955-965 | S59021A | 08 | 562-563 | S60021A | 24 | 955-965 | ||
| S56407D | 23 | 949-950 | S59021A | 24 | 955-965 | S60021D | 23 | 949-950 | ||
| S56407S | 21 | 913-914 | S59021D | 08 | 559-561 | S60021S | 09 | 604-605 | ||
| S56408A | 21 | 913-914 | S59021G | 08 | 559-561 | S60022A | 09 | 604-605 | ||
| S56408A | 24 | 955-965 | S59021K | 08 | 564-566 | S60022A | 24 | 955-965 | ||
| S56408D | 23 | 949-950 | S59021P | 08 | 564-566 | S60022D | 23 | 949-950 | ||
| S56408S | 21 | 913-914 | S59021S | 08 | 559-561 | S60022S | 09 | 604-605 | ||
| S56409A | 21 | 913-914 | S59022A | 08 | 562-563 | S60029A | 09 | 604-605 | ||
| S56409A | 24 | 955-965 | S59022A | 24 | 955-965 | S60029A | 24 | 955-965 | ||
| S56409D | 23 | 949-950 | S59022D | 08 | 559-561 | S60029D | 23 | 949-950 | ||
| S56409S | 21 | 913-914 | S59022G | 08 | 559-561 | S60029S | 09 | 604-605 | ||
| S56411A | 08 | 562-563 | S59022K | 08 | 564-566 | S60031A | 09 | 604-605 | ||
| S56411A | 24 | 955-965 | S59022P | 08 | 564-566 | S60031A | 24 | 955-965 | ||
| S56411D | 23 | 949-950 | S59022S | 08 | 559-561 | S60031D | 23 | 949-950 | ||
| S56411S | 08 | 562-563 | S59029A | 08 | 562-563 | S60031S | 09 | 604-605 | ||
| S56412A | 08 | 562-563 | S59029A | 24 | 955-965 | S60032A | 09 | 604-605 | ||
| S56412A | 24 | 955-965 | S59029D | 08 | 559-561 | S60032A | 24 | 955-965 | ||
| S56412D | 23 | 949-950 | S59029G | 08 | 559-561 | S60032D | 23 | 949-950 | ||
| S56412S | 08 | 562-563 | S59029K | 08 | 564-566 | S60032S | 09 | 604-605 | ||
| S56413A | 08 | 562-563 | S59029P | 08 | 564-566 | S60039A | 09 | 604-605 | ||
| S56413A | 24 | 955-965 | S59029S | 08 | 559-561 | S60039A | 24 | 955-965 | ||
| S56413D | 23 | 949-950 | S59031A | 08 | 562-563 | S60039D | 23 | 949-950 | ||
| S56413S | 08 | 562-563 | S59031A | 24 | 955-965 | S60039S | 09 | 604-605 | ||
| S56414A | 08 | 562-563 | S59031D | 08 | 559-561 | S60041A | 09 | 604-605 | ||
| S56414A | 24 | 955-965 | S59031G | 08 | 559-561 | S60041A | 24 | 955-965 | ||
| S56414D | 23 | 949-950 | S59031K | 08 | 564-566 | S60041D | 23 | 949-950 | ||
| S56414S | 08 | 562-563 | S59031P | 08 | 564-566 | S60041S | 09 | 604-605 | ||
| S56415A | 08 | 562-563 | S59031S | 08 | 559-561 | S60042A | 09 | 604-605 | ||
| S56415A | 24 | 955-965 | S59032A | 08 | 562-563 | S60042A | 24 | 955-965 | ||
| S56415D | 23 | 949-950 | S59032A | 24 | 955-965 | S60042D | 23 | 949-950 | ||
| S56415S | 08 | 562-563 | S59032D | 08 | 559-561 | S60042S | 09 | 604-605 | ||
| S56416A | 08 | 562-563 | S59032G | 08 | 559-561 | S60049A | 09 | 604-605 | ||
| S56416A | 24 | 955-965 | S59032K | 08 | 564-566 | S60049A | 24 | 955-965 | ||
| S56416D | 23 | 949-950 | S59032P | 08 | 564-566 | S60049D | 23 | 949-950 | ||
| S56416S | 08 | 562-563 | S59032S | 08 | 559-561 | S60049S | 09 | 604-605 | ||
| S56417A | 08 | 562-563 | S59039A | 08 | 562-563 | S60051A | 09 | 604-605 | ||
