ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 38 of 74 |
| A000 B302 C577 C8442 D309 E093493 E13621 F40232 H02049 H26499 H54415A I5033 I70592 J9602 K8502 L89814 M10062 M24444 M5383 M80021D M84575S M89539 N8112 O281 O361921 O45023 P111 Q685 R936 S0242XG S06384D S12500K S20469D S25102D S3141XD S32454K S36291D S42012D S42392D S45302S S52023C S52254D S52509J S5491XA S59242D S61310S S62246P S62629G S63416A S66312A S72002S S72092G S7225XB S72424H S76022A S82023A S82225C S82461F S83126S S89032P S91312S S92335P S95112A T17298S T2270XD T25039D T382X1S T43591D T484X5A T578X4A T71132A T82838S Z0571 Z89112 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S42012D | 08 | 559-561 | S42145A | 08 | 562-563 | S42271P | 08 | 564-566 | ||
| S42012G | 08 | 559-561 | S42145A | 24 | 963-965 | S42271S | 08 | 559-561 | ||
| S42012K | 08 | 564-566 | S42145B | 08 | 562-563 | S42272A | 08 | 562-563 | ||
| S42012P | 08 | 564-566 | S42145B | 24 | 963-965 | S42272A | 24 | 963-965 | ||
| S42012S | 08 | 559-561 | S42145D | 08 | 559-561 | S42272D | 08 | 559-561 | ||
| S42013A | 08 | 562-563 | S42145G | 08 | 559-561 | S42272G | 08 | 559-561 | ||
| S42013A | 24 | 963-965 | S42145K | 08 | 564-566 | S42272K | 08 | 564-566 | ||
| S42013B | 08 | 562-563 | S42145P | 08 | 564-566 | S42272P | 08 | 564-566 | ||
| S42013B | 24 | 963-965 | S42145S | 08 | 559-561 | S42272S | 08 | 559-561 | ||
| S42013D | 08 | 559-561 | S42146A | 08 | 562-563 | S42279A | 08 | 562-563 | ||
| S42013G | 08 | 559-561 | S42146A | 24 | 963-965 | S42279A | 24 | 963-965 | ||
| S42013K | 08 | 564-566 | S42146B | 08 | 562-563 | S42279D | 08 | 559-561 | ||
| S42013P | 08 | 564-566 | S42146B | 24 | 963-965 | S42279G | 08 | 559-561 | ||
| S42013S | 08 | 559-561 | S42146D | 08 | 559-561 | S42279K | 08 | 564-566 | ||
| S42014A | 08 | 562-563 | S42146G | 08 | 559-561 | S42279P | 08 | 564-566 | ||
| S42014A | 24 | 963-965 | S42146K | 08 | 564-566 | S42279S | 08 | 559-561 | ||
| S42014B | 08 | 562-563 | S42146P | 08 | 564-566 | S42291A | 08 | 562-563 | ||
| S42014B | 24 | 963-965 | S42146S | 08 | 559-561 | S42291A | 24 | 963-965 | ||
| S42014D | 08 | 559-561 | S42151A | 08 | 562-563 | S42291B | 08 | 562-563 | ||
| S42014G | 08 | 559-561 | S42151A | 24 | 963-965 | S42291B | 24 | 963-965 | ||
| S42014K | 08 | 564-566 | S42151B | 08 | 562-563 | S42291D | 08 | 559-561 | ||
| S42014P | 08 | 564-566 | S42151B | 24 | 963-965 | S42291G | 08 | 559-561 | ||
| S42014S | 08 | 559-561 | S42151D | 08 | 559-561 | S42291K | 08 | 564-566 | ||
| S42015A | 08 | 562-563 | S42151G | 08 | 559-561 | S42291P | 08 | 564-566 | ||
| S42015A | 24 | 963-965 | S42151K | 08 | 564-566 | S42291S | 08 | 559-561 | ||
| S42015B | 08 | 562-563 | S42151P | 08 | 564-566 | S42292A | 08 | 562-563 | ||
| S42015B | 24 | 963-965 | S42151S | 08 | 559-561 | S42292A | 24 | 963-965 | ||
| S42015D | 08 | 559-561 | S42152A | 08 | 562-563 | S42292B | 08 | 562-563 | ||
| S42015G | 08 | 559-561 | S42152A | 24 | 963-965 | S42292B | 24 | 963-965 | ||
| S42015K | 08 | 564-566 | S42152B | 08 | 562-563 | S42292D | 08 | 559-561 | ||
| S42015P | 08 | 564-566 | S42152B | 24 | 963-965 | S42292G | 08 | 559-561 | ||
| S42015S | 08 | 559-561 | S42152D | 08 | 559-561 | S42292K | 08 | 564-566 | ||
| S42016A | 08 | 562-563 | S42152G | 08 | 559-561 | S42292P | 08 | 564-566 | ||
| S42016A | 24 | 963-965 | S42152K | 08 | 564-566 | S42292S | 08 | 559-561 | ||
| S42016B | 08 | 562-563 | S42152P | 08 | 564-566 | S42293A | 08 | 562-563 | ||
| S42016B | 24 | 963-965 | S42152S | 08 | 559-561 | S42293A | 24 | 963-965 | ||
| S42016D | 08 | 559-561 | S42153A | 08 | 562-563 | S42293B | 08 | 562-563 | ||
| S42016G | 08 | 559-561 | S42153A | 24 | 963-965 | S42293B | 24 | 963-965 | ||
| S42016K | 08 | 564-566 | S42153B | 08 | 562-563 | S42293D | 08 | 559-561 | ||
| S42016P | 08 | 564-566 | S42153B | 24 | 963-965 | S42293G | 08 | 559-561 | ||
| S42016S | 08 | 559-561 | S42153D | 08 | 559-561 | S42293K | 08 | 564-566 | ||
| S42017A | 08 | 562-563 | S42153G | 08 | 559-561 | S42293P | 08 | 564-566 | ||
| S42017A | 24 | 963-965 | S42153K | 08 | 564-566 | S42293S | 08 | 559-561 | ||
