ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual
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ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 46 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 Z887 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S61310S | 09 | 604-605 | S62014K | 08 | 564-566 | S62154B | 08 | 562-563 | ||
| S61311A | 09 | 604-605 | S62014P | 08 | 564-566 | S62154B | 24 | 963-965 | ||
| S61311A | 24 | 963-965 | S62014S | 08 | 559-561 | S62154D | 08 | 559-561 | ||
| S61311D | 23 | 949-950 | S62015A | 08 | 562-563 | S62154G | 08 | 559-561 | ||
| S61311S | 09 | 604-605 | S62015A | 24 | 963-965 | S62154K | 08 | 564-566 | ||
| S61312A | 09 | 604-605 | S62015B | 08 | 562-563 | S62154P | 08 | 564-566 | ||
| S61312A | 24 | 963-965 | S62015B | 24 | 963-965 | S62154S | 08 | 559-561 | ||
| S61312D | 23 | 949-950 | S62015D | 08 | 559-561 | S62155A | 08 | 562-563 | ||
| S61312S | 09 | 604-605 | S62015G | 08 | 559-561 | S62155A | 24 | 963-965 | ||
| S61313A | 09 | 604-605 | S62015K | 08 | 564-566 | S62155B | 08 | 562-563 | ||
| S61313A | 24 | 963-965 | S62015P | 08 | 564-566 | S62155B | 24 | 963-965 | ||
| S61313D | 23 | 949-950 | S62015S | 08 | 559-561 | S62155D | 08 | 559-561 | ||
| S61313S | 09 | 604-605 | S62016A | 08 | 562-563 | S62155G | 08 | 559-561 | ||
| S61314A | 09 | 604-605 | S62016A | 24 | 963-965 | S62155K | 08 | 564-566 | ||
| S61314A | 24 | 963-965 | S62016B | 08 | 562-563 | S62155P | 08 | 564-566 | ||
| S61314D | 23 | 949-950 | S62016B | 24 | 963-965 | S62155S | 08 | 559-561 | ||
| S61314S | 09 | 604-605 | S62016D | 08 | 559-561 | S62156A | 08 | 562-563 | ||
| S61315A | 09 | 604-605 | S62016G | 08 | 559-561 | S62156A | 24 | 963-965 | ||
| S61315A | 24 | 963-965 | S62016K | 08 | 564-566 | S62156B | 08 | 562-563 | ||
| S61315D | 23 | 949-950 | S62016P | 08 | 564-566 | S62156B | 24 | 963-965 | ||
| S61315S | 09 | 604-605 | S62016S | 08 | 559-561 | S62156D | 08 | 559-561 | ||
| S61316A | 09 | 604-605 | S62021A | 08 | 562-563 | S62156G | 08 | 559-561 | ||
| S61316A | 24 | 963-965 | S62021A | 24 | 963-965 | S62156K | 08 | 564-566 | ||
| S61316D | 23 | 949-950 | S62021B | 08 | 562-563 | S62156P | 08 | 564-566 | ||
| S61316S | 09 | 604-605 | S62021B | 24 | 963-965 | S62156S | 08 | 559-561 | ||
| S61317A | 09 | 604-605 | S62021D | 08 | 559-561 | S62161A | 08 | 562-563 | ||
| S61317A | 24 | 963-965 | S62021G | 08 | 559-561 | S62161A | 24 | 963-965 | ||
| S61317D | 23 | 949-950 | S62021K | 08 | 564-566 | S62161B | 08 | 562-563 | ||
| S61317S | 09 | 604-605 | S62021P | 08 | 564-566 | S62161B | 24 | 963-965 | ||
| S61318A | 09 | 604-605 | S62021S | 08 | 559-561 | S62161D | 08 | 559-561 | ||
| S61318A | 24 | 963-965 | S62022A | 08 | 562-563 | S62161G | 08 | 559-561 | ||
