ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 38 of 70 |
| A000 B400 C7640 C84A9 D4412 E1069 F13930 G808 H18732 H47621 I2609 I70534 K05223 L03111 L98498 M151 M2759 M65152 M84375P M86669 N35813 O2292 O352XX1 O418X22 O99353 Q659 S0000XA S02611K S066X9S S13110A S21309S S2599XS S31824S S33141S S37539D S42213A S4292XK S49032D S52126N S52331Q S52611B S56419A S60476S S62102G S62351D S63063D S65012D S68111D S72062B S72335Q S72465N S79129D S82121J S82299P S82843P S85211S S90462D S92131D S92599B S98329A T2121XS T23529A T3253 T40903S T462X1S T524X1S T63632S T81718D T85828S Z85040 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S49032D | 08 | 559-561 | S51002D | 23 | 949-950 | S52034N | 08 | 564-566 | ||
| S49032G | 08 | 559-561 | S51002S | 09 | 604-605 | S52034P | 08 | 564-566 | ||
| S49032K | 08 | 564-566 | S51009A | 09 | 604-605 | S52034Q | 08 | 564-566 | ||
| S49032P | 08 | 564-566 | S51009A | 24 | 955-965 | S52034R | 08 | 564-566 | ||
| S49032S | 08 | 559-561 | S51009D | 23 | 949-950 | S52034S | 08 | 559-561 | ||
| S49039A | 08 | 562-563 | S51009S | 09 | 604-605 | S52035A | 08 | 562-563 | ||
| S49039A | 24 | 955-965 | S51011A | 09 | 604-605 | S52035A | 24 | 955-965 | ||
| S49039D | 08 | 559-561 | S51011A | 24 | 955-965 | S52035B | 08 | 562-563 | ||
| S49039G | 08 | 559-561 | S51011D | 23 | 949-950 | S52035B | 24 | 955-965 | ||
| S49039K | 08 | 564-566 | S51011S | 09 | 604-605 | S52035C | 08 | 562-563 | ||
| S49039P | 08 | 564-566 | S51012A | 09 | 604-605 | S52035C | 24 | 955-965 | ||
| S49039S | 08 | 559-561 | S51012A | 24 | 955-965 | S52035D | 08 | 559-561 | ||
| S49041A | 08 | 562-563 | S51012D | 23 | 949-950 | S52035E | 08 | 559-561 | ||
| S49041A | 24 | 955-965 | S51012S | 09 | 604-605 | S52035F | 08 | 559-561 | ||
| S49041D | 08 | 559-561 | S51019A | 09 | 604-605 | S52035G | 08 | 559-561 | ||
| S49041G | 08 | 559-561 | S51019A | 24 | 955-965 | S52035H | 08 | 559-561 | ||
| S49041K | 08 | 564-566 | S51019D | 23 | 949-950 | S52035J | 08 | 559-561 | ||
| S49041P | 08 | 564-566 | S51019S | 09 | 604-605 | S52035K | 08 | 564-566 | ||
| S49041S | 08 | 559-561 | S51021A | 21 | 913-914 | S52035M | 08 | 564-566 | ||
| S49042A | 08 | 562-563 | S51021A | 24 | 955-965 | S52035N | 08 | 564-566 | ||
| S49042A | 24 | 955-965 | S51021D | 23 | 949-950 | S52035P | 08 | 564-566 | ||
| S49042D | 08 | 559-561 | S51021S | 09 | 604-605 | S52035Q | 08 | 564-566 | ||
| S49042G | 08 | 559-561 | S51022A | 21 | 913-914 | S52035R | 08 | 564-566 | ||
| S49042K | 08 | 564-566 | S51022A | 24 | 955-965 | S52035S | 08 | 559-561 | ||
| S49042P | 08 | 564-566 | S51022D | 23 | 949-950 | S52036A | 08 | 562-563 | ||
| S49042S | 08 | 559-561 | S51022S | 09 | 604-605 | S52036A | 24 | 955-965 | ||
| S49049A | 08 | 562-563 | S51029A | 21 | 913-914 | S52036B | 08 | 562-563 | ||
| S49049A | 24 | 955-965 | S51029A | 24 | 955-965 | S52036B | 24 | 955-965 | ||
| S49049D | 08 | 559-561 | S51029D | 23 | 949-950 | S52036C | 08 | 562-563 | ||
| S49049G | 08 | 559-561 | S51029S | 09 | 604-605 | S52036C | 24 | 955-965 | ||
| S49049K | 08 | 564-566 | S51031A | 09 | 604-605 | S52036D | 08 | 559-561 | ||
| S49049P | 08 | 564-566 | S51031A | 24 | 955-965 | S52036E | 08 | 559-561 | ||
| S49049S | 08 | 559-561 | S51031D | 23 | 949-950 | S52036F | 08 | 559-561 | ||
| S49091A | 08 | 562-563 | S51031S | 09 | 604-605 | S52036G | 08 | 559-561 | ||
| S49091A | 24 | 955-965 | S51032A | 09 | 604-605 | S52036H | 08 | 559-561 | ||
| S49091D | 08 | 559-561 | S51032A | 24 | 955-965 | S52036J | 08 | 559-561 | ||
| S49091G | 08 | 559-561 | S51032D | 23 | 949-950 | S52036K | 08 | 564-566 | ||
| S49091K | 08 | 564-566 | S51032S | 09 | 604-605 | S52036M | 08 | 564-566 | ||
| S49091P | 08 | 564-566 | S51039A | 09 | 604-605 | S52036N | 08 | 564-566 | ||
| S49091S | 08 | 559-561 | S51039A | 24 | 955-965 | S52036P | 08 | 564-566 | ||
| S49092A | 08 | 562-563 | S51039D | 23 | 949-950 | S52036Q | 08 | 564-566 | ||
| S49092A | 24 | 955-965 | S51039S | 09 | 604-605 | S52036R | 08 | 564-566 | ||
| S49092D | 08 | 559-561 | S51041A | 21 | 913-914 | S52036S | 08 | 559-561 | ||