| S56417A | 24 | 955-965 | S59039A | 24 | 955-965 | S60051A | 24 | 955-965 | ||
| S56417D | 23 | 949-950 | S59039D | 08 | 559-561 | S60051D | 23 | 949-950 | ||
| S56417S | 08 | 562-563 | S59039G | 08 | 559-561 | S60051S | 09 | 604-605 | ||
| S56418A | 08 | 562-563 | S59039K | 08 | 564-566 | S60052A | 09 | 604-605 | ||
| S56418A | 24 | 955-965 | S59039P | 08 | 564-566 | S60052A | 24 | 955-965 | ||
| S56418D | 23 | 949-950 | S59039S | 08 | 559-561 | S60052D | 23 | 949-950 | ||
| S56418S | 08 | 562-563 | S59041A | 08 | 562-563 | S60052S | 09 | 604-605 | ||
| S56419A | 08 | 562-563 | S59041A | 24 | 955-965 | S60059A | 09 | 604-605 | ||
| S56419A | 24 | 955-965 | S59041D | 08 | 559-561 | S60059A | 24 | 955-965 | ||
| S56419D | 23 | 949-950 | S59041G | 08 | 559-561 | S60059D | 23 | 949-950 | ||
| S56419S | 08 | 562-563 | S59041K | 08 | 564-566 | S60059S | 09 | 604-605 | ||
| S56421A | 08 | 564-566 | S59041P | 08 | 564-566 | S6010XA | 09 | 604-605 | ||
| S56421A | 24 | 955-965 | S59041S | 08 | 559-561 | S6010XA | 24 | 955-965 | ||
| S56421D | 23 | 949-950 | S59042A | 08 | 562-563 | S6010XD | 23 | 949-950 | ||
| S56421S | 09 | 604-605 | S59042A | 24 | 955-965 | S6010XS | 09 | 604-605 | ||
| S56422A | 08 | 564-566 | S59042D | 08 | 559-561 | S60111A | 09 | 604-605 | ||
| S56422A | 24 | 955-965 | S59042G | 08 | 559-561 | S60111A | 24 | 955-965 | ||
| S56422D | 23 | 949-950 | S59042K | 08 | 564-566 | S60111D | 23 | 949-950 | ||
| S56422S | 09 | 604-605 | S59042P | 08 | 564-566 | S60111S | 09 | 604-605 | ||
| S56423A | 08 | 564-566 | S59042S | 08 | 559-561 | S60112A | 09 | 604-605 | ||
| S56423A | 24 | 955-965 | S59049A | 08 | 562-563 | S60112A | 24 | 955-965 | ||
| S56423D | 23 | 949-950 | S59049A | 24 | 955-965 | S60112D | 23 | 949-950 | ||
| S56423S | 09 | 604-605 | S59049D | 08 | 559-561 | S60112S | 09 | 604-605 | ||
| S56424A | 08 | 564-566 | S59049G | 08 | 559-561 | S60119A | 09 | 604-605 | ||
| S56424A | 24 | 955-965 | S59049K | 08 | 564-566 | S60119A | 24 | 955-965 | ||
| S56424D | 23 | 949-950 | S59049P | 08 | 564-566 | S60119D | 23 | 949-950 | ||
| S56424S | 09 | 604-605 | S59049S | 08 | 559-561 | S60119S | 09 | 604-605 | ||
| S56425A | 08 | 564-566 | S59091A | 08 | 562-563 | S60121A | 09 | 604-605 | ||
| S56425A | 24 | 955-965 | S59091A | 24 | 955-965 | S60121A | 24 | 955-965 | ||
| S56425D | 23 | 949-950 | S59091D | 08 | 559-561 | S60121D | 23 | 949-950 | ||
| S56425S | 09 | 604-605 | S59091G | 08 | 559-561 | S60121S | 09 | 604-605 | ||
| S56426A | 08 | 564-566 | S59091K | 08 | 564-566 | S60122A | 09 | 604-605 | ||
| S56426A | 24 | 955-965 | S59091P | 08 | 564-566 | S60122A | 24 | 955-965 | ||
| S56426D | 23 | 949-950 | S59091S | 08 | 559-561 | S60122D | 23 | 949-950 | ||
| S56426S | 09 | 604-605 | S59092A | 08 | 562-563 | S60122S | 09 | 604-605 | ||