| S61318D | 23 | 949-950 | S62022A | 24 | 963-965 | S62161K | 08 | 564-566 | ||
| S61318S | 09 | 604-605 | S62022B | 08 | 562-563 | S62161P | 08 | 564-566 | ||
| S61319A | 09 | 604-605 | S62022B | 24 | 963-965 | S62161S | 08 | 559-561 | ||
| S61319A | 24 | 963-965 | S62022D | 08 | 559-561 | S62162A | 08 | 562-563 | ||
| S61319D | 23 | 949-950 | S62022G | 08 | 559-561 | S62162A | 24 | 963-965 | ||
| S61319S | 09 | 604-605 | S62022K | 08 | 564-566 | S62162B | 08 | 562-563 | ||
| S61320A | 21 | 913-914 | S62022P | 08 | 564-566 | S62162B | 24 | 963-965 | ||
| S61320A | 24 | 963-965 | S62022S | 08 | 559-561 | S62162D | 08 | 559-561 | ||
| S61320D | 23 | 949-950 | S62023A | 08 | 562-563 | S62162G | 08 | 559-561 | ||
| S61320S | 09 | 604-605 | S62023A | 24 | 963-965 | S62162K | 08 | 564-566 | ||
| S61321A | 21 | 913-914 | S62023B | 08 | 562-563 | S62162P | 08 | 564-566 | ||
| S61321A | 24 | 963-965 | S62023B | 24 | 963-965 | S62162S | 08 | 559-561 | ||
| S61321D | 23 | 949-950 | S62023D | 08 | 559-561 | S62163A | 08 | 562-563 | ||
| S61321S | 09 | 604-605 | S62023G | 08 | 559-561 | S62163A | 24 | 963-965 | ||
| S61322A | 21 | 913-914 | S62023K | 08 | 564-566 | S62163B | 08 | 562-563 | ||
| S61322A | 24 | 963-965 | S62023P | 08 | 564-566 | S62163B | 24 | 963-965 | ||
| S61322D | 23 | 949-950 | S62023S | 08 | 559-561 | S62163D | 08 | 559-561 | ||
| S61322S | 09 | 604-605 | S62024A | 08 | 562-563 | S62163G | 08 | 559-561 | ||
| S61323A | 21 | 913-914 | S62024A | 24 | 963-965 | S62163K | 08 | 564-566 | ||
| S61323A | 24 | 963-965 | S62024B | 08 | 562-563 | S62163P | 08 | 564-566 | ||
| S61323D | 23 | 949-950 | S62024B | 24 | 963-965 | S62163S | 08 | 559-561 | ||
| S61323S | 09 | 604-605 | S62024D | 08 | 559-561 | S62164A | 08 | 562-563 | ||
| S61324A | 21 | 913-914 | S62024G | 08 | 559-561 | S62164A | 24 | 963-965 | ||
| S61324A | 24 | 963-965 | S62024K | 08 | 564-566 | S62164B | 08 | 562-563 | ||
| S61324D | 23 | 949-950 | S62024P | 08 | 564-566 | S62164B | 24 | 963-965 | ||
| S61324S | 09 | 604-605 | S62024S | 08 | 559-561 | S62164D | 08 | 559-561 | ||
| S61325A | 21 | 913-914 | S62025A | 08 | 562-563 | S62164G | 08 | 559-561 | ||
| S61325A | 24 | 963-965 | S62025A | 24 | 963-965 | S62164K | 08 | 564-566 | ||
| S61325D | 23 | 949-950 | S62025B | 08 | 562-563 | S62164P | 08 | 564-566 | ||
| S61325S | 09 | 604-605 | S62025B | 24 | 963-965 | S62164S | 08 | 559-561 | ||
| S61326A | 21 | 913-914 | S62025D | 08 | 559-561 | S62165A | 08 | 562-563 | ||
| S61326A | 24 | 963-965 | S62025G | 08 | 559-561 | S62165A | 24 | 963-965 | ||
| S61326D | 23 | 949-950 | S62025K | 08 | 564-566 | S62165B | 08 | 562-563 | ||
| S61326S | 09 | 604-605 | S62025P | 08 | 564-566 | S62165B | 24 | 963-965 | ||