| S49092G | 08 | 559-561 | S51041A | 24 | 955-965 | S52041A | 08 | 562-563 | ||
| S49092K | 08 | 564-566 | S51041D | 23 | 949-950 | S52041A | 24 | 955-965 | ||
| S49092P | 08 | 564-566 | S51041S | 09 | 604-605 | S52041B | 08 | 562-563 | ||
| S49092S | 08 | 559-561 | S51042A | 21 | 913-914 | S52041B | 24 | 955-965 | ||
| S49099A | 08 | 562-563 | S51042A | 24 | 955-965 | S52041C | 08 | 562-563 | ||
| S49099A | 24 | 955-965 | S51042D | 23 | 949-950 | S52041C | 24 | 955-965 | ||
| S49099D | 08 | 559-561 | S51042S | 09 | 604-605 | S52041D | 08 | 559-561 | ||
| S49099G | 08 | 559-561 | S51049A | 21 | 913-914 | S52041E | 08 | 559-561 | ||
| S49099K | 08 | 564-566 | S51049A | 24 | 955-965 | S52041F | 08 | 559-561 | ||
| S49099P | 08 | 564-566 | S51049D | 23 | 949-950 | S52041G | 08 | 559-561 | ||
| S49099S | 08 | 559-561 | S51049S | 09 | 604-605 | S52041H | 08 | 559-561 | ||
| S49101A | 08 | 562-563 | S51051A | 09 | 604-605 | S52041J | 08 | 559-561 | ||
| S49101A | 24 | 955-965 | S51051A | 24 | 955-965 | S52041K | 08 | 564-566 | ||
| S49101D | 08 | 559-561 | S51051D | 23 | 949-950 | S52041M | 08 | 564-566 | ||
| S49101G | 08 | 559-561 | S51051S | 09 | 604-605 | S52041N | 08 | 564-566 | ||
| S49101K | 08 | 564-566 | S51052A | 09 | 604-605 | S52041P | 08 | 564-566 | ||
| S49101P | 08 | 564-566 | S51052A | 24 | 955-965 | S52041Q | 08 | 564-566 | ||
| S49101S | 08 | 559-561 | S51052D | 23 | 949-950 | S52041R | 08 | 564-566 | ||
| S49102A | 08 | 562-563 | S51052S | 09 | 604-605 | S52041S | 08 | 559-561 | ||
| S49102A | 24 | 955-965 | S51059A | 09 | 604-605 | S52042A | 08 | 562-563 | ||
| S49102D | 08 | 559-561 | S51059A | 24 | 955-965 | S52042A | 24 | 955-965 | ||
| S49102G | 08 | 559-561 | S51059D | 23 | 949-950 | S52042B | 08 | 562-563 | ||
| S49102K | 08 | 564-566 | S51059S | 09 | 604-605 | S52042B | 24 | 955-965 | ||
| S49102P | 08 | 564-566 | S51801A | 09 | 604-605 | S52042C | 08 | 562-563 | ||
| S49102S | 08 | 559-561 | S51801A | 24 | 955-965 | S52042C | 24 | 955-965 | ||
| S49109A | 08 | 562-563 | S51801D | 23 | 949-950 | S52042D | 08 | 559-561 | ||
| S49109A | 24 | 955-965 | S51801S | 09 | 604-605 | S52042E | 08 | 559-561 | ||
| S49109D | 08 | 559-561 | S51802A | 09 | 604-605 | S52042F | 08 | 559-561 | ||
| S49109G | 08 | 559-561 | S51802A | 24 | 955-965 | S52042G | 08 | 559-561 | ||
| S49109K | 08 | 564-566 | S51802D | 23 | 949-950 | S52042H | 08 | 559-561 | ||
| S49109P | 08 | 564-566 | S51802S | 09 | 604-605 | S52042J | 08 | 559-561 | ||
| S49109S | 08 | 559-561 | S51809A | 09 | 604-605 | S52042K | 08 | 564-566 | ||
| S49111A | 08 | 562-563 | S51809A | 24 | 955-965 | S52042M | 08 | 564-566 | ||
| S49111A | 24 | 955-965 | S51809D | 23 | 949-950 | S52042N | 08 | 564-566 | ||
| S49111D | 08 | 559-561 | S51809S | 09 | 604-605 | S52042P | 08 | 564-566 | ||
| S49111G | 08 | 559-561 | S51811A | 09 | 604-605 | S52042Q | 08 | 564-566 | ||
| S49111K | 08 | 564-566 | S51811A | 24 | 955-965 | S52042R | 08 | 564-566 | ||
| S49111P | 08 | 564-566 | S51811D | 23 | 949-950 | S52042S | 08 | 559-561 | ||
| S49111S | 08 | 559-561 | S51811S | 09 | 604-605 | S52043A | 08 | 562-563 | ||
| S49112A | 08 | 562-563 | S51812A | 09 | 604-605 | S52043A | 24 | 955-965 | ||
| S49112A | 24 | 955-965 | S51812A | 24 | 955-965 | S52043B | 08 | 562-563 | ||
| S49112D | 08 | 559-561 | S51812D | 23 | 949-950 | S52043B | 24 | 955-965 | ||
| S49112G | 08 | 559-561 | S51812S | 09 | 604-605 | S52043C | 08 | 562-563 | ||
| S49112K | 08 | 564-566 | S51819A | 09 | 604-605 | S52043C | 24 | 955-965 | ||
| S49112P | 08 | 564-566 | S51819A | 24 | 955-965 | S52043D | 08 | 559-561 | ||
| S49112S | 08 | 559-561 | S51819D | 23 | 949-950 | S52043E | 08 | 559-561 | ||
| S49119A | 08 | 562-563 | S51819S | 09 | 604-605 | S52043F | 08 | 559-561 | ||
| S49119A | 24 | 955-965 | S51821A | 21 | 913-914 | S52043G | 08 | 559-561 | ||
| S49119D | 08 | 559-561 | S51821A | 24 | 955-965 | S52043H | 08 | 559-561 | ||
| S49119G | 08 | 559-561 | S51821D | 23 | 949-950 | S52043J | 08 | 559-561 | ||
| S49119K | 08 | 564-566 | S51821S | 09 | 604-605 | S52043K | 08 | 564-566 | ||
| S49119P | 08 | 564-566 | S51822A | 21 | 913-914 | S52043M | 08 | 564-566 | ||