| S56427A | 08 | 564-566 | S59092A | 24 | 955-965 | S60129A | 09 | 604-605 | ||
| S56427A | 24 | 955-965 | S59092D | 08 | 559-561 | S60129A | 24 | 955-965 | ||
| S56427D | 23 | 949-950 | S59092G | 08 | 559-561 | S60129D | 23 | 949-950 | ||
| S56427S | 09 | 604-605 | S59092K | 08 | 564-566 | S60129S | 09 | 604-605 | ||
| S56428A | 08 | 564-566 | S59092P | 08 | 564-566 | S60131A | 09 | 604-605 | ||
| S56428A | 24 | 955-965 | S59092S | 08 | 559-561 | S60131A | 24 | 955-965 | ||
| S56428D | 23 | 949-950 | S59099A | 08 | 562-563 | S60131D | 23 | 949-950 | ||
| S56428S | 09 | 604-605 | S59099A | 24 | 955-965 | S60131S | 09 | 604-605 | ||
| S56429A | 08 | 564-566 | S59099D | 08 | 559-561 | S60132A | 09 | 604-605 | ||
| S56429A | 24 | 955-965 | S59099G | 08 | 559-561 | S60132A | 24 | 955-965 | ||
| S56429D | 23 | 949-950 | S59099K | 08 | 564-566 | S60132D | 23 | 949-950 | ||
| S56429S | 09 | 604-605 | S59099P | 08 | 564-566 | S60132S | 09 | 604-605 | ||
| S56491A | 21 | 913-914 | S59099S | 08 | 559-561 | S60139A | 09 | 604-605 | ||
| S56491A | 24 | 955-965 | S59101A | 08 | 562-563 | S60139A | 24 | 955-965 | ||
| S56491D | 23 | 949-950 | S59101A | 24 | 955-965 | S60139D | 23 | 949-950 | ||
| S56491S | 21 | 913-914 | S59101D | 08 | 559-561 | S60139S | 09 | 604-605 | ||
| S56492A | 21 | 913-914 | S59101G | 08 | 559-561 | S60141A | 09 | 604-605 | ||
| S56492A | 24 | 955-965 | S59101K | 08 | 564-566 | S60141A | 24 | 955-965 | ||
| S56492D | 23 | 949-950 | S59101P | 08 | 564-566 | S60141D | 23 | 949-950 | ||
| S56492S | 21 | 913-914 | S59101S | 08 | 559-561 | S60141S | 09 | 604-605 | ||
| S56493A | 21 | 913-914 | S59102A | 08 | 562-563 | S60142A | 09 | 604-605 | ||
| S56493A | 24 | 955-965 | S59102A | 24 | 955-965 | S60142A | 24 | 955-965 | ||
| S56493D | 23 | 949-950 | S59102D | 08 | 559-561 | S60142D | 23 | 949-950 | ||
| S56493S | 21 | 913-914 | S59102G | 08 | 559-561 | S60142S | 09 | 604-605 | ||
| S56494A | 21 | 913-914 | S59102K | 08 | 564-566 | S60149A | 09 | 604-605 | ||
| S56494A | 24 | 955-965 | S59102P | 08 | 564-566 | S60149A | 24 | 955-965 | ||
| S56494D | 23 | 949-950 | S59102S | 08 | 559-561 | S60149D | 23 | 949-950 | ||
| S56494S | 21 | 913-914 | S59109A | 08 | 562-563 | S60149S | 09 | 604-605 | ||
| S56495A | 21 | 913-914 | S59109A | 24 | 955-965 | S60151A | 09 | 604-605 | ||
| S56495A | 24 | 955-965 | S59109D | 08 | 559-561 | S60151A | 24 | 955-965 | ||
| S56495D | 23 | 949-950 | S59109G | 08 | 559-561 | S60151D | 23 | 949-950 | ||
| S56495S | 21 | 913-914 | S59109K | 08 | 564-566 | S60151S | 09 | 604-605 | ||
| S56496A | 21 | 913-914 | S59109P | 08 | 564-566 | S60152A | 09 | 604-605 | ||
| S56496A | 24 | 955-965 | S59109S | 08 | 559-561 | S60152A | 24 | 955-965 | ||
| S56496D | 23 | 949-950 | S59111A | 08 | 562-563 | S60152D | 23 | 949-950 | ||
| S56496S | 21 | 913-914 | S59111A | 24 | 955-965 | S60152S | 09 | 604-605 | ||