| S61327A | 21 | 913-914 | S62025S | 08 | 559-561 | S62165D | 08 | 559-561 | ||
| S61327A | 24 | 963-965 | S62026A | 08 | 562-563 | S62165G | 08 | 559-561 | ||
| S61327D | 23 | 949-950 | S62026A | 24 | 963-965 | S62165K | 08 | 564-566 | ||
| S61327S | 09 | 604-605 | S62026B | 08 | 562-563 | S62165P | 08 | 564-566 | ||
| S61328A | 21 | 913-914 | S62026B | 24 | 963-965 | S62165S | 08 | 559-561 | ||
| S61328A | 24 | 963-965 | S62026D | 08 | 559-561 | S62166A | 08 | 562-563 | ||
| S61328D | 23 | 949-950 | S62026G | 08 | 559-561 | S62166A | 24 | 963-965 | ||
| S61328S | 09 | 604-605 | S62026K | 08 | 564-566 | S62166B | 08 | 562-563 | ||
| S61329A | 21 | 913-914 | S62026P | 08 | 564-566 | S62166B | 24 | 963-965 | ||
| S61329A | 24 | 963-965 | S62026S | 08 | 559-561 | S62166D | 08 | 559-561 | ||
| S61329D | 23 | 949-950 | S62031A | 08 | 562-563 | S62166G | 08 | 559-561 | ||
| S61329S | 09 | 604-605 | S62031A | 24 | 963-965 | S62166K | 08 | 564-566 | ||
| S61330A | 09 | 604-605 | S62031B | 08 | 562-563 | S62166P | 08 | 564-566 | ||
| S61330A | 24 | 963-965 | S62031B | 24 | 963-965 | S62166S | 08 | 559-561 | ||
| S61330D | 23 | 949-950 | S62031D | 08 | 559-561 | S62171A | 08 | 562-563 | ||
| S61330S | 09 | 604-605 | S62031G | 08 | 559-561 | S62171A | 24 | 963-965 | ||
| S61331A | 09 | 604-605 | S62031K | 08 | 564-566 | S62171B | 08 | 562-563 | ||
| S61331A | 24 | 963-965 | S62031P | 08 | 564-566 | S62171B | 24 | 963-965 | ||
| S61331D | 23 | 949-950 | S62031S | 08 | 559-561 | S62171D | 08 | 559-561 | ||
| S61331S | 09 | 604-605 | S62032A | 08 | 562-563 | S62171G | 08 | 559-561 | ||
| S61332A | 09 | 604-605 | S62032A | 24 | 963-965 | S62171K | 08 | 564-566 | ||
| S61332A | 24 | 963-965 | S62032B | 08 | 562-563 | S62171P | 08 | 564-566 | ||
| S61332D | 23 | 949-950 | S62032B | 24 | 963-965 | S62171S | 08 | 559-561 | ||
| S61332S | 09 | 604-605 | S62032D | 08 | 559-561 | S62172A | 08 | 562-563 | ||
| S61333A | 09 | 604-605 | S62032G | 08 | 559-561 | S62172A | 24 | 963-965 | ||
| S61333A | 24 | 963-965 | S62032K | 08 | 564-566 | S62172B | 08 | 562-563 | ||
| S61333D | 23 | 949-950 | S62032P | 08 | 564-566 | S62172B | 24 | 963-965 | ||
| S61333S | 09 | 604-605 | S62032S | 08 | 559-561 | S62172D | 08 | 559-561 | ||
| S61334A | 09 | 604-605 | S62033A | 08 | 562-563 | S62172G | 08 | 559-561 | ||
| S61334A | 24 | 963-965 | S62033A | 24 | 963-965 | S62172K | 08 | 564-566 | ||
| S61334D | 23 | 949-950 | S62033B | 08 | 562-563 | S62172P | 08 | 564-566 | ||
| S61334S | 09 | 604-605 | S62033B | 24 | 963-965 | S62172S | 08 | 559-561 | ||
| S61335A | 09 | 604-605 | S62033D | 08 | 559-561 | S62173A | 08 | 562-563 | ||
| S61335A | 24 | 963-965 | S62033G | 08 | 559-561 | S62173A | 24 | 963-965 | ||
| S61335D | 23 | 949-950 | S62033K | 08 | 564-566 | S62173B | 08 | 562-563 | ||