| S49119S | 08 | 559-561 | S51822A | 24 | 955-965 | S52043N | 08 | 564-566 | ||
| S49121A | 08 | 562-563 | S51822D | 23 | 949-950 | S52043P | 08 | 564-566 | ||
| S49121A | 24 | 955-965 | S51822S | 09 | 604-605 | S52043Q | 08 | 564-566 | ||
| S49121D | 08 | 559-561 | S51829A | 21 | 913-914 | S52043R | 08 | 564-566 | ||
| S49121G | 08 | 559-561 | S51829A | 24 | 955-965 | S52043S | 08 | 559-561 | ||
| S49121K | 08 | 564-566 | S51829D | 23 | 949-950 | S52044A | 08 | 562-563 | ||
| S49121P | 08 | 564-566 | S51829S | 09 | 604-605 | S52044A | 24 | 955-965 | ||
| S49121S | 08 | 559-561 | S51831A | 09 | 604-605 | S52044B | 08 | 562-563 | ||
| S49122A | 08 | 562-563 | S51831A | 24 | 955-965 | S52044B | 24 | 955-965 | ||
| S49122A | 24 | 955-965 | S51831D | 23 | 949-950 | S52044C | 08 | 562-563 | ||
| S49122D | 08 | 559-561 | S51831S | 09 | 604-605 | S52044C | 24 | 955-965 | ||
| S49122G | 08 | 559-561 | S51832A | 09 | 604-605 | S52044D | 08 | 559-561 | ||
| S49122K | 08 | 564-566 | S51832A | 24 | 955-965 | S52044E | 08 | 559-561 | ||
| S49122P | 08 | 564-566 | S51832D | 23 | 949-950 | S52044F | 08 | 559-561 | ||
| S49122S | 08 | 559-561 | S51832S | 09 | 604-605 | S52044G | 08 | 559-561 | ||
| S49129A | 08 | 562-563 | S51839A | 09 | 604-605 | S52044H | 08 | 559-561 | ||
| S49129A | 24 | 955-965 | S51839A | 24 | 955-965 | S52044J | 08 | 559-561 | ||
| S49129D | 08 | 559-561 | S51839D | 23 | 949-950 | S52044K | 08 | 564-566 | ||
| S49129G | 08 | 559-561 | S51839S | 09 | 604-605 | S52044M | 08 | 564-566 | ||
| S49129K | 08 | 564-566 | S51841A | 21 | 913-914 | S52044N | 08 | 564-566 | ||
| S49129P | 08 | 564-566 | S51841A | 24 | 955-965 | S52044P | 08 | 564-566 | ||
| S49129S | 08 | 559-561 | S51841D | 23 | 949-950 | S52044Q | 08 | 564-566 | ||
| S49131A | 08 | 562-563 | S51841S | 09 | 604-605 | S52044R | 08 | 564-566 | ||
| S49131A | 24 | 955-965 | S51842A | 21 | 913-914 | S52044S | 08 | 559-561 | ||
| S49131D | 08 | 559-561 | S51842A | 24 | 955-965 | S52045A | 08 | 562-563 | ||
| S49131G | 08 | 559-561 | S51842D | 23 | 949-950 | S52045A | 24 | 955-965 | ||
| S49131K | 08 | 564-566 | S51842S | 09 | 604-605 | S52045B | 08 | 562-563 | ||
| S49131P | 08 | 564-566 | S51849A | 21 | 913-914 | S52045B | 24 | 955-965 | ||
| S49131S | 08 | 559-561 | S51849A | 24 | 955-965 | S52045C | 08 | 562-563 | ||
| S49132A | 08 | 562-563 | S51849D | 23 | 949-950 | S52045C | 24 | 955-965 | ||
| S49132A | 24 | 955-965 | S51849S | 09 | 604-605 | S52045D | 08 | 559-561 | ||
| S49132D | 08 | 559-561 | S51851A | 09 | 604-605 | S52045E | 08 | 559-561 | ||
| S49132G | 08 | 559-561 | S51851A | 24 | 955-965 | S52045F | 08 | 559-561 | ||
| S49132K | 08 | 564-566 | S51851D | 23 | 949-950 | S52045G | 08 | 559-561 | ||
| S49132P | 08 | 564-566 | S51851S | 09 | 604-605 | S52045H | 08 | 559-561 | ||
| S49132S | 08 | 559-561 | S51852A | 09 | 604-605 | S52045J | 08 | 559-561 | ||
| S49139A | 08 | 562-563 | S51852A | 24 | 955-965 | S52045K | 08 | 564-566 | ||
| S49139A | 24 | 955-965 | S51852D | 23 | 949-950 | S52045M | 08 | 564-566 | ||
| S49139D | 08 | 559-561 | S51852S | 09 | 604-605 | S52045N | 08 | 564-566 | ||
| S49139G | 08 | 559-561 | S51859A | 09 | 604-605 | S52045P | 08 | 564-566 | ||
| S49139K | 08 | 564-566 | S51859A | 24 | 955-965 | S52045Q | 08 | 564-566 | ||
| S49139P | 08 | 564-566 | S51859D | 23 | 949-950 | S52045R | 08 | 564-566 | ||
| S49139S | 08 | 559-561 | S51859S | 09 | 604-605 | S52045S | 08 | 559-561 | ||
| S49141A | 08 | 562-563 | S52001A | 08 | 562-563 | S52046A | 08 | 562-563 | ||
| S49141A | 24 | 955-965 | S52001A | 24 | 955-965 | S52046A | 24 | 955-965 | ||
| S49141D | 08 | 559-561 | S52001B | 08 | 562-563 | S52046B | 08 | 562-563 | ||
| S49141G | 08 | 559-561 | S52001B | 24 | 955-965 | S52046B | 24 | 955-965 | ||
| S49141K | 08 | 564-566 | S52001C | 08 | 562-563 | S52046C | 08 | 562-563 | ||
| S49141P | 08 | 564-566 | S52001C | 24 | 955-965 | S52046C | 24 | 955-965 | ||
| S49141S | 08 | 559-561 | S52001D | 08 | 559-561 | S52046D | 08 | 559-561 | ||
| S49142A | 08 | 562-563 | S52001E | 08 | 559-561 | S52046E | 08 | 559-561 | ||