| S42017B | 08 | 562-563 | S42153P | 08 | 564-566 | S42294A | 08 | 562-563 | ||
| S42017B | 24 | 963-965 | S42153S | 08 | 559-561 | S42294A | 24 | 963-965 | ||
| S42017D | 08 | 559-561 | S42154A | 08 | 562-563 | S42294B | 08 | 562-563 | ||
| S42017G | 08 | 559-561 | S42154A | 24 | 963-965 | S42294B | 24 | 963-965 | ||
| S42017K | 08 | 564-566 | S42154B | 08 | 562-563 | S42294D | 08 | 559-561 | ||
| S42017P | 08 | 564-566 | S42154B | 24 | 963-965 | S42294G | 08 | 559-561 | ||
| S42017S | 08 | 559-561 | S42154D | 08 | 559-561 | S42294K | 08 | 564-566 | ||
| S42018A | 08 | 562-563 | S42154G | 08 | 559-561 | S42294P | 08 | 564-566 | ||
| S42018A | 24 | 963-965 | S42154K | 08 | 564-566 | S42294S | 08 | 559-561 | ||
| S42018B | 08 | 562-563 | S42154P | 08 | 564-566 | S42295A | 08 | 562-563 | ||
| S42018B | 24 | 963-965 | S42154S | 08 | 559-561 | S42295A | 24 | 963-965 | ||
| S42018D | 08 | 559-561 | S42155A | 08 | 562-563 | S42295B | 08 | 562-563 | ||
| S42018G | 08 | 559-561 | S42155A | 24 | 963-965 | S42295B | 24 | 963-965 | ||
| S42018K | 08 | 564-566 | S42155B | 08 | 562-563 | S42295D | 08 | 559-561 | ||
| S42018P | 08 | 564-566 | S42155B | 24 | 963-965 | S42295G | 08 | 559-561 | ||
| S42018S | 08 | 559-561 | S42155D | 08 | 559-561 | S42295K | 08 | 564-566 | ||
| S42019A | 08 | 562-563 | S42155G | 08 | 559-561 | S42295P | 08 | 564-566 | ||
| S42019A | 24 | 963-965 | S42155K | 08 | 564-566 | S42295S | 08 | 559-561 | ||
| S42019B | 08 | 562-563 | S42155P | 08 | 564-566 | S42296A | 08 | 562-563 | ||
| S42019B | 24 | 963-965 | S42155S | 08 | 559-561 | S42296A | 24 | 963-965 | ||
| S42019D | 08 | 559-561 | S42156A | 08 | 562-563 | S42296B | 08 | 562-563 | ||
| S42019G | 08 | 559-561 | S42156A | 24 | 963-965 | S42296B | 24 | 963-965 | ||
| S42019K | 08 | 564-566 | S42156B | 08 | 562-563 | S42296D | 08 | 559-561 | ||
| S42019P | 08 | 564-566 | S42156B | 24 | 963-965 | S42296G | 08 | 559-561 | ||
| S42019S | 08 | 559-561 | S42156D | 08 | 559-561 | S42296K | 08 | 564-566 | ||
| S42021A | 08 | 562-563 | S42156G | 08 | 559-561 | S42296P | 08 | 564-566 | ||
| S42021A | 24 | 963-965 | S42156K | 08 | 564-566 | S42296S | 08 | 559-561 | ||
| S42021B | 08 | 562-563 | S42156P | 08 | 564-566 | S42301A | 08 | 562-563 | ||
| S42021B | 24 | 963-965 | S42156S | 08 | 559-561 | S42301A | 24 | 963-965 | ||
| S42021D | 08 | 559-561 | S42191A | 08 | 564-566 | S42301B | 08 | 562-563 | ||
| S42021G | 08 | 559-561 | S42191A | 24 | 963-965 | S42301B | 24 | 963-965 | ||
| S42021K | 08 | 564-566 | S42191B | 08 | 564-566 | S42301D | 08 | 559-561 | ||
| S42021P | 08 | 564-566 | S42191B | 24 | 963-965 | S42301G | 08 | 559-561 | ||
| S42021S | 08 | 559-561 | S42191D | 08 | 559-561 | S42301K | 08 | 564-566 | ||
| S42022A | 08 | 562-563 | S42191G | 08 | 559-561 | S42301P | 08 | 564-566 | ||
| S42022A | 24 | 963-965 | S42191K | 08 | 564-566 | S42301S | 08 | 559-561 | ||
| S42022B | 08 | 562-563 | S42191P | 08 | 564-566 | S42302A | 08 | 562-563 | ||
| S42022B | 24 | 963-965 | S42191S | 08 | 559-561 | S42302A | 24 | 963-965 | ||
| S42022D | 08 | 559-561 | S42192A | 08 | 564-566 | S42302B | 08 | 562-563 | ||
| S42022G | 08 | 559-561 | S42192A | 24 | 963-965 | S42302B | 24 | 963-965 | ||
| S42022K | 08 | 564-566 | S42192B | 08 | 564-566 | S42302D | 08 | 559-561 | ||
| S42022P | 08 | 564-566 | S42192B | 24 | 963-965 | S42302G | 08 | 559-561 | ||
| S42022S | 08 | 559-561 | S42192D | 08 | 559-561 | S42302K | 08 | 564-566 | ||
| S42023A | 08 | 562-563 | S42192G | 08 | 559-561 | S42302P | 08 | 564-566 | ||
| S42023A | 24 | 963-965 | S42192K | 08 | 564-566 | S42302S | 08 | 559-561 | ||
| S42023B | 08 | 562-563 | S42192P | 08 | 564-566 | S42309A | 08 | 562-563 | ||
| S42023B | 24 | 963-965 | S42192S | 08 | 559-561 | S42309A | 24 | 963-965 | ||
| S42023D | 08 | 559-561 | S42199A | 08 | 564-566 | S42309B | 08 | 562-563 | ||
| S42023G | 08 | 559-561 | S42199A | 24 | 963-965 | S42309B | 24 | 963-965 | ||
| S42023K | 08 | 564-566 | S42199B | 08 | 564-566 | S42309D | 08 | 559-561 | ||
| S42023P | 08 | 564-566 | S42199B | 24 | 963-965 | S42309G | 08 | 559-561 | ||