| S56497A | 21 | 913-914 | S59111D | 08 | 559-561 | S60159A | 09 | 604-605 | ||
| S56497A | 24 | 955-965 | S59111G | 08 | 559-561 | S60159A | 24 | 955-965 | ||
| S56497D | 23 | 949-950 | S59111K | 08 | 564-566 | S60159D | 23 | 949-950 | ||
| S56497S | 21 | 913-914 | S59111P | 08 | 564-566 | S60159S | 09 | 604-605 | ||
| S56498A | 21 | 913-914 | S59111S | 08 | 559-561 | S60211A | 09 | 604-605 | ||
| S56498A | 24 | 955-965 | S59112A | 08 | 562-563 | S60211A | 24 | 955-965 | ||
| S56498D | 23 | 949-950 | S59112A | 24 | 955-965 | S60211D | 23 | 949-950 | ||
| S56498S | 21 | 913-914 | S59112D | 08 | 559-561 | S60211S | 09 | 604-605 | ||
| S56499A | 21 | 913-914 | S59112G | 08 | 559-561 | S60212A | 09 | 604-605 | ||
| S56499A | 24 | 955-965 | S59112K | 08 | 564-566 | S60212A | 24 | 955-965 | ||
| S56499D | 23 | 949-950 | S59112P | 08 | 564-566 | S60212D | 23 | 949-950 | ||
| S56499S | 21 | 913-914 | S59112S | 08 | 559-561 | S60212S | 09 | 604-605 | ||
| S56501A | 21 | 913-914 | S59119A | 08 | 562-563 | S60219A | 09 | 604-605 | ||
| S56501A | 24 | 955-965 | S59119A | 24 | 955-965 | S60219A | 24 | 955-965 | ||
| S56501D | 23 | 949-950 | S59119D | 08 | 559-561 | S60219D | 23 | 949-950 | ||
| S56501S | 21 | 913-914 | S59119G | 08 | 559-561 | S60219S | 09 | 604-605 | ||
| S56502A | 21 | 913-914 | S59119K | 08 | 564-566 | S60221A | 09 | 604-605 | ||
| S56502A | 24 | 955-965 | S59119P | 08 | 564-566 | S60221A | 24 | 955-965 | ||
| S56502D | 23 | 949-950 | S59119S | 08 | 559-561 | S60221D | 23 | 949-950 | ||
| S56502S | 21 | 913-914 | S59121A | 08 | 562-563 | S60221S | 09 | 604-605 | ||
| S56509A | 21 | 913-914 | S59121A | 24 | 955-965 | S60222A | 09 | 604-605 | ||
| S56509A | 24 | 955-965 | S59121D | 08 | 559-561 | S60222A | 24 | 955-965 | ||
| S56509D | 23 | 949-950 | S59121G | 08 | 559-561 | S60222D | 23 | 949-950 | ||
| S56509S | 21 | 913-914 | S59121K | 08 | 564-566 | S60222S | 09 | 604-605 | ||
| S56511A | 08 | 562-563 | S59121P | 08 | 564-566 | S60229A | 09 | 604-605 | ||
| S56511A | 24 | 955-965 | S59121S | 08 | 559-561 | S60229A | 24 | 955-965 | ||
| S56511D | 23 | 949-950 | S59122A | 08 | 562-563 | S60229D | 23 | 949-950 | ||
| S56511S | 08 | 562-563 | S59122A | 24 | 955-965 | S60229S | 09 | 604-605 | ||
| S56512A | 08 | 562-563 | S59122D | 08 | 559-561 | S60311A | 09 | 604-605 | ||
| S56512A | 24 | 955-965 | S59122G | 08 | 559-561 | S60311A | 24 | 955-965 | ||
| S56512D | 23 | 949-950 | S59122K | 08 | 564-566 | S60311D | 23 | 949-950 | ||
| S56512S | 08 | 562-563 | S59122P | 08 | 564-566 | S60311S | 09 | 604-605 | ||
| S56519A | 08 | 562-563 | S59122S | 08 | 559-561 | S60312A | 09 | 604-605 | ||
| S56519A | 24 | 955-965 | S59129A | 08 | 562-563 | S60312A | 24 | 955-965 | ||
| S56519D | 23 | 949-950 | S59129A | 24 | 955-965 | S60312D | 23 | 949-950 | ||