| S49142A | 24 | 955-965 | S52001F | 08 | 559-561 | S52046F | 08 | 559-561 | ||
| S49142D | 08 | 559-561 | S52001G | 08 | 559-561 | S52046G | 08 | 559-561 | ||
| S49142G | 08 | 559-561 | S52001H | 08 | 559-561 | S52046H | 08 | 559-561 | ||
| S49142K | 08 | 564-566 | S52001J | 08 | 559-561 | S52046J | 08 | 559-561 | ||
| S49142P | 08 | 564-566 | S52001K | 08 | 564-566 | S52046K | 08 | 564-566 | ||
| S49142S | 08 | 559-561 | S52001M | 08 | 564-566 | S52046M | 08 | 564-566 | ||
| S49149A | 08 | 562-563 | S52001N | 08 | 564-566 | S52046N | 08 | 564-566 | ||
| S49149A | 24 | 955-965 | S52001P | 08 | 564-566 | S52046P | 08 | 564-566 | ||
| S49149D | 08 | 559-561 | S52001Q | 08 | 564-566 | S52046Q | 08 | 564-566 | ||
| S49149G | 08 | 559-561 | S52001R | 08 | 564-566 | S52046R | 08 | 564-566 | ||
| S49149K | 08 | 564-566 | S52001S | 08 | 559-561 | S52046S | 08 | 559-561 | ||
| S49149P | 08 | 564-566 | S52002A | 08 | 562-563 | S52091A | 08 | 562-563 | ||
| S49149S | 08 | 559-561 | S52002A | 24 | 955-965 | S52091A | 24 | 955-965 | ||
| S49191A | 08 | 562-563 | S52002B | 08 | 562-563 | S52091B | 08 | 562-563 | ||
| S49191A | 24 | 955-965 | S52002B | 24 | 955-965 | S52091B | 24 | 955-965 | ||
| S49191D | 08 | 559-561 | S52002C | 08 | 562-563 | S52091C | 08 | 562-563 | ||
| S49191G | 08 | 559-561 | S52002C | 24 | 955-965 | S52091C | 24 | 955-965 | ||
| S49191K | 08 | 564-566 | S52002D | 08 | 559-561 | S52091D | 08 | 559-561 | ||
| S49191P | 08 | 564-566 | S52002E | 08 | 559-561 | S52091E | 08 | 559-561 | ||
| S49191S | 08 | 559-561 | S52002F | 08 | 559-561 | S52091F | 08 | 559-561 | ||
| S49192A | 08 | 562-563 | S52002G | 08 | 559-561 | S52091G | 08 | 559-561 | ||
| S49192A | 24 | 955-965 | S52002H | 08 | 559-561 | S52091H | 08 | 559-561 | ||
| S49192D | 08 | 559-561 | S52002J | 08 | 559-561 | S52091J | 08 | 559-561 | ||
| S49192G | 08 | 559-561 | S52002K | 08 | 564-566 | S52091K | 08 | 564-566 | ||
| S49192K | 08 | 564-566 | S52002M | 08 | 564-566 | S52091M | 08 | 564-566 | ||
| S49192P | 08 | 564-566 | S52002N | 08 | 564-566 | S52091N | 08 | 564-566 | ||
| S49192S | 08 | 559-561 | S52002P | 08 | 564-566 | S52091P | 08 | 564-566 | ||
| S49199A | 08 | 562-563 | S52002Q | 08 | 564-566 | S52091Q | 08 | 564-566 | ||
| S49199A | 24 | 955-965 | S52002R | 08 | 564-566 | S52091R | 08 | 564-566 | ||
| S49199D | 08 | 559-561 | S52002S | 08 | 559-561 | S52091S | 08 | 559-561 | ||
| S49199G | 08 | 559-561 | S52009A | 08 | 562-563 | S52092A | 08 | 562-563 | ||
| S49199K | 08 | 564-566 | S52009A | 24 | 955-965 | S52092A | 24 | 955-965 | ||
| S49199P | 08 | 564-566 | S52009B | 08 | 562-563 | S52092B | 08 | 562-563 | ||
| S49199S | 08 | 559-561 | S52009B | 24 | 955-965 | S52092B | 24 | 955-965 | ||
| S4980XA | 21 | 913-914 | S52009C | 08 | 562-563 | S52092C | 08 | 562-563 | ||
| S4980XA | 24 | 955-965 | S52009C | 24 | 955-965 | S52092C | 24 | 955-965 | ||
| S4980XD | 23 | 949-950 | S52009D | 08 | 559-561 | S52092D | 08 | 559-561 | ||
| S4980XS | 21 | 913-914 | S52009E | 08 | 559-561 | S52092E | 08 | 559-561 | ||
| S4981XA | 21 | 913-914 | S52009F | 08 | 559-561 | S52092F | 08 | 559-561 | ||
| S4981XA | 24 | 955-965 | S52009G | 08 | 559-561 | S52092G | 08 | 559-561 | ||
| S4981XD | 23 | 949-950 | S52009H | 08 | 559-561 | S52092H | 08 | 559-561 | ||
| S4981XS | 21 | 913-914 | S52009J | 08 | 559-561 | S52092J | 08 | 559-561 | ||
| S4982XA | 21 | 913-914 | S52009K | 08 | 564-566 | S52092K | 08 | 564-566 | ||
| S4982XA | 24 | 955-965 | S52009M | 08 | 564-566 | S52092M | 08 | 564-566 | ||
| S4982XD | 23 | 949-950 | S52009N | 08 | 564-566 | S52092N | 08 | 564-566 | ||
| S4982XS | 21 | 913-914 | S52009P | 08 | 564-566 | S52092P | 08 | 564-566 | ||
| S4990XA | 21 | 913-914 | S52009Q | 08 | 564-566 | S52092Q | 08 | 564-566 | ||
| S4990XA | 24 | 955-965 | S52009R | 08 | 564-566 | S52092R | 08 | 564-566 | ||
| S4990XD | 23 | 949-950 | S52009S | 08 | 559-561 | S52092S | 08 | 559-561 | ||
| S4990XS | 21 | 913-914 | S52011A | 08 | 562-563 | S52099A | 08 | 562-563 | ||
| S4991XA | 21 | 913-914 | S52011A | 24 | 955-965 | S52099A | 24 | 955-965 | ||