| S42023S | 08 | 559-561 | S42199D | 08 | 559-561 | S42309K | 08 | 564-566 | ||
| S42024A | 08 | 562-563 | S42199G | 08 | 559-561 | S42309P | 08 | 564-566 | ||
| S42024A | 24 | 963-965 | S42199K | 08 | 564-566 | S42309S | 08 | 559-561 | ||
| S42024B | 08 | 562-563 | S42199P | 08 | 564-566 | S42311A | 08 | 562-563 | ||
| S42024B | 24 | 963-965 | S42199S | 08 | 559-561 | S42311A | 24 | 963-965 | ||
| S42024D | 08 | 559-561 | S42201A | 08 | 562-563 | S42311D | 08 | 559-561 | ||
| S42024G | 08 | 559-561 | S42201A | 24 | 963-965 | S42311G | 08 | 559-561 | ||
| S42024K | 08 | 564-566 | S42201B | 08 | 562-563 | S42311K | 08 | 564-566 | ||
| S42024P | 08 | 564-566 | S42201B | 24 | 963-965 | S42311P | 08 | 564-566 | ||
| S42024S | 08 | 559-561 | S42201D | 08 | 559-561 | S42311S | 08 | 559-561 | ||
| S42025A | 08 | 562-563 | S42201G | 08 | 559-561 | S42312A | 08 | 562-563 | ||
| S42025A | 24 | 963-965 | S42201K | 08 | 564-566 | S42312A | 24 | 963-965 | ||
| S42025B | 08 | 562-563 | S42201P | 08 | 564-566 | S42312D | 08 | 559-561 | ||
| S42025B | 24 | 963-965 | S42201S | 08 | 559-561 | S42312G | 08 | 559-561 | ||
| S42025D | 08 | 559-561 | S42202A | 08 | 562-563 | S42312K | 08 | 564-566 | ||
| S42025G | 08 | 559-561 | S42202A | 24 | 963-965 | S42312P | 08 | 564-566 | ||
| S42025K | 08 | 564-566 | S42202B | 08 | 562-563 | S42312S | 08 | 559-561 | ||
| S42025P | 08 | 564-566 | S42202B | 24 | 963-965 | S42319A | 08 | 562-563 | ||
| S42025S | 08 | 559-561 | S42202D | 08 | 559-561 | S42319A | 24 | 963-965 | ||
| S42026A | 08 | 562-563 | S42202G | 08 | 559-561 | S42319D | 08 | 559-561 | ||
| S42026A | 24 | 963-965 | S42202K | 08 | 564-566 | S42319G | 08 | 559-561 | ||
| S42026B | 08 | 562-563 | S42202P | 08 | 564-566 | S42319K | 08 | 564-566 | ||
| S42026B | 24 | 963-965 | S42202S | 08 | 559-561 | S42319P | 08 | 564-566 | ||
| S42026D | 08 | 559-561 | S42209A | 08 | 562-563 | S42319S | 08 | 559-561 | ||
| S42026G | 08 | 559-561 | S42209A | 24 | 963-965 | S42321A | 08 | 562-563 | ||
| S42026K | 08 | 564-566 | S42209B | 08 | 562-563 | S42321A | 24 | 963-965 | ||
| S42026P | 08 | 564-566 | S42209B | 24 | 963-965 | S42321B | 08 | 562-563 | ||
| S42026S | 08 | 559-561 | S42209D | 08 | 559-561 | S42321B | 24 | 963-965 | ||
| S42031A | 08 | 562-563 | S42209G | 08 | 559-561 | S42321D | 08 | 559-561 | ||
| S42031A | 24 | 963-965 | S42209K | 08 | 564-566 | S42321G | 08 | 559-561 | ||
| S42031B | 08 | 562-563 | S42209P | 08 | 564-566 | S42321K | 08 | 564-566 | ||
| S42031B | 24 | 963-965 | S42209S | 08 | 559-561 | S42321P | 08 | 564-566 | ||
| S42031D | 08 | 559-561 | S42211A | 08 | 562-563 | S42321S | 08 | 559-561 | ||
| S42031G | 08 | 559-561 | S42211A | 24 | 963-965 | S42322A | 08 | 562-563 | ||
| S42031K | 08 | 564-566 | S42211B | 08 | 562-563 | S42322A | 24 | 963-965 | ||
| S42031P | 08 | 564-566 | S42211B | 24 | 963-965 | S42322B | 08 | 562-563 | ||
| S42031S | 08 | 559-561 | S42211D | 08 | 559-561 | S42322B | 24 | 963-965 | ||
| S42032A | 08 | 562-563 | S42211G | 08 | 559-561 | S42322D | 08 | 559-561 | ||
| S42032A | 24 | 963-965 | S42211K | 08 | 564-566 | S42322G | 08 | 559-561 | ||
| S42032B | 08 | 562-563 | S42211P | 08 | 564-566 | S42322K | 08 | 564-566 | ||
| S42032B | 24 | 963-965 | S42211S | 08 | 559-561 | S42322P | 08 | 564-566 | ||
| S42032D | 08 | 559-561 | S42212A | 08 | 562-563 | S42322S | 08 | 559-561 | ||
| S42032G | 08 | 559-561 | S42212A | 24 | 963-965 | S42323A | 08 | 562-563 | ||
| S42032K | 08 | 564-566 | S42212B | 08 | 562-563 | S42323A | 24 | 963-965 | ||
| S42032P | 08 | 564-566 | S42212B | 24 | 963-965 | S42323B | 08 | 562-563 | ||
| S42032S | 08 | 559-561 | S42212D | 08 | 559-561 | S42323B | 24 | 963-965 | ||
| S42033A | 08 | 562-563 | S42212G | 08 | 559-561 | S42323D | 08 | 559-561 | ||
| S42033A | 24 | 963-965 | S42212K | 08 | 564-566 | S42323G | 08 | 559-561 | ||
| S42033B | 08 | 562-563 | S42212P | 08 | 564-566 | S42323K | 08 | 564-566 | ||
| S42033B | 24 | 963-965 | S42212S | 08 | 559-561 | S42323P | 08 | 564-566 | ||
| S42033D | 08 | 559-561 | S42213A | 08 | 562-563 | S42323S | 08 | 559-561 | ||
| S42033G | 08 | 559-561 | S42213A | 24 | 963-965 | S42324A | 08 | 562-563 | ||