| S61335S | 09 | 604-605 | S62033P | 08 | 564-566 | S62173B | 24 | 963-965 | ||
| S61336A | 09 | 604-605 | S62033S | 08 | 559-561 | S62173D | 08 | 559-561 | ||
| S61336A | 24 | 963-965 | S62034A | 08 | 562-563 | S62173G | 08 | 559-561 | ||
| S61336D | 23 | 949-950 | S62034A | 24 | 963-965 | S62173K | 08 | 564-566 | ||
| S61336S | 09 | 604-605 | S62034B | 08 | 562-563 | S62173P | 08 | 564-566 | ||
| S61337A | 09 | 604-605 | S62034B | 24 | 963-965 | S62173S | 08 | 559-561 | ||
| S61337A | 24 | 963-965 | S62034D | 08 | 559-561 | S62174A | 08 | 562-563 | ||
| S61337D | 23 | 949-950 | S62034G | 08 | 559-561 | S62174A | 24 | 963-965 | ||
| S61337S | 09 | 604-605 | S62034K | 08 | 564-566 | S62174B | 08 | 562-563 | ||
| S61338A | 09 | 604-605 | S62034P | 08 | 564-566 | S62174B | 24 | 963-965 | ||
| S61338A | 24 | 963-965 | S62034S | 08 | 559-561 | S62174D | 08 | 559-561 | ||
| S61338D | 23 | 949-950 | S62035A | 08 | 562-563 | S62174G | 08 | 559-561 | ||
| S61338S | 09 | 604-605 | S62035A | 24 | 963-965 | S62174K | 08 | 564-566 | ||
| S61339A | 09 | 604-605 | S62035B | 08 | 562-563 | S62174P | 08 | 564-566 | ||
| S61339A | 24 | 963-965 | S62035B | 24 | 963-965 | S62174S | 08 | 559-561 | ||
| S61339D | 23 | 949-950 | S62035D | 08 | 559-561 | S62175A | 08 | 562-563 | ||
| S61339S | 09 | 604-605 | S62035G | 08 | 559-561 | S62175A | 24 | 963-965 | ||
| S61340A | 21 | 913-914 | S62035K | 08 | 564-566 | S62175B | 08 | 562-563 | ||
| S61340A | 24 | 963-965 | S62035P | 08 | 564-566 | S62175B | 24 | 963-965 | ||
| S61340D | 23 | 949-950 | S62035S | 08 | 559-561 | S62175D | 08 | 559-561 | ||
| S61340S | 09 | 604-605 | S62036A | 08 | 562-563 | S62175G | 08 | 559-561 | ||
| S61341A | 21 | 913-914 | S62036A | 24 | 963-965 | S62175K | 08 | 564-566 | ||
| S61341A | 24 | 963-965 | S62036B | 08 | 562-563 | S62175P | 08 | 564-566 | ||
| S61341D | 23 | 949-950 | S62036B | 24 | 963-965 | S62175S | 08 | 559-561 | ||
| S61341S | 09 | 604-605 | S62036D | 08 | 559-561 | S62176A | 08 | 562-563 | ||
| S61342A | 21 | 913-914 | S62036G | 08 | 559-561 | S62176A | 24 | 963-965 | ||
| S61342A | 24 | 963-965 | S62036K | 08 | 564-566 | S62176B | 08 | 562-563 | ||
| S61342D | 23 | 949-950 | S62036P | 08 | 564-566 | S62176B | 24 | 963-965 | ||
| S61342S | 09 | 604-605 | S62036S | 08 | 559-561 | S62176D | 08 | 559-561 | ||
| S61343A | 21 | 913-914 | S62101A | 08 | 562-563 | S62176G | 08 | 559-561 | ||
| S61343A | 24 | 963-965 | S62101A | 24 | 963-965 | S62176K | 08 | 564-566 | ||
| S61343D | 23 | 949-950 | S62101B | 08 | 562-563 | S62176P | 08 | 564-566 | ||
| S61343S | 09 | 604-605 | S62101B | 24 | 963-965 | S62176S | 08 | 559-561 | ||
| S61344A | 21 | 913-914 | S62101D | 08 | 559-561 | S62181A | 08 | 562-563 | ||