| S4991XA | 24 | 955-965 | S52011D | 08 | 559-561 | S52099B | 08 | 562-563 | ||
| S4991XD | 23 | 949-950 | S52011G | 08 | 559-561 | S52099B | 24 | 955-965 | ||
| S4991XS | 21 | 913-914 | S52011K | 08 | 564-566 | S52099C | 08 | 562-563 | ||
| S4992XA | 21 | 913-914 | S52011P | 08 | 564-566 | S52099C | 24 | 955-965 | ||
| S4992XA | 24 | 955-965 | S52011S | 08 | 559-561 | S52099D | 08 | 559-561 | ||
| S4992XD | 23 | 949-950 | S52012A | 08 | 562-563 | S52099E | 08 | 559-561 | ||
| S4992XS | 21 | 913-914 | S52012A | 24 | 955-965 | S52099F | 08 | 559-561 | ||
| S5000XA | 09 | 604-605 | S52012D | 08 | 559-561 | S52099G | 08 | 559-561 | ||
| S5000XA | 24 | 955-965 | S52012G | 08 | 559-561 | S52099H | 08 | 559-561 | ||
| S5000XD | 23 | 949-950 | S52012K | 08 | 564-566 | S52099J | 08 | 559-561 | ||
| S5000XS | 09 | 604-605 | S52012P | 08 | 564-566 | S52099K | 08 | 564-566 | ||
| S5001XA | 09 | 604-605 | S52012S | 08 | 559-561 | S52099M | 08 | 564-566 | ||
| S5001XA | 24 | 955-965 | S52019A | 08 | 562-563 | S52099N | 08 | 564-566 | ||
| S5001XD | 23 | 949-950 | S52019A | 24 | 955-965 | S52099P | 08 | 564-566 | ||
| S5001XS | 09 | 604-605 | S52019D | 08 | 559-561 | S52099Q | 08 | 564-566 | ||
| S5002XA | 09 | 604-605 | S52019G | 08 | 559-561 | S52099R | 08 | 564-566 | ||
| S5002XA | 24 | 955-965 | S52019K | 08 | 564-566 | S52099S | 08 | 559-561 | ||
| S5002XD | 23 | 949-950 | S52019P | 08 | 564-566 | S52101A | 08 | 562-563 | ||
| S5002XS | 09 | 604-605 | S52019S | 08 | 559-561 | S52101A | 24 | 955-965 | ||
| S5010XA | 09 | 604-605 | S52021A | 08 | 562-563 | S52101B | 08 | 562-563 | ||
| S5010XA | 24 | 955-965 | S52021A | 24 | 955-965 | S52101B | 24 | 955-965 | ||
| S5010XD | 23 | 949-950 | S52021B | 08 | 562-563 | S52101C | 08 | 562-563 | ||
| S5010XS | 09 | 604-605 | S52021B | 24 | 955-965 | S52101C | 24 | 955-965 | ||
| S5011XA | 09 | 604-605 | S52021C | 08 | 562-563 | S52101D | 08 | 559-561 | ||
| S5011XA | 24 | 955-965 | S52021C | 24 | 955-965 | S52101E | 08 | 559-561 | ||
| S5011XD | 23 | 949-950 | S52021D | 08 | 559-561 | S52101F | 08 | 559-561 | ||
| S5011XS | 09 | 604-605 | S52021E | 08 | 559-561 | S52101G | 08 | 559-561 | ||
| S5012XA | 09 | 604-605 | S52021F | 08 | 559-561 | S52101H | 08 | 559-561 | ||
| S5012XA | 24 | 955-965 | S52021G | 08 | 559-561 | S52101J | 08 | 559-561 | ||
| S5012XD | 23 | 949-950 | S52021H | 08 | 559-561 | S52101K | 08 | 564-566 | ||
| S5012XS | 09 | 604-605 | S52021J | 08 | 559-561 | S52101M | 08 | 564-566 | ||
| S50311A | 09 | 604-605 | S52021K | 08 | 564-566 | S52101N | 08 | 564-566 | ||
| S50311A | 24 | 955-965 | S52021M | 08 | 564-566 | S52101P | 08 | 564-566 | ||
| S50311D | 23 | 949-950 | S52021N | 08 | 564-566 | S52101Q | 08 | 564-566 | ||
| S50311S | 09 | 604-605 | S52021P | 08 | 564-566 | S52101R | 08 | 564-566 | ||
| S50312A | 09 | 604-605 | S52021Q | 08 | 564-566 | S52101S | 08 | 559-561 | ||
| S50312A | 24 | 955-965 | S52021R | 08 | 564-566 | S52102A | 08 | 562-563 | ||
| S50312D | 23 | 949-950 | S52021S | 08 | 559-561 | S52102A | 24 | 955-965 | ||
| S50312S | 09 | 604-605 | S52022A | 08 | 562-563 | S52102B | 08 | 562-563 | ||
| S50319A | 09 | 604-605 | S52022A | 24 | 955-965 | S52102B | 24 | 955-965 | ||
| S50319A | 24 | 955-965 | S52022B | 08 | 562-563 | S52102C | 08 | 562-563 | ||
| S50319D | 23 | 949-950 | S52022B | 24 | 955-965 | S52102C | 24 | 955-965 | ||
| S50319S | 09 | 604-605 | S52022C | 08 | 562-563 | S52102D | 08 | 559-561 | ||
| S50321A | 09 | 606-607 | S52022C | 24 | 955-965 | S52102E | 08 | 559-561 | ||
| S50321A | 24 | 955-965 | S52022D | 08 | 559-561 | S52102F | 08 | 559-561 | ||
| S50321D | 23 | 949-950 | S52022E | 08 | 559-561 | S52102G | 08 | 559-561 | ||
| S50321S | 09 | 604-605 | S52022F | 08 | 559-561 | S52102H | 08 | 559-561 | ||
| S50322A | 09 | 606-607 | S52022G | 08 | 559-561 | S52102J | 08 | 559-561 | ||
| S50322A | 24 | 955-965 | S52022H | 08 | 559-561 | S52102K | 08 | 564-566 | ||
| S50322D | 23 | 949-950 | S52022J | 08 | 559-561 | S52102M | 08 | 564-566 | ||
| S50322S | 09 | 604-605 | S52022K | 08 | 564-566 | S52102N | 08 | 564-566 | ||
| S50329A | 09 | 606-607 | S52022M | 08 | 564-566 | S52102P | 08 | 564-566 | ||