| S42033K | 08 | 564-566 | S42213B | 08 | 562-563 | S42324A | 24 | 963-965 | ||
| S42033P | 08 | 564-566 | S42213B | 24 | 963-965 | S42324B | 08 | 562-563 | ||
| S42033S | 08 | 559-561 | S42213D | 08 | 559-561 | S42324B | 24 | 963-965 | ||
| S42034A | 08 | 562-563 | S42213G | 08 | 559-561 | S42324D | 08 | 559-561 | ||
| S42034A | 24 | 963-965 | S42213K | 08 | 564-566 | S42324G | 08 | 559-561 | ||
| S42034B | 08 | 562-563 | S42213P | 08 | 564-566 | S42324K | 08 | 564-566 | ||
| S42034B | 24 | 963-965 | S42213S | 08 | 559-561 | S42324P | 08 | 564-566 | ||
| S42034D | 08 | 559-561 | S42214A | 08 | 562-563 | S42324S | 08 | 559-561 | ||
| S42034G | 08 | 559-561 | S42214A | 24 | 963-965 | S42325A | 08 | 562-563 | ||
| S42034K | 08 | 564-566 | S42214B | 08 | 562-563 | S42325A | 24 | 963-965 | ||
| S42034P | 08 | 564-566 | S42214B | 24 | 963-965 | S42325B | 08 | 562-563 | ||
| S42034S | 08 | 559-561 | S42214D | 08 | 559-561 | S42325B | 24 | 963-965 | ||
| S42035A | 08 | 562-563 | S42214G | 08 | 559-561 | S42325D | 08 | 559-561 | ||
| S42035A | 24 | 963-965 | S42214K | 08 | 564-566 | S42325G | 08 | 559-561 | ||
| S42035B | 08 | 562-563 | S42214P | 08 | 564-566 | S42325K | 08 | 564-566 | ||
| S42035B | 24 | 963-965 | S42214S | 08 | 559-561 | S42325P | 08 | 564-566 | ||
| S42035D | 08 | 559-561 | S42215A | 08 | 562-563 | S42325S | 08 | 559-561 | ||
| S42035G | 08 | 559-561 | S42215A | 24 | 963-965 | S42326A | 08 | 562-563 | ||
| S42035K | 08 | 564-566 | S42215B | 08 | 562-563 | S42326A | 24 | 963-965 | ||
| S42035P | 08 | 564-566 | S42215B | 24 | 963-965 | S42326B | 08 | 562-563 | ||
| S42035S | 08 | 559-561 | S42215D | 08 | 559-561 | S42326B | 24 | 963-965 | ||
| S42036A | 08 | 562-563 | S42215G | 08 | 559-561 | S42326D | 08 | 559-561 | ||
| S42036A | 24 | 963-965 | S42215K | 08 | 564-566 | S42326G | 08 | 559-561 | ||
| S42036B | 08 | 562-563 | S42215P | 08 | 564-566 | S42326K | 08 | 564-566 | ||
| S42036B | 24 | 963-965 | S42215S | 08 | 559-561 | S42326P | 08 | 564-566 | ||
| S42036D | 08 | 559-561 | S42216A | 08 | 562-563 | S42326S | 08 | 559-561 | ||
| S42036G | 08 | 559-561 | S42216A | 24 | 963-965 | S42331A | 08 | 562-563 | ||
| S42036K | 08 | 564-566 | S42216B | 08 | 562-563 | S42331A | 24 | 963-965 | ||
| S42036P | 08 | 564-566 | S42216B | 24 | 963-965 | S42331B | 08 | 562-563 | ||
| S42036S | 08 | 559-561 | S42216D | 08 | 559-561 | S42331B | 24 | 963-965 | ||
| S42101A | 08 | 562-563 | S42216G | 08 | 559-561 | S42331D | 08 | 559-561 | ||
| S42101A | 24 | 963-965 | S42216K | 08 | 564-566 | S42331G | 08 | 559-561 | ||
| S42101B | 08 | 562-563 | S42216P | 08 | 564-566 | S42331K | 08 | 564-566 | ||
| S42101B | 24 | 963-965 | S42216S | 08 | 559-561 | S42331P | 08 | 564-566 | ||
| S42101D | 08 | 559-561 | S42221A | 08 | 562-563 | S42331S | 08 | 559-561 | ||
| S42101G | 08 | 559-561 | S42221A | 24 | 963-965 | S42332A | 08 | 562-563 | ||
| S42101K | 08 | 564-566 | S42221B | 08 | 562-563 | S42332A | 24 | 963-965 | ||
| S42101P | 08 | 564-566 | S42221B | 24 | 963-965 | S42332B | 08 | 562-563 | ||
| S42101S | 08 | 559-561 | S42221D | 08 | 559-561 | S42332B | 24 | 963-965 | ||
| S42102A | 08 | 562-563 | S42221G | 08 | 559-561 | S42332D | 08 | 559-561 | ||
| S42102A | 24 | 963-965 | S42221K | 08 | 564-566 | S42332G | 08 | 559-561 | ||
| S42102B | 08 | 562-563 | S42221P | 08 | 564-566 | S42332K | 08 | 564-566 | ||
| S42102B | 24 | 963-965 | S42221S | 08 | 559-561 | S42332P | 08 | 564-566 | ||
| S42102D | 08 | 559-561 | S42222A | 08 | 562-563 | S42332S | 08 | 559-561 | ||
| S42102G | 08 | 559-561 | S42222A | 24 | 963-965 | S42333A | 08 | 562-563 | ||
| S42102K | 08 | 564-566 | S42222B | 08 | 562-563 | S42333A | 24 | 963-965 | ||
| S42102P | 08 | 564-566 | S42222B | 24 | 963-965 | S42333B | 08 | 562-563 | ||
| S42102S | 08 | 559-561 | S42222D | 08 | 559-561 | S42333B | 24 | 963-965 | ||
| S42109A | 08 | 562-563 | S42222G | 08 | 559-561 | S42333D | 08 | 559-561 | ||
| S42109A | 24 | 963-965 | S42222K | 08 | 564-566 | S42333G | 08 | 559-561 | ||
| S42109B | 08 | 562-563 | S42222P | 08 | 564-566 | S42333K | 08 | 564-566 | ||