| S61344A | 24 | 963-965 | S62101G | 08 | 559-561 | S62181A | 24 | 963-965 | ||
| S61344D | 23 | 949-950 | S62101K | 08 | 564-566 | S62181B | 08 | 562-563 | ||
| S61344S | 09 | 604-605 | S62101P | 08 | 564-566 | S62181B | 24 | 963-965 | ||
| S61345A | 21 | 913-914 | S62101S | 08 | 559-561 | S62181D | 08 | 559-561 | ||
| S61345A | 24 | 963-965 | S62102A | 08 | 562-563 | S62181G | 08 | 559-561 | ||
| S61345D | 23 | 949-950 | S62102A | 24 | 963-965 | S62181K | 08 | 564-566 | ||
| S61345S | 09 | 604-605 | S62102B | 08 | 562-563 | S62181P | 08 | 564-566 | ||
| S61346A | 21 | 913-914 | S62102B | 24 | 963-965 | S62181S | 08 | 559-561 | ||
| S61346A | 24 | 963-965 | S62102D | 08 | 559-561 | S62182A | 08 | 562-563 | ||
| S61346D | 23 | 949-950 | S62102G | 08 | 559-561 | S62182A | 24 | 963-965 | ||
| S61346S | 09 | 604-605 | S62102K | 08 | 564-566 | S62182B | 08 | 562-563 | ||
| S61347A | 21 | 913-914 | S62102P | 08 | 564-566 | S62182B | 24 | 963-965 | ||
| S61347A | 24 | 963-965 | S62102S | 08 | 559-561 | S62182D | 08 | 559-561 | ||
| S61347D | 23 | 949-950 | S62109A | 08 | 562-563 | S62182G | 08 | 559-561 | ||
| S61347S | 09 | 604-605 | S62109A | 24 | 963-965 | S62182K | 08 | 564-566 | ||
| S61348A | 21 | 913-914 | S62109B | 08 | 562-563 | S62182P | 08 | 564-566 | ||
| S61348A | 24 | 963-965 | S62109B | 24 | 963-965 | S62182S | 08 | 559-561 | ||
| S61348D | 23 | 949-950 | S62109D | 08 | 559-561 | S62183A | 08 | 562-563 | ||
| S61348S | 09 | 604-605 | S62109G | 08 | 559-561 | S62183A | 24 | 963-965 | ||
| S61349A | 21 | 913-914 | S62109K | 08 | 564-566 | S62183B | 08 | 562-563 | ||
| S61349A | 24 | 963-965 | S62109P | 08 | 564-566 | S62183B | 24 | 963-965 | ||
| S61349D | 23 | 949-950 | S62109S | 08 | 559-561 | S62183D | 08 | 559-561 | ||
| S61349S | 09 | 604-605 | S62111A | 08 | 562-563 | S62183G | 08 | 559-561 | ||
| S61350A | 09 | 604-605 | S62111A | 24 | 963-965 | S62183K | 08 | 564-566 | ||
| S61350A | 24 | 963-965 | S62111B | 08 | 562-563 | S62183P | 08 | 564-566 | ||
| S61350D | 23 | 949-950 | S62111B | 24 | 963-965 | S62183S | 08 | 559-561 | ||
| S61350S | 09 | 604-605 | S62111D | 08 | 559-561 | S62184A | 08 | 562-563 | ||
| S61351A | 09 | 604-605 | S62111G | 08 | 559-561 | S62184A | 24 | 963-965 | ||
| S61351A | 24 | 963-965 | S62111K | 08 | 564-566 | S62184B | 08 | 562-563 | ||
| S61351D | 23 | 949-950 | S62111P | 08 | 564-566 | S62184B | 24 | 963-965 | ||
| S61351S | 09 | 604-605 | S62111S | 08 | 559-561 | S62184D | 08 | 559-561 | ||
| S61352A | 09 | 604-605 | S62112A | 08 | 562-563 | S62184G | 08 | 559-561 | ||
| S61352A | 24 | 963-965 | S62112A | 24 | 963-965 | S62184K | 08 | 564-566 | ||
| S61352D | 23 | 949-950 | S62112B | 08 | 562-563 | S62184P | 08 | 564-566 | ||
| S61352S | 09 | 604-605 | S62112B | 24 | 963-965 | S62184S | 08 | 559-561 | ||