| S56519S | 08 | 562-563 | S59129D | 08 | 559-561 | S60312S | 09 | 604-605 | ||
| S56521A | 08 | 564-566 | S59129G | 08 | 559-561 | S60319A | 09 | 604-605 | ||
| S56521A | 24 | 955-965 | S59129K | 08 | 564-566 | S60319A | 24 | 955-965 | ||
| S56521D | 23 | 949-950 | S59129P | 08 | 564-566 | S60319D | 23 | 949-950 | ||
| S56521S | 09 | 604-605 | S59129S | 08 | 559-561 | S60319S | 09 | 604-605 | ||
| S56522A | 08 | 564-566 | S59131A | 08 | 562-563 | S60321A | 09 | 606-607 | ||
| S56522A | 24 | 955-965 | S59131A | 24 | 955-965 | S60321A | 24 | 955-965 | ||
| S56522D | 23 | 949-950 | S59131D | 08 | 559-561 | S60321D | 23 | 949-950 | ||
| S56522S | 09 | 604-605 | S59131G | 08 | 559-561 | S60321S | 09 | 604-605 | ||
| S56529A | 08 | 564-566 | S59131K | 08 | 564-566 | S60322A | 09 | 606-607 | ||
| S56529A | 24 | 955-965 | S59131P | 08 | 564-566 | S60322A | 24 | 955-965 | ||
| S56529D | 23 | 949-950 | S59131S | 08 | 559-561 | S60322D | 23 | 949-950 | ||
| S56529S | 09 | 604-605 | S59132A | 08 | 562-563 | S60322S | 09 | 604-605 | ||
| S56591A | 21 | 913-914 | S59132A | 24 | 955-965 | S60329A | 09 | 606-607 | ||
| S56591A | 24 | 955-965 | S59132D | 08 | 559-561 | S60329A | 24 | 955-965 | ||
| S56591D | 23 | 949-950 | S59132G | 08 | 559-561 | S60329D | 23 | 949-950 | ||
| S56591S | 21 | 913-914 | S59132K | 08 | 564-566 | S60329S | 09 | 604-605 | ||
| S56592A | 21 | 913-914 | S59132P | 08 | 564-566 | S60341A | 09 | 604-605 | ||
| S56592A | 24 | 955-965 | S59132S | 08 | 559-561 | S60341A | 24 | 955-965 | ||
| S56592D | 23 | 949-950 | S59139A | 08 | 562-563 | S60341D | 23 | 949-950 | ||
| S56592S | 21 | 913-914 | S59139A | 24 | 955-965 | S60341S | 09 | 604-605 | ||
| S56599A | 21 | 913-914 | S59139D | 08 | 559-561 | S60342A | 09 | 604-605 | ||
| S56599A | 24 | 955-965 | S59139G | 08 | 559-561 | S60342A | 24 | 955-965 | ||
| S56599D | 23 | 949-950 | S59139K | 08 | 564-566 | S60342D | 23 | 949-950 | ||
| S56599S | 21 | 913-914 | S59139P | 08 | 564-566 | S60342S | 09 | 604-605 | ||
| S56801A | 21 | 913-914 | S59139S | 08 | 559-561 | S60349A | 09 | 604-605 | ||
| S56801A | 24 | 955-965 | S59141A | 08 | 562-563 | S60349A | 24 | 955-965 | ||
| S56801D | 23 | 949-950 | S59141A | 24 | 955-965 | S60349D | 23 | 949-950 | ||
| S56801S | 21 | 913-914 | S59141D | 08 | 559-561 | S60349S | 09 | 604-605 | ||
| S56802A | 21 | 913-914 | S59141G | 08 | 559-561 | S60351A | 09 | 604-605 | ||
| S56802A | 24 | 955-965 | S59141K | 08 | 564-566 | S60351A | 24 | 955-965 | ||
| S56802D | 23 | 949-950 | S59141P | 08 | 564-566 | S60351D | 23 | 949-950 | ||
| S56802S | 21 | 913-914 | S59141S | 08 | 559-561 | S60351S | 09 | 604-605 | ||
| S56809A | 21 | 913-914 | S59142A | 08 | 562-563 | S60352A | 09 | 604-605 | ||
| S56809A | 24 | 955-965 | S59142A | 24 | 955-965 | S60352A | 24 | 955-965 | ||
| S56809D | 23 | 949-950 | S59142D | 08 | 559-561 | S60352D | 23 | 949-950 | ||