| S42109B | 24 | 963-965 | S42222S | 08 | 559-561 | S42333P | 08 | 564-566 | ||
| S42109D | 08 | 559-561 | S42223A | 08 | 562-563 | S42333S | 08 | 559-561 | ||
| S42109G | 08 | 559-561 | S42223A | 24 | 963-965 | S42334A | 08 | 562-563 | ||
| S42109K | 08 | 564-566 | S42223B | 08 | 562-563 | S42334A | 24 | 963-965 | ||
| S42109P | 08 | 564-566 | S42223B | 24 | 963-965 | S42334B | 08 | 562-563 | ||
| S42109S | 08 | 559-561 | S42223D | 08 | 559-561 | S42334B | 24 | 963-965 | ||
| S42111A | 08 | 564-566 | S42223G | 08 | 559-561 | S42334D | 08 | 559-561 | ||
| S42111A | 24 | 963-965 | S42223K | 08 | 564-566 | S42334G | 08 | 559-561 | ||
| S42111B | 08 | 564-566 | S42223P | 08 | 564-566 | S42334K | 08 | 564-566 | ||
| S42111B | 24 | 963-965 | S42223S | 08 | 559-561 | S42334P | 08 | 564-566 | ||
| S42111D | 08 | 559-561 | S42224A | 08 | 562-563 | S42334S | 08 | 559-561 | ||
| S42111G | 08 | 559-561 | S42224A | 24 | 963-965 | S42335A | 08 | 562-563 | ||
| S42111K | 08 | 564-566 | S42224B | 08 | 562-563 | S42335A | 24 | 963-965 | ||
| S42111P | 08 | 564-566 | S42224B | 24 | 963-965 | S42335B | 08 | 562-563 | ||
| S42111S | 08 | 559-561 | S42224D | 08 | 559-561 | S42335B | 24 | 963-965 | ||
| S42112A | 08 | 564-566 | S42224G | 08 | 559-561 | S42335D | 08 | 559-561 | ||
| S42112A | 24 | 963-965 | S42224K | 08 | 564-566 | S42335G | 08 | 559-561 | ||
| S42112B | 08 | 564-566 | S42224P | 08 | 564-566 | S42335K | 08 | 564-566 | ||
| S42112B | 24 | 963-965 | S42224S | 08 | 559-561 | S42335P | 08 | 564-566 | ||
| S42112D | 08 | 559-561 | S42225A | 08 | 562-563 | S42335S | 08 | 559-561 | ||
| S42112G | 08 | 559-561 | S42225A | 24 | 963-965 | S42336A | 08 | 562-563 | ||
| S42112K | 08 | 564-566 | S42225B | 08 | 562-563 | S42336A | 24 | 963-965 | ||
| S42112P | 08 | 564-566 | S42225B | 24 | 963-965 | S42336B | 08 | 562-563 | ||
| S42112S | 08 | 559-561 | S42225D | 08 | 559-561 | S42336B | 24 | 963-965 | ||
| S42113A | 08 | 564-566 | S42225G | 08 | 559-561 | S42336D | 08 | 559-561 | ||
| S42113A | 24 | 963-965 | S42225K | 08 | 564-566 | S42336G | 08 | 559-561 | ||
| S42113B | 08 | 564-566 | S42225P | 08 | 564-566 | S42336K | 08 | 564-566 | ||
| S42113B | 24 | 963-965 | S42225S | 08 | 559-561 | S42336P | 08 | 564-566 | ||
| S42113D | 08 | 559-561 | S42226A | 08 | 562-563 | S42336S | 08 | 559-561 | ||
| S42113G | 08 | 559-561 | S42226A | 24 | 963-965 | S42341A | 08 | 562-563 | ||
| S42113K | 08 | 564-566 | S42226B | 08 | 562-563 | S42341A | 24 | 963-965 | ||
| S42113P | 08 | 564-566 | S42226B | 24 | 963-965 | S42341B | 08 | 562-563 | ||
| S42113S | 08 | 559-561 | S42226D | 08 | 559-561 | S42341B | 24 | 963-965 | ||
| S42114A | 08 | 564-566 | S42226G | 08 | 559-561 | S42341D | 08 | 559-561 | ||
| S42114A | 24 | 963-965 | S42226K | 08 | 564-566 | S42341G | 08 | 559-561 | ||
| S42114B | 08 | 564-566 | S42226P | 08 | 564-566 | S42341K | 08 | 564-566 | ||
| S42114B | 24 | 963-965 | S42226S | 08 | 559-561 | S42341P | 08 | 564-566 | ||
| S42114D | 08 | 559-561 | S42231A | 08 | 562-563 | S42341S | 08 | 559-561 | ||
| S42114G | 08 | 559-561 | S42231A | 24 | 963-965 | S42342A | 08 | 562-563 | ||
| S42114K | 08 | 564-566 | S42231B | 08 | 562-563 | S42342A | 24 | 963-965 | ||
| S42114P | 08 | 564-566 | S42231B | 24 | 963-965 | S42342B | 08 | 562-563 | ||
| S42114S | 08 | 559-561 | S42231D | 08 | 559-561 | S42342B | 24 | 963-965 | ||
| S42115A | 08 | 564-566 | S42231G | 08 | 559-561 | S42342D | 08 | 559-561 | ||
| S42115A | 24 | 963-965 | S42231K | 08 | 564-566 | S42342G | 08 | 559-561 | ||
| S42115B | 08 | 564-566 | S42231P | 08 | 564-566 | S42342K | 08 | 564-566 | ||
| S42115B | 24 | 963-965 | S42231S | 08 | 559-561 | S42342P | 08 | 564-566 | ||
| S42115D | 08 | 559-561 | S42232A | 08 | 562-563 | S42342S | 08 | 559-561 | ||
| S42115G | 08 | 559-561 | S42232A | 24 | 963-965 | S42343A | 08 | 562-563 | ||
| S42115K | 08 | 564-566 | S42232B | 08 | 562-563 | S42343A | 24 | 963-965 | ||
| S42115P | 08 | 564-566 | S42232B | 24 | 963-965 | S42343B | 08 | 562-563 | ||
| S42115S | 08 | 559-561 | S42232D | 08 | 559-561 | S42343B | 24 | 963-965 | ||