| S50329A | 24 | 955-965 | S52022N | 08 | 564-566 | S52102Q | 08 | 564-566 | ||
| S50329D | 23 | 949-950 | S52022P | 08 | 564-566 | S52102R | 08 | 564-566 | ||
| S50329S | 09 | 604-605 | S52022Q | 08 | 564-566 | S52102S | 08 | 559-561 | ||
| S50341A | 09 | 604-605 | S52022R | 08 | 564-566 | S52109A | 08 | 562-563 | ||
| S50341A | 24 | 955-965 | S52022S | 08 | 559-561 | S52109A | 24 | 955-965 | ||
| S50341D | 23 | 949-950 | S52023A | 08 | 562-563 | S52109B | 08 | 562-563 | ||
| S50341S | 09 | 604-605 | S52023A | 24 | 955-965 | S52109B | 24 | 955-965 | ||
| S50342A | 09 | 604-605 | S52023B | 08 | 562-563 | S52109C | 08 | 562-563 | ||
| S50342A | 24 | 955-965 | S52023B | 24 | 955-965 | S52109C | 24 | 955-965 | ||
| S50342D | 23 | 949-950 | S52023C | 08 | 562-563 | S52109D | 08 | 559-561 | ||
| S50342S | 09 | 604-605 | S52023C | 24 | 955-965 | S52109E | 08 | 559-561 | ||
| S50349A | 09 | 604-605 | S52023D | 08 | 559-561 | S52109F | 08 | 559-561 | ||
| S50349A | 24 | 955-965 | S52023E | 08 | 559-561 | S52109G | 08 | 559-561 | ||
| S50349D | 23 | 949-950 | S52023F | 08 | 559-561 | S52109H | 08 | 559-561 | ||
| S50349S | 09 | 604-605 | S52023G | 08 | 559-561 | S52109J | 08 | 559-561 | ||
| S50351A | 09 | 604-605 | S52023H | 08 | 559-561 | S52109K | 08 | 564-566 | ||
| S50351A | 24 | 955-965 | S52023J | 08 | 559-561 | S52109M | 08 | 564-566 | ||
| S50351D | 23 | 949-950 | S52023K | 08 | 564-566 | S52109N | 08 | 564-566 | ||
| S50351S | 09 | 604-605 | S52023M | 08 | 564-566 | S52109P | 08 | 564-566 | ||
| S50352A | 09 | 604-605 | S52023N | 08 | 564-566 | S52109Q | 08 | 564-566 | ||
| S50352A | 24 | 955-965 | S52023P | 08 | 564-566 | S52109R | 08 | 564-566 | ||
| S50352D | 23 | 949-950 | S52023Q | 08 | 564-566 | S52109S | 08 | 559-561 | ||
| S50352S | 09 | 604-605 | S52023R | 08 | 564-566 | S52111A | 08 | 562-563 | ||
| S50359A | 09 | 604-605 | S52023S | 08 | 559-561 | S52111A | 24 | 955-965 | ||
| S50359A | 24 | 955-965 | S52024A | 08 | 562-563 | S52111D | 08 | 559-561 | ||
| S50359D | 23 | 949-950 | S52024A | 24 | 955-965 | S52111G | 08 | 559-561 | ||
| S50359S | 09 | 604-605 | S52024B | 08 | 562-563 | S52111K | 08 | 564-566 | ||
| S50361A | 09 | 606-607 | S52024B | 24 | 955-965 | S52111P | 08 | 564-566 | ||
| S50361A | 24 | 955-965 | S52024C | 08 | 562-563 | S52111S | 08 | 559-561 | ||
| S50361D | 23 | 949-950 | S52024C | 24 | 955-965 | S52112A | 08 | 562-563 | ||
| S50361S | 09 | 604-605 | S52024D | 08 | 559-561 | S52112A | 24 | 955-965 | ||
| S50362A | 09 | 606-607 | S52024E | 08 | 559-561 | S52112D | 08 | 559-561 | ||
| S50362A | 24 | 955-965 | S52024F | 08 | 559-561 | S52112G | 08 | 559-561 | ||
| S50362D | 23 | 949-950 | S52024G | 08 | 559-561 | S52112K | 08 | 564-566 | ||
| S50362S | 09 | 604-605 | S52024H | 08 | 559-561 | S52112P | 08 | 564-566 | ||
| S50369A | 09 | 606-607 | S52024J | 08 | 559-561 | S52112S | 08 | 559-561 | ||
| S50369A | 24 | 955-965 | S52024K | 08 | 564-566 | S52119A | 08 | 562-563 | ||
| S50369D | 23 | 949-950 | S52024M | 08 | 564-566 | S52119A | 24 | 955-965 | ||
| S50369S | 09 | 604-605 | S52024N | 08 | 564-566 | S52119D | 08 | 559-561 | ||
| S50371A | 09 | 604-605 | S52024P | 08 | 564-566 | S52119G | 08 | 559-561 | ||
| S50371A | 24 | 955-965 | S52024Q | 08 | 564-566 | S52119K | 08 | 564-566 | ||
| S50371D | 23 | 949-950 | S52024R | 08 | 564-566 | S52119P | 08 | 564-566 | ||
| S50371S | 09 | 604-605 | S52024S | 08 | 559-561 | S52119S | 08 | 559-561 | ||
| S50372A | 09 | 604-605 | S52025A | 08 | 562-563 | S52121A | 08 | 562-563 | ||
| S50372A | 24 | 955-965 | S52025A | 24 | 955-965 | S52121A | 24 | 955-965 | ||
| S50372D | 23 | 949-950 | S52025B | 08 | 562-563 | S52121B | 08 | 562-563 | ||
| S50372S | 09 | 604-605 | S52025B | 24 | 955-965 | S52121B | 24 | 955-965 | ||
| S50379A | 09 | 604-605 | S52025C | 08 | 562-563 | S52121C | 08 | 562-563 | ||
| S50379A | 24 | 955-965 | S52025C | 24 | 955-965 | S52121C | 24 | 955-965 | ||
| S50379D | 23 | 949-950 | S52025D | 08 | 559-561 | S52121D | 08 | 559-561 | ||
| S50379S | 09 | 604-605 | S52025E | 08 | 559-561 | S52121E | 08 | 559-561 | ||