| S61353A | 09 | 604-605 | S62112D | 08 | 559-561 | S62185A | 08 | 562-563 | ||
| S61353A | 24 | 963-965 | S62112G | 08 | 559-561 | S62185A | 24 | 963-965 | ||
| S61353D | 23 | 949-950 | S62112K | 08 | 564-566 | S62185B | 08 | 562-563 | ||
| S61353S | 09 | 604-605 | S62112P | 08 | 564-566 | S62185B | 24 | 963-965 | ||
| S61354A | 09 | 604-605 | S62112S | 08 | 559-561 | S62185D | 08 | 559-561 | ||
| S61354A | 24 | 963-965 | S62113A | 08 | 562-563 | S62185G | 08 | 559-561 | ||
| S61354D | 23 | 949-950 | S62113A | 24 | 963-965 | S62185K | 08 | 564-566 | ||
| S61354S | 09 | 604-605 | S62113B | 08 | 562-563 | S62185P | 08 | 564-566 | ||
| S61355A | 09 | 604-605 | S62113B | 24 | 963-965 | S62185S | 08 | 559-561 | ||
| S61355A | 24 | 963-965 | S62113D | 08 | 559-561 | S62186A | 08 | 562-563 | ||
| S61355D | 23 | 949-950 | S62113G | 08 | 559-561 | S62186A | 24 | 963-965 | ||
| S61355S | 09 | 604-605 | S62113K | 08 | 564-566 | S62186B | 08 | 562-563 | ||
| S61356A | 09 | 604-605 | S62113P | 08 | 564-566 | S62186B | 24 | 963-965 | ||
| S61356A | 24 | 963-965 | S62113S | 08 | 559-561 | S62186D | 08 | 559-561 | ||
| S61356D | 23 | 949-950 | S62114A | 08 | 562-563 | S62186G | 08 | 559-561 | ||
| S61356S | 09 | 604-605 | S62114A | 24 | 963-965 | S62186K | 08 | 564-566 | ||
| S61357A | 09 | 604-605 | S62114B | 08 | 562-563 | S62186P | 08 | 564-566 | ||
| S61357A | 24 | 963-965 | S62114B | 24 | 963-965 | S62186S | 08 | 559-561 | ||
| S61357D | 23 | 949-950 | S62114D | 08 | 559-561 | S62201A | 08 | 562-563 | ||
| S61357S | 09 | 604-605 | S62114G | 08 | 559-561 | S62201A | 24 | 963-965 | ||
| S61358A | 09 | 604-605 | S62114K | 08 | 564-566 | S62201B | 08 | 562-563 | ||
| S61358A | 24 | 963-965 | S62114P | 08 | 564-566 | S62201B | 24 | 963-965 | ||
| S61358D | 23 | 949-950 | S62114S | 08 | 559-561 | S62201D | 08 | 559-561 | ||
| S61358S | 09 | 604-605 | S62115A | 08 | 562-563 | S62201G | 08 | 559-561 | ||
| S61359A | 09 | 604-605 | S62115A | 24 | 963-965 | S62201K | 08 | 564-566 | ||
| S61359A | 24 | 963-965 | S62115B | 08 | 562-563 | S62201P | 08 | 564-566 | ||
| S61359D | 23 | 949-950 | S62115B | 24 | 963-965 | S62201S | 08 | 559-561 | ||
| S61359S | 09 | 604-605 | S62115D | 08 | 559-561 | S62202A | 08 | 562-563 | ||
| S61401A | 09 | 604-605 | S62115G | 08 | 559-561 | S62202A | 24 | 963-965 | ||
| S61401A | 24 | 963-965 | S62115K | 08 | 564-566 | S62202B | 08 | 562-563 | ||
| S61401D | 23 | 949-950 | S62115P | 08 | 564-566 | S62202B | 24 | 963-965 | ||
| S61401S | 09 | 604-605 | S62115S | 08 | 559-561 | S62202D | 08 | 559-561 | ||
| S61402A | 09 | 604-605 | S62116A | 08 | 562-563 | S62202G | 08 | 559-561 | ||
| S61402A | 24 | 963-965 | S62116A | 24 | 963-965 | S62202K | 08 | 564-566 | ||