| S42116A | 08 | 564-566 | S42232G | 08 | 559-561 | S42343D | 08 | 559-561 | ||
| S42116A | 24 | 963-965 | S42232K | 08 | 564-566 | S42343G | 08 | 559-561 | ||
| S42116B | 08 | 564-566 | S42232P | 08 | 564-566 | S42343K | 08 | 564-566 | ||
| S42116B | 24 | 963-965 | S42232S | 08 | 559-561 | S42343P | 08 | 564-566 | ||
| S42116D | 08 | 559-561 | S42239A | 08 | 562-563 | S42343S | 08 | 559-561 | ||
| S42116G | 08 | 559-561 | S42239A | 24 | 963-965 | S42344A | 08 | 562-563 | ||
| S42116K | 08 | 564-566 | S42239B | 08 | 562-563 | S42344A | 24 | 963-965 | ||
| S42116P | 08 | 564-566 | S42239B | 24 | 963-965 | S42344B | 08 | 562-563 | ||
| S42116S | 08 | 559-561 | S42239D | 08 | 559-561 | S42344B | 24 | 963-965 | ||
| S42121A | 08 | 562-563 | S42239G | 08 | 559-561 | S42344D | 08 | 559-561 | ||
| S42121A | 24 | 963-965 | S42239K | 08 | 564-566 | S42344G | 08 | 559-561 | ||
| S42121B | 08 | 562-563 | S42239P | 08 | 564-566 | S42344K | 08 | 564-566 | ||
| S42121B | 24 | 963-965 | S42239S | 08 | 559-561 | S42344P | 08 | 564-566 | ||
| S42121D | 08 | 559-561 | S42241A | 08 | 562-563 | S42344S | 08 | 559-561 | ||
| S42121G | 08 | 559-561 | S42241A | 24 | 963-965 | S42345A | 08 | 562-563 | ||
| S42121K | 08 | 564-566 | S42241B | 08 | 562-563 | S42345A | 24 | 963-965 | ||
| S42121P | 08 | 564-566 | S42241B | 24 | 963-965 | S42345B | 08 | 562-563 | ||
| S42121S | 08 | 559-561 | S42241D | 08 | 559-561 | S42345B | 24 | 963-965 | ||
| S42122A | 08 | 562-563 | S42241G | 08 | 559-561 | S42345D | 08 | 559-561 | ||
| S42122A | 24 | 963-965 | S42241K | 08 | 564-566 | S42345G | 08 | 559-561 | ||
| S42122B | 08 | 562-563 | S42241P | 08 | 564-566 | S42345K | 08 | 564-566 | ||
| S42122B | 24 | 963-965 | S42241S | 08 | 559-561 | S42345P | 08 | 564-566 | ||
| S42122D | 08 | 559-561 | S42242A | 08 | 562-563 | S42345S | 08 | 559-561 | ||
| S42122G | 08 | 559-561 | S42242A | 24 | 963-965 | S42346A | 08 | 562-563 | ||
| S42122K | 08 | 564-566 | S42242B | 08 | 562-563 | S42346A | 24 | 963-965 | ||
| S42122P | 08 | 564-566 | S42242B | 24 | 963-965 | S42346B | 08 | 562-563 | ||
| S42122S | 08 | 559-561 | S42242D | 08 | 559-561 | S42346B | 24 | 963-965 | ||
| S42123A | 08 | 562-563 | S42242G | 08 | 559-561 | S42346D | 08 | 559-561 | ||
| S42123A | 24 | 963-965 | S42242K | 08 | 564-566 | S42346G | 08 | 559-561 | ||
| S42123B | 08 | 562-563 | S42242P | 08 | 564-566 | S42346K | 08 | 564-566 | ||
| S42123B | 24 | 963-965 | S42242S | 08 | 559-561 | S42346P | 08 | 564-566 | ||
| S42123D | 08 | 559-561 | S42249A | 08 | 562-563 | S42346S | 08 | 559-561 | ||
| S42123G | 08 | 559-561 | S42249A | 24 | 963-965 | S42351A | 08 | 562-563 | ||
| S42123K | 08 | 564-566 | S42249B | 08 | 562-563 | S42351A | 24 | 963-965 | ||
| S42123P | 08 | 564-566 | S42249B | 24 | 963-965 | S42351B | 08 | 562-563 | ||
| S42123S | 08 | 559-561 | S42249D | 08 | 559-561 | S42351B | 24 | 963-965 | ||
| S42124A | 08 | 562-563 | S42249G | 08 | 559-561 | S42351D | 08 | 559-561 | ||
| S42124A | 24 | 963-965 | S42249K | 08 | 564-566 | S42351G | 08 | 559-561 | ||
| S42124B | 08 | 562-563 | S42249P | 08 | 564-566 | S42351K | 08 | 564-566 | ||
| S42124B | 24 | 963-965 | S42249S | 08 | 559-561 | S42351P | 08 | 564-566 | ||
| S42124D | 08 | 559-561 | S42251A | 08 | 562-563 | S42351S | 08 | 559-561 | ||
| S42124G | 08 | 559-561 | S42251A | 24 | 963-965 | S42352A | 08 | 562-563 | ||
| S42124K | 08 | 564-566 | S42251B | 08 | 562-563 | S42352A | 24 | 963-965 | ||
| S42124P | 08 | 564-566 | S42251B | 24 | 963-965 | S42352B | 08 | 562-563 | ||
| S42124S | 08 | 559-561 | S42251D | 08 | 559-561 | S42352B | 24 | 963-965 | ||
| S42125A | 08 | 562-563 | S42251G | 08 | 559-561 | S42352D | 08 | 559-561 | ||
| S42125A | 24 | 963-965 | S42251K | 08 | 564-566 | S42352G | 08 | 559-561 | ||
| S42125B | 08 | 562-563 | S42251P | 08 | 564-566 | S42352K | 08 | 564-566 | ||
| S42125B | 24 | 963-965 | S42251S | 08 | 559-561 | S42352P | 08 | 564-566 | ||
| S42125D | 08 | 559-561 | S42252A | 08 | 562-563 | S42352S | 08 | 559-561 | ||
| S42125G | 08 | 559-561 | S42252A | 24 | 963-965 | S42353A | 08 | 562-563 | ||
| S42125K | 08 | 564-566 | S42252B | 08 | 562-563 | S42353A | 24 | 963-965 | ||