| S50811A | 09 | 604-605 | S52025F | 08 | 559-561 | S52121F | 08 | 559-561 | ||
| S50811A | 24 | 955-965 | S52025G | 08 | 559-561 | S52121G | 08 | 559-561 | ||
| S50811D | 23 | 949-950 | S52025H | 08 | 559-561 | S52121H | 08 | 559-561 | ||
| S50811S | 09 | 604-605 | S52025J | 08 | 559-561 | S52121J | 08 | 559-561 | ||
| S50812A | 09 | 604-605 | S52025K | 08 | 564-566 | S52121K | 08 | 564-566 | ||
| S50812A | 24 | 955-965 | S52025M | 08 | 564-566 | S52121M | 08 | 564-566 | ||
| S50812D | 23 | 949-950 | S52025N | 08 | 564-566 | S52121N | 08 | 564-566 | ||
| S50812S | 09 | 604-605 | S52025P | 08 | 564-566 | S52121P | 08 | 564-566 | ||
| S50819A | 09 | 604-605 | S52025Q | 08 | 564-566 | S52121Q | 08 | 564-566 | ||
| S50819A | 24 | 955-965 | S52025R | 08 | 564-566 | S52121R | 08 | 564-566 | ||
| S50819D | 23 | 949-950 | S52025S | 08 | 559-561 | S52121S | 08 | 559-561 | ||
| S50819S | 09 | 604-605 | S52026A | 08 | 562-563 | S52122A | 08 | 562-563 | ||
| S50821A | 09 | 606-607 | S52026A | 24 | 955-965 | S52122A | 24 | 955-965 | ||
| S50821A | 24 | 955-965 | S52026B | 08 | 562-563 | S52122B | 08 | 562-563 | ||
| S50821D | 23 | 949-950 | S52026B | 24 | 955-965 | S52122B | 24 | 955-965 | ||
| S50821S | 09 | 604-605 | S52026C | 08 | 562-563 | S52122C | 08 | 562-563 | ||
| S50822A | 09 | 606-607 | S52026C | 24 | 955-965 | S52122C | 24 | 955-965 | ||
| S50822A | 24 | 955-965 | S52026D | 08 | 559-561 | S52122D | 08 | 559-561 | ||
| S50822D | 23 | 949-950 | S52026E | 08 | 559-561 | S52122E | 08 | 559-561 | ||
| S50822S | 09 | 604-605 | S52026F | 08 | 559-561 | S52122F | 08 | 559-561 | ||
| S50829A | 09 | 606-607 | S52026G | 08 | 559-561 | S52122G | 08 | 559-561 | ||
| S50829A | 24 | 955-965 | S52026H | 08 | 559-561 | S52122H | 08 | 559-561 | ||
| S50829D | 23 | 949-950 | S52026J | 08 | 559-561 | S52122J | 08 | 559-561 | ||
| S50829S | 09 | 604-605 | S52026K | 08 | 564-566 | S52122K | 08 | 564-566 | ||
| S50841A | 09 | 604-605 | S52026M | 08 | 564-566 | S52122M | 08 | 564-566 | ||
| S50841A | 24 | 955-965 | S52026N | 08 | 564-566 | S52122N | 08 | 564-566 | ||
| S50841D | 23 | 949-950 | S52026P | 08 | 564-566 | S52122P | 08 | 564-566 | ||
| S50841S | 09 | 604-605 | S52026Q | 08 | 564-566 | S52122Q | 08 | 564-566 | ||
| S50842A | 09 | 604-605 | S52026R | 08 | 564-566 | S52122R | 08 | 564-566 | ||
| S50842A | 24 | 955-965 | S52026S | 08 | 559-561 | S52122S | 08 | 559-561 | ||
| S50842D | 23 | 949-950 | S52031A | 08 | 562-563 | S52123A | 08 | 562-563 | ||
| S50842S | 09 | 604-605 | S52031A | 24 | 955-965 | S52123A | 24 | 955-965 | ||
| S50849A | 09 | 604-605 | S52031B | 08 | 562-563 | S52123B | 08 | 562-563 | ||
| S50849A | 24 | 955-965 | S52031B | 24 | 955-965 | S52123B | 24 | 955-965 | ||
| S50849D | 23 | 949-950 | S52031C | 08 | 562-563 | S52123C | 08 | 562-563 | ||
| S50849S | 09 | 604-605 | S52031C | 24 | 955-965 | S52123C | 24 | 955-965 | ||
| S50851A | 09 | 604-605 | S52031D | 08 | 559-561 | S52123D | 08 | 559-561 | ||
| S50851A | 24 | 955-965 | S52031E | 08 | 559-561 | S52123E | 08 | 559-561 | ||
| S50851D | 23 | 949-950 | S52031F | 08 | 559-561 | S52123F | 08 | 559-561 | ||
| S50851S | 09 | 604-605 | S52031G | 08 | 559-561 | S52123G | 08 | 559-561 | ||
| S50852A | 09 | 604-605 | S52031H | 08 | 559-561 | S52123H | 08 | 559-561 | ||
| S50852A | 24 | 955-965 | S52031J | 08 | 559-561 | S52123J | 08 | 559-561 | ||
| S50852D | 23 | 949-950 | S52031K | 08 | 564-566 | S52123K | 08 | 564-566 | ||
| S50852S | 09 | 604-605 | S52031M | 08 | 564-566 | S52123M | 08 | 564-566 | ||
| S50859A | 09 | 604-605 | S52031N | 08 | 564-566 | S52123N | 08 | 564-566 | ||
| S50859A | 24 | 955-965 | S52031P | 08 | 564-566 | S52123P | 08 | 564-566 | ||
| S50859D | 23 | 949-950 | S52031Q | 08 | 564-566 | S52123Q | 08 | 564-566 | ||
| S50859S | 09 | 604-605 | S52031R | 08 | 564-566 | S52123R | 08 | 564-566 | ||
| S50861A | 09 | 606-607 | S52031S | 08 | 559-561 | S52123S | 08 | 559-561 | ||
| S50861A | 24 | 955-965 | S52032A | 08 | 562-563 | S52124A | 08 | 562-563 | ||
| S50861D | 23 | 949-950 | S52032A | 24 | 955-965 | S52124A | 24 | 955-965 | ||