| S56809S | 21 | 913-914 | S59142G | 08 | 559-561 | S60352S | 09 | 604-605 | ||
| S56811A | 08 | 562-563 | S59142K | 08 | 564-566 | S60359A | 09 | 604-605 | ||
| S56811A | 24 | 955-965 | S59142P | 08 | 564-566 | S60359A | 24 | 955-965 | ||
| S56811D | 23 | 949-950 | S59142S | 08 | 559-561 | S60359D | 23 | 949-950 | ||
| S56811S | 08 | 562-563 | S59149A | 08 | 562-563 | S60359S | 09 | 604-605 | ||
| S56812A | 08 | 562-563 | S59149A | 24 | 955-965 | S60361A | 09 | 606-607 | ||
| S56812A | 24 | 955-965 | S59149D | 08 | 559-561 | S60361A | 24 | 955-965 | ||
| S56812D | 23 | 949-950 | S59149G | 08 | 559-561 | S60361D | 23 | 949-950 | ||
| S56812S | 08 | 562-563 | S59149K | 08 | 564-566 | S60361S | 09 | 604-605 | ||
| S56819A | 08 | 562-563 | S59149P | 08 | 564-566 | S60362A | 09 | 606-607 | ||
| S56819A | 24 | 955-965 | S59149S | 08 | 559-561 | S60362A | 24 | 955-965 | ||
| S56819D | 23 | 949-950 | S59191A | 08 | 562-563 | S60362D | 23 | 949-950 | ||
| S56819S | 08 | 562-563 | S59191A | 24 | 955-965 | S60362S | 09 | 604-605 | ||
| S56821A | 08 | 564-566 | S59191D | 08 | 559-561 | S60369A | 09 | 606-607 | ||
| S56821A | 24 | 955-965 | S59191G | 08 | 559-561 | S60369A | 24 | 955-965 | ||
| S56821D | 23 | 949-950 | S59191K | 08 | 564-566 | S60369D | 23 | 949-950 | ||
| S56821S | 09 | 604-605 | S59191P | 08 | 564-566 | S60369S | 09 | 604-605 | ||
| S56822A | 08 | 564-566 | S59191S | 08 | 559-561 | S60371A | 09 | 604-605 | ||
| S56822A | 24 | 955-965 | S59192A | 08 | 562-563 | S60371A | 24 | 955-965 | ||
| S56822D | 23 | 949-950 | S59192A | 24 | 955-965 | S60371D | 23 | 949-950 | ||
| S56822S | 09 | 604-605 | S59192D | 08 | 559-561 | S60371S | 09 | 604-605 | ||
| S56829A | 08 | 564-566 | S59192G | 08 | 559-561 | S60372A | 09 | 604-605 | ||
| S56829A | 24 | 955-965 | S59192K | 08 | 564-566 | S60372A | 24 | 955-965 | ||
| S56829D | 23 | 949-950 | S59192P | 08 | 564-566 | S60372D | 23 | 949-950 | ||
| S56829S | 09 | 604-605 | S59192S | 08 | 559-561 | S60372S | 09 | 604-605 | ||
| S56891A | 21 | 913-914 | S59199A | 08 | 562-563 | S60379A | 09 | 604-605 | ||
| S56891A | 24 | 955-965 | S59199A | 24 | 955-965 | S60379A | 24 | 955-965 | ||
| S56891D | 23 | 949-950 | S59199D | 08 | 559-561 | S60379D | 23 | 949-950 | ||
| S56891S | 21 | 913-914 | S59199G | 08 | 559-561 | S60379S | 09 | 604-605 | ||
| S56892A | 21 | 913-914 | S59199K | 08 | 564-566 | S60391A | 09 | 604-605 | ||
| S56892A | 24 | 955-965 | S59199P | 08 | 564-566 | S60391A | 24 | 955-965 | ||
| S56892D | 23 | 949-950 | S59199S | 08 | 559-561 | S60391D | 23 | 949-950 | ||
| S56892S | 21 | 913-914 | S59201A | 08 | 562-563 | S60391S | 09 | 604-605 | ||
| S56899A | 21 | 913-914 | S59201A | 24 | 955-965 | S60392A | 09 | 604-605 | ||
| S56899A | 24 | 955-965 | S59201D | 08 | 559-561 | S60392A | 24 | 955-965 | ||