| S61402D | 23 | 949-950 | S62116B | 08 | 562-563 | S62202P | 08 | 564-566 | ||
| S61402S | 09 | 604-605 | S62116B | 24 | 963-965 | S62202S | 08 | 559-561 | ||
| S61409A | 09 | 604-605 | S62116D | 08 | 559-561 | S62209A | 08 | 562-563 | ||
| S61409A | 24 | 963-965 | S62116G | 08 | 559-561 | S62209A | 24 | 963-965 | ||
| S61409D | 23 | 949-950 | S62116K | 08 | 564-566 | S62209B | 08 | 562-563 | ||
| S61409S | 09 | 604-605 | S62116P | 08 | 564-566 | S62209B | 24 | 963-965 | ||
| S61411A | 09 | 604-605 | S62116S | 08 | 559-561 | S62209D | 08 | 559-561 | ||
| S61411A | 24 | 963-965 | S62121A | 08 | 562-563 | S62209G | 08 | 559-561 | ||
| S61411D | 23 | 949-950 | S62121A | 24 | 963-965 | S62209K | 08 | 564-566 | ||
| S61411S | 09 | 604-605 | S62121B | 08 | 562-563 | S62209P | 08 | 564-566 | ||
| S61412A | 09 | 604-605 | S62121B | 24 | 963-965 | S62209S | 08 | 559-561 | ||
| S61412A | 24 | 963-965 | S62121D | 08 | 559-561 | S62211A | 08 | 562-563 | ||
| S61412D | 23 | 949-950 | S62121G | 08 | 559-561 | S62211A | 24 | 963-965 | ||
| S61412S | 09 | 604-605 | S62121K | 08 | 564-566 | S62211B | 08 | 562-563 | ||
| S61419A | 09 | 604-605 | S62121P | 08 | 564-566 | S62211B | 24 | 963-965 | ||
| S61419A | 24 | 963-965 | S62121S | 08 | 559-561 | S62211D | 08 | 559-561 | ||
| S61419D | 23 | 949-950 | S62122A | 08 | 562-563 | S62211G | 08 | 559-561 | ||
| S61419S | 09 | 604-605 | S62122A | 24 | 963-965 | S62211K | 08 | 564-566 | ||
| S61421A | 21 | 913-914 | S62122B | 08 | 562-563 | S62211P | 08 | 564-566 | ||
| S61421A | 24 | 963-965 | S62122B | 24 | 963-965 | S62211S | 08 | 559-561 | ||
| S61421D | 23 | 949-950 | S62122D | 08 | 559-561 | S62212A | 08 | 562-563 | ||
| S61421S | 09 | 604-605 | S62122G | 08 | 559-561 | S62212A | 24 | 963-965 | ||
| S61422A | 21 | 913-914 | S62122K | 08 | 564-566 | S62212B | 08 | 562-563 | ||
| S61422A | 24 | 963-965 | S62122P | 08 | 564-566 | S62212B | 24 | 963-965 | ||
| S61422D | 23 | 949-950 | S62122S | 08 | 559-561 | S62212D | 08 | 559-561 | ||
| S61422S | 09 | 604-605 | S62123A | 08 | 562-563 | S62212G | 08 | 559-561 | ||
| S61429A | 21 | 913-914 | S62123A | 24 | 963-965 | S62212K | 08 | 564-566 | ||
| S61429A | 24 | 963-965 | S62123B | 08 | 562-563 | S62212P | 08 | 564-566 | ||
| S61429D | 23 | 949-950 | S62123B | 24 | 963-965 | S62212S | 08 | 559-561 | ||
| S61429S | 09 | 604-605 | S62123D | 08 | 559-561 | S62213A | 08 | 562-563 | ||
| S61431A | 09 | 604-605 | S62123G | 08 | 559-561 | S62213A | 24 | 963-965 | ||
| S61431A | 24 | 963-965 | S62123K | 08 | 564-566 | S62213B | 08 | 562-563 | ||
| S61431D | 23 | 949-950 | S62123P | 08 | 564-566 | S62213B | 24 | 963-965 | ||
| S61431S | 09 | 604-605 | S62123S | 08 | 559-561 | S62213D | 08 | 559-561 | ||
| S61432A | 09 | 604-605 | S62124A | 08 | 562-563 | S62213G | 08 | 559-561 | ||