| S42125P | 08 | 564-566 | S42252B | 24 | 963-965 | S42353B | 08 | 562-563 | ||
| S42125S | 08 | 559-561 | S42252D | 08 | 559-561 | S42353B | 24 | 963-965 | ||
| S42126A | 08 | 562-563 | S42252G | 08 | 559-561 | S42353D | 08 | 559-561 | ||
| S42126A | 24 | 963-965 | S42252K | 08 | 564-566 | S42353G | 08 | 559-561 | ||
| S42126B | 08 | 562-563 | S42252P | 08 | 564-566 | S42353K | 08 | 564-566 | ||
| S42126B | 24 | 963-965 | S42252S | 08 | 559-561 | S42353P | 08 | 564-566 | ||
| S42126D | 08 | 559-561 | S42253A | 08 | 562-563 | S42353S | 08 | 559-561 | ||
| S42126G | 08 | 559-561 | S42253A | 24 | 963-965 | S42354A | 08 | 562-563 | ||
| S42126K | 08 | 564-566 | S42253B | 08 | 562-563 | S42354A | 24 | 963-965 | ||
| S42126P | 08 | 564-566 | S42253B | 24 | 963-965 | S42354B | 08 | 562-563 | ||
| S42126S | 08 | 559-561 | S42253D | 08 | 559-561 | S42354B | 24 | 963-965 | ||
| S42131A | 08 | 562-563 | S42253G | 08 | 559-561 | S42354D | 08 | 559-561 | ||
| S42131A | 24 | 963-965 | S42253K | 08 | 564-566 | S42354G | 08 | 559-561 | ||
| S42131B | 08 | 562-563 | S42253P | 08 | 564-566 | S42354K | 08 | 564-566 | ||
| S42131B | 24 | 963-965 | S42253S | 08 | 559-561 | S42354P | 08 | 564-566 | ||
| S42131D | 08 | 559-561 | S42254A | 08 | 562-563 | S42354S | 08 | 559-561 | ||
| S42131G | 08 | 559-561 | S42254A | 24 | 963-965 | S42355A | 08 | 562-563 | ||
| S42131K | 08 | 564-566 | S42254B | 08 | 562-563 | S42355A | 24 | 963-965 | ||
| S42131P | 08 | 564-566 | S42254B | 24 | 963-965 | S42355B | 08 | 562-563 | ||
| S42131S | 08 | 559-561 | S42254D | 08 | 559-561 | S42355B | 24 | 963-965 | ||
| S42132A | 08 | 562-563 | S42254G | 08 | 559-561 | S42355D | 08 | 559-561 | ||
| S42132A | 24 | 963-965 | S42254K | 08 | 564-566 | S42355G | 08 | 559-561 | ||
| S42132B | 08 | 562-563 | S42254P | 08 | 564-566 | S42355K | 08 | 564-566 | ||
| S42132B | 24 | 963-965 | S42254S | 08 | 559-561 | S42355P | 08 | 564-566 | ||
| S42132D | 08 | 559-561 | S42255A | 08 | 562-563 | S42355S | 08 | 559-561 | ||
| S42132G | 08 | 559-561 | S42255A | 24 | 963-965 | S42356A | 08 | 562-563 | ||
| S42132K | 08 | 564-566 | S42255B | 08 | 562-563 | S42356A | 24 | 963-965 | ||
| S42132P | 08 | 564-566 | S42255B | 24 | 963-965 | S42356B | 08 | 562-563 | ||
| S42132S | 08 | 559-561 | S42255D | 08 | 559-561 | S42356B | 24 | 963-965 | ||
| S42133A | 08 | 562-563 | S42255G | 08 | 559-561 | S42356D | 08 | 559-561 | ||
| S42133A | 24 | 963-965 | S42255K | 08 | 564-566 | S42356G | 08 | 559-561 | ||
| S42133B | 08 | 562-563 | S42255P | 08 | 564-566 | S42356K | 08 | 564-566 | ||
| S42133B | 24 | 963-965 | S42255S | 08 | 559-561 | S42356P | 08 | 564-566 | ||
| S42133D | 08 | 559-561 | S42256A | 08 | 562-563 | S42356S | 08 | 559-561 | ||
| S42133G | 08 | 559-561 | S42256A | 24 | 963-965 | S42361A | 08 | 562-563 | ||
| S42133K | 08 | 564-566 | S42256B | 08 | 562-563 | S42361A | 24 | 963-965 | ||
| S42133P | 08 | 564-566 | S42256B | 24 | 963-965 | S42361B | 08 | 562-563 | ||
| S42133S | 08 | 559-561 | S42256D | 08 | 559-561 | S42361B | 24 | 963-965 | ||
| S42134A | 08 | 562-563 | S42256G | 08 | 559-561 | S42361D | 08 | 559-561 | ||
| S42134A | 24 | 963-965 | S42256K | 08 | 564-566 | S42361G | 08 | 559-561 | ||
| S42134B | 08 | 562-563 | S42256P | 08 | 564-566 | S42361K | 08 | 564-566 | ||
| S42134B | 24 | 963-965 | S42256S | 08 | 559-561 | S42361P | 08 | 564-566 | ||
| S42134D | 08 | 559-561 | S42261A | 08 | 562-563 | S42361S | 08 | 559-561 | ||
| S42134G | 08 | 559-561 | S42261A | 24 | 963-965 | S42362A | 08 | 562-563 | ||
| S42134K | 08 | 564-566 | S42261B | 08 | 562-563 | S42362A | 24 | 963-965 | ||
| S42134P | 08 | 564-566 | S42261B | 24 | 963-965 | S42362B | 08 | 562-563 | ||
| S42134S | 08 | 559-561 | S42261D | 08 | 559-561 | S42362B | 24 | 963-965 | ||
| S42135A | 08 | 562-563 | S42261G | 08 | 559-561 | S42362D | 08 | 559-561 | ||
| S42135A | 24 | 963-965 | S42261K | 08 | 564-566 | S42362G | 08 | 559-561 | ||
| S42135B | 08 | 562-563 | S42261P | 08 | 564-566 | S42362K | 08 | 564-566 | ||
| S42135B | 24 | 963-965 | S42261S | 08 | 559-561 | S42362P | 08 | 564-566 | ||