| S50861S | 09 | 604-605 | S52032B | 08 | 562-563 | S52124B | 08 | 562-563 | ||
| S50862A | 09 | 606-607 | S52032B | 24 | 955-965 | S52124B | 24 | 955-965 | ||
| S50862A | 24 | 955-965 | S52032C | 08 | 562-563 | S52124C | 08 | 562-563 | ||
| S50862D | 23 | 949-950 | S52032C | 24 | 955-965 | S52124C | 24 | 955-965 | ||
| S50862S | 09 | 604-605 | S52032D | 08 | 559-561 | S52124D | 08 | 559-561 | ||
| S50869A | 09 | 606-607 | S52032E | 08 | 559-561 | S52124E | 08 | 559-561 | ||
| S50869A | 24 | 955-965 | S52032F | 08 | 559-561 | S52124F | 08 | 559-561 | ||
| S50869D | 23 | 949-950 | S52032G | 08 | 559-561 | S52124G | 08 | 559-561 | ||
| S50869S | 09 | 604-605 | S52032H | 08 | 559-561 | S52124H | 08 | 559-561 | ||
| S50871A | 09 | 604-605 | S52032J | 08 | 559-561 | S52124J | 08 | 559-561 | ||
| S50871A | 24 | 955-965 | S52032K | 08 | 564-566 | S52124K | 08 | 564-566 | ||
| S50871D | 23 | 949-950 | S52032M | 08 | 564-566 | S52124M | 08 | 564-566 | ||
| S50871S | 09 | 604-605 | S52032N | 08 | 564-566 | S52124N | 08 | 564-566 | ||
| S50872A | 09 | 604-605 | S52032P | 08 | 564-566 | S52124P | 08 | 564-566 | ||
| S50872A | 24 | 955-965 | S52032Q | 08 | 564-566 | S52124Q | 08 | 564-566 | ||
| S50872D | 23 | 949-950 | S52032R | 08 | 564-566 | S52124R | 08 | 564-566 | ||
| S50872S | 09 | 604-605 | S52032S | 08 | 559-561 | S52124S | 08 | 559-561 | ||
| S50879A | 09 | 604-605 | S52033A | 08 | 562-563 | S52125A | 08 | 562-563 | ||
| S50879A | 24 | 955-965 | S52033A | 24 | 955-965 | S52125A | 24 | 955-965 | ||
| S50879D | 23 | 949-950 | S52033B | 08 | 562-563 | S52125B | 08 | 562-563 | ||
| S50879S | 09 | 604-605 | S52033B | 24 | 955-965 | S52125B | 24 | 955-965 | ||
| S50901A | 09 | 604-605 | S52033C | 08 | 562-563 | S52125C | 08 | 562-563 | ||
| S50901A | 24 | 955-965 | S52033C | 24 | 955-965 | S52125C | 24 | 955-965 | ||
| S50901D | 23 | 949-950 | S52033D | 08 | 559-561 | S52125D | 08 | 559-561 | ||
| S50901S | 09 | 604-605 | S52033E | 08 | 559-561 | S52125E | 08 | 559-561 | ||
| S50902A | 09 | 604-605 | S52033F | 08 | 559-561 | S52125F | 08 | 559-561 | ||
| S50902A | 24 | 955-965 | S52033G | 08 | 559-561 | S52125G | 08 | 559-561 | ||
| S50902D | 23 | 949-950 | S52033H | 08 | 559-561 | S52125H | 08 | 559-561 | ||
| S50902S | 09 | 604-605 | S52033J | 08 | 559-561 | S52125J | 08 | 559-561 | ||
| S50909A | 09 | 604-605 | S52033K | 08 | 564-566 | S52125K | 08 | 564-566 | ||
| S50909A | 24 | 955-965 | S52033M | 08 | 564-566 | S52125M | 08 | 564-566 | ||
| S50909D | 23 | 949-950 | S52033N | 08 | 564-566 | S52125N | 08 | 564-566 | ||
| S50909S | 09 | 604-605 | S52033P | 08 | 564-566 | S52125P | 08 | 564-566 | ||
| S50911A | 09 | 604-605 | S52033Q | 08 | 564-566 | S52125Q | 08 | 564-566 | ||
| S50911A | 24 | 955-965 | S52033R | 08 | 564-566 | S52125R | 08 | 564-566 | ||
| S50911D | 23 | 949-950 | S52033S | 08 | 559-561 | S52125S | 08 | 559-561 | ||
| S50911S | 09 | 604-605 | S52034A | 08 | 562-563 | S52126A | 08 | 562-563 | ||
| S50912A | 09 | 604-605 | S52034A | 24 | 955-965 | S52126A | 24 | 955-965 | ||
| S50912A | 24 | 955-965 | S52034B | 08 | 562-563 | S52126B | 08 | 562-563 | ||
| S50912D | 23 | 949-950 | S52034B | 24 | 955-965 | S52126B | 24 | 955-965 | ||
| S50912S | 09 | 604-605 | S52034C | 08 | 562-563 | S52126C | 08 | 562-563 | ||
| S50919A | 09 | 604-605 | S52034C | 24 | 955-965 | S52126C | 24 | 955-965 | ||
| S50919A | 24 | 955-965 | S52034D | 08 | 559-561 | S52126D | 08 | 559-561 | ||
| S50919D | 23 | 949-950 | S52034E | 08 | 559-561 | S52126E | 08 | 559-561 | ||
| S50919S | 09 | 604-605 | S52034F | 08 | 559-561 | S52126F | 08 | 559-561 | ||
| S51001A | 09 | 604-605 | S52034G | 08 | 559-561 | S52126G | 08 | 559-561 | ||
| S51001A | 24 | 955-965 | S52034H | 08 | 559-561 | S52126H | 08 | 559-561 | ||
| S51001D | 23 | 949-950 | S52034J | 08 | 559-561 | S52126J | 08 | 559-561 | ||
| S51001S | 09 | 604-605 | S52034K | 08 | 564-566 | S52126K | 08 | 564-566 | ||
| S51002A | 09 | 604-605 | S52034M | 08 | 564-566 | S52126M | 08 | 564-566 | ||
| S51002A | 24 | 955-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 04 Oct 2018 16:21:08 CMS, code-revision=145, description-revision=1114 |