| S56899D | 23 | 949-950 | S59201G | 08 | 559-561 | S60392D | 23 | 949-950 | ||
| S56899S | 21 | 913-914 | S59201K | 08 | 564-566 | S60392S | 09 | 604-605 | ||
| S56901A | 21 | 913-914 | S59201P | 08 | 564-566 | S60399A | 09 | 604-605 | ||
| S56901A | 24 | 955-965 | S59201S | 08 | 559-561 | S60399A | 24 | 955-965 | ||
| S56901D | 23 | 949-950 | S59202A | 08 | 562-563 | S60399D | 23 | 949-950 | ||
| S56901S | 21 | 913-914 | S59202A | 24 | 955-965 | S60399S | 09 | 604-605 | ||
| S56902A | 21 | 913-914 | S59202D | 08 | 559-561 | S60410A | 09 | 604-605 | ||
| S56902A | 24 | 955-965 | S59202G | 08 | 559-561 | S60410A | 24 | 955-965 | ||
| S56902D | 23 | 949-950 | S59202K | 08 | 564-566 | S60410D | 23 | 949-950 | ||
| S56902S | 21 | 913-914 | S59202P | 08 | 564-566 | S60410S | 09 | 604-605 | ||
| S56909A | 21 | 913-914 | S59202S | 08 | 559-561 | S60411A | 09 | 604-605 | ||
| S56909A | 24 | 955-965 | S59209A | 08 | 562-563 | S60411A | 24 | 955-965 | ||
| S56909D | 23 | 949-950 | S59209A | 24 | 955-965 | S60411D | 23 | 949-950 | ||
| S56909S | 21 | 913-914 | S59209D | 08 | 559-561 | S60411S | 09 | 604-605 | ||
| S56911A | 08 | 562-563 | S59209G | 08 | 559-561 | S60412A | 09 | 604-605 | ||
| S56911A | 24 | 955-965 | S59209K | 08 | 564-566 | S60412A | 24 | 955-965 | ||
| S56911D | 23 | 949-950 | S59209P | 08 | 564-566 | S60412D | 23 | 949-950 | ||
| S56911S | 08 | 562-563 | S59209S | 08 | 559-561 | S60412S | 09 | 604-605 | ||
| S56912A | 08 | 562-563 | S59211A | 08 | 562-563 | S60413A | 09 | 604-605 | ||
| S56912A | 24 | 955-965 | S59211A | 24 | 955-965 | S60413A | 24 | 955-965 | ||
| S56912D | 23 | 949-950 | S59211D | 08 | 559-561 | S60413D | 23 | 949-950 | ||
| S56912S | 08 | 562-563 | S59211G | 08 | 559-561 | S60413S | 09 | 604-605 | ||
| S56919A | 08 | 562-563 | S59211K | 08 | 564-566 | S60414A | 09 | 604-605 | ||
| S56919A | 24 | 955-965 | S59211P | 08 | 564-566 | S60414A | 24 | 955-965 | ||
| S56919D | 23 | 949-950 | S59211S | 08 | 559-561 | S60414D | 23 | 949-950 | ||
| S56919S | 08 | 562-563 | S59212A | 08 | 562-563 | S60414S | 09 | 604-605 | ||
| S56921A | 08 | 564-566 | S59212A | 24 | 955-965 | S60415A | 09 | 604-605 | ||
| S56921A | 24 | 955-965 | S59212D | 08 | 559-561 | S60415A | 24 | 955-965 | ||
| S56921D | 23 | 949-950 | S59212G | 08 | 559-561 | S60415D | 23 | 949-950 | ||
| S56921S | 09 | 604-605 | S59212K | 08 | 564-566 | S60415S | 09 | 604-605 | ||
| S56922A | 08 | 564-566 | S59212P | 08 | 564-566 | S60416A | 09 | 604-605 | ||
| S56922A | 24 | 955-965 | S59212S | 08 | 559-561 | S60416A | 24 | 955-965 | ||
| S56922D | 23 | 949-950 | S59219A | 08 | 562-563 | S60416D | 23 | 949-950 | ||
| S56922S | 09 | 604-605 | S59219A | 24 | 955-965 | S60416S | 09 | 604-605 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Aug 2017 11:52:25 CMS, code-revision=63, description-revision=616 |