| S42135D | 08 | 559-561 | S42262A | 08 | 562-563 | S42362S | 08 | 559-561 | ||
| S42135G | 08 | 559-561 | S42262A | 24 | 963-965 | S42363A | 08 | 562-563 | ||
| S42135K | 08 | 564-566 | S42262B | 08 | 562-563 | S42363A | 24 | 963-965 | ||
| S42135P | 08 | 564-566 | S42262B | 24 | 963-965 | S42363B | 08 | 562-563 | ||
| S42135S | 08 | 559-561 | S42262D | 08 | 559-561 | S42363B | 24 | 963-965 | ||
| S42136A | 08 | 562-563 | S42262G | 08 | 559-561 | S42363D | 08 | 559-561 | ||
| S42136A | 24 | 963-965 | S42262K | 08 | 564-566 | S42363G | 08 | 559-561 | ||
| S42136B | 08 | 562-563 | S42262P | 08 | 564-566 | S42363K | 08 | 564-566 | ||
| S42136B | 24 | 963-965 | S42262S | 08 | 559-561 | S42363P | 08 | 564-566 | ||
| S42136D | 08 | 559-561 | S42263A | 08 | 562-563 | S42363S | 08 | 559-561 | ||
| S42136G | 08 | 559-561 | S42263A | 24 | 963-965 | S42364A | 08 | 562-563 | ||
| S42136K | 08 | 564-566 | S42263B | 08 | 562-563 | S42364A | 24 | 963-965 | ||
| S42136P | 08 | 564-566 | S42263B | 24 | 963-965 | S42364B | 08 | 562-563 | ||
| S42136S | 08 | 559-561 | S42263D | 08 | 559-561 | S42364B | 24 | 963-965 | ||
| S42141A | 08 | 562-563 | S42263G | 08 | 559-561 | S42364D | 08 | 559-561 | ||
| S42141A | 24 | 963-965 | S42263K | 08 | 564-566 | S42364G | 08 | 559-561 | ||
| S42141B | 08 | 562-563 | S42263P | 08 | 564-566 | S42364K | 08 | 564-566 | ||
| S42141B | 24 | 963-965 | S42263S | 08 | 559-561 | S42364P | 08 | 564-566 | ||
| S42141D | 08 | 559-561 | S42264A | 08 | 562-563 | S42364S | 08 | 559-561 | ||
| S42141G | 08 | 559-561 | S42264A | 24 | 963-965 | S42365A | 08 | 562-563 | ||
| S42141K | 08 | 564-566 | S42264B | 08 | 562-563 | S42365A | 24 | 963-965 | ||
| S42141P | 08 | 564-566 | S42264B | 24 | 963-965 | S42365B | 08 | 562-563 | ||
| S42141S | 08 | 559-561 | S42264D | 08 | 559-561 | S42365B | 24 | 963-965 | ||
| S42142A | 08 | 562-563 | S42264G | 08 | 559-561 | S42365D | 08 | 559-561 | ||
| S42142A | 24 | 963-965 | S42264K | 08 | 564-566 | S42365G | 08 | 559-561 | ||
| S42142B | 08 | 562-563 | S42264P | 08 | 564-566 | S42365K | 08 | 564-566 | ||
| S42142B | 24 | 963-965 | S42264S | 08 | 559-561 | S42365P | 08 | 564-566 | ||
| S42142D | 08 | 559-561 | S42265A | 08 | 562-563 | S42365S | 08 | 559-561 | ||
| S42142G | 08 | 559-561 | S42265A | 24 | 963-965 | S42366A | 08 | 562-563 | ||
| S42142K | 08 | 564-566 | S42265B | 08 | 562-563 | S42366A | 24 | 963-965 | ||
| S42142P | 08 | 564-566 | S42265B | 24 | 963-965 | S42366B | 08 | 562-563 | ||
| S42142S | 08 | 559-561 | S42265D | 08 | 559-561 | S42366B | 24 | 963-965 | ||
| S42143A | 08 | 562-563 | S42265G | 08 | 559-561 | S42366D | 08 | 559-561 | ||
| S42143A | 24 | 963-965 | S42265K | 08 | 564-566 | S42366G | 08 | 559-561 | ||
| S42143B | 08 | 562-563 | S42265P | 08 | 564-566 | S42366K | 08 | 564-566 | ||
| S42143B | 24 | 963-965 | S42265S | 08 | 559-561 | S42366P | 08 | 564-566 | ||
| S42143D | 08 | 559-561 | S42266A | 08 | 562-563 | S42366S | 08 | 559-561 | ||
| S42143G | 08 | 559-561 | S42266A | 24 | 963-965 | S42391A | 08 | 562-563 | ||
| S42143K | 08 | 564-566 | S42266B | 08 | 562-563 | S42391A | 24 | 963-965 | ||
| S42143P | 08 | 564-566 | S42266B | 24 | 963-965 | S42391B | 08 | 562-563 | ||
| S42143S | 08 | 559-561 | S42266D | 08 | 559-561 | S42391B | 24 | 963-965 | ||
| S42144A | 08 | 562-563 | S42266G | 08 | 559-561 | S42391D | 08 | 559-561 | ||
| S42144A | 24 | 963-965 | S42266K | 08 | 564-566 | S42391G | 08 | 559-561 | ||
| S42144B | 08 | 562-563 | S42266P | 08 | 564-566 | S42391K | 08 | 564-566 | ||
| S42144B | 24 | 963-965 | S42266S | 08 | 559-561 | S42391P | 08 | 564-566 | ||
| S42144D | 08 | 559-561 | S42271A | 08 | 562-563 | S42391S | 08 | 559-561 | ||
| S42144G | 08 | 559-561 | S42271A | 24 | 963-965 | S42392A | 08 | 562-563 | ||
| S42144K | 08 | 564-566 | S42271D | 08 | 559-561 | S42392A | 24 | 963-965 | ||
| S42144P | 08 | 564-566 | S42271G | 08 | 559-561 | S42392B | 08 | 562-563 | ||
| S42144S | 08 | 559-561 | S42271K | 08 | 564-566 | S42392B | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 08 Mar 2021 20:13:49 CMS, code-revision=301, description-revision=1298 |