| S61432A | 24 | 963-965 | S62124A | 24 | 963-965 | S62213K | 08 | 564-566 | ||
| S61432D | 23 | 949-950 | S62124B | 08 | 562-563 | S62213P | 08 | 564-566 | ||
| S61432S | 09 | 604-605 | S62124B | 24 | 963-965 | S62213S | 08 | 559-561 | ||
| S61439A | 09 | 604-605 | S62124D | 08 | 559-561 | S62221A | 08 | 562-563 | ||
| S61439A | 24 | 963-965 | S62124G | 08 | 559-561 | S62221A | 24 | 963-965 | ||
| S61439D | 23 | 949-950 | S62124K | 08 | 564-566 | S62221B | 08 | 562-563 | ||
| S61439S | 09 | 604-605 | S62124P | 08 | 564-566 | S62221B | 24 | 963-965 | ||
| S61441A | 21 | 913-914 | S62124S | 08 | 559-561 | S62221D | 08 | 559-561 | ||
| S61441A | 24 | 963-965 | S62125A | 08 | 562-563 | S62221G | 08 | 559-561 | ||
| S61441D | 23 | 949-950 | S62125A | 24 | 963-965 | S62221K | 08 | 564-566 | ||
| S61441S | 09 | 604-605 | S62125B | 08 | 562-563 | S62221P | 08 | 564-566 | ||
| S61442A | 21 | 913-914 | S62125B | 24 | 963-965 | S62221S | 08 | 559-561 | ||
| S61442A | 24 | 963-965 | S62125D | 08 | 559-561 | S62222A | 08 | 562-563 | ||
| S61442D | 23 | 949-950 | S62125G | 08 | 559-561 | S62222A | 24 | 963-965 | ||
| S61442S | 09 | 604-605 | S62125K | 08 | 564-566 | S62222B | 08 | 562-563 | ||
| S61449A | 21 | 913-914 | S62125P | 08 | 564-566 | S62222B | 24 | 963-965 | ||
| S61449A | 24 | 963-965 | S62125S | 08 | 559-561 | S62222D | 08 | 559-561 | ||
| S61449D | 23 | 949-950 | S62126A | 08 | 562-563 | S62222G | 08 | 559-561 | ||
| S61449S | 09 | 604-605 | S62126A | 24 | 963-965 | S62222K | 08 | 564-566 | ||
| S61451A | 09 | 604-605 | S62126B | 08 | 562-563 | S62222P | 08 | 564-566 | ||
| S61451A | 24 | 963-965 | S62126B | 24 | 963-965 | S62222S | 08 | 559-561 | ||
| S61451D | 23 | 949-950 | S62126D | 08 | 559-561 | S62223A | 08 | 562-563 | ||
| S61451S | 09 | 604-605 | S62126G | 08 | 559-561 | S62223A | 24 | 963-965 | ||
| S61452A | 09 | 604-605 | S62126K | 08 | 564-566 | S62223B | 08 | 562-563 | ||
| S61452A | 24 | 963-965 | S62126P | 08 | 564-566 | S62223B | 24 | 963-965 | ||
| S61452D | 23 | 949-950 | S62126S | 08 | 559-561 | S62223D | 08 | 559-561 | ||
| S61452S | 09 | 604-605 | S62131A | 08 | 562-563 | S62223G | 08 | 559-561 | ||
| S61459A | 09 | 604-605 | S62131A | 24 | 963-965 | S62223K | 08 | 564-566 | ||
| S61459A | 24 | 963-965 | S62131B | 08 | 562-563 | S62223P | 08 | 564-566 | ||
| S61459D | 23 | 949-950 | S62131B | 24 | 963-965 | S62223S | 08 | 559-561 | ||
| S61459S | 09 | 604-605 | S62131D | 08 | 559-561 | S62224A | 08 | 562-563 | ||
| S61501A | 09 | 604-605 | S62131G | 08 | 559-561 | S62224A | 24 | 963-965 | ||
| S61501A | 24 | 963-965 | S62131K | 08 | 564-566 | S62224B | 08 | 562-563 | ||
| S61501D | 23 | 949-950 | S62131P | 08 | 564-566 | S62224B | 24 | 963-965 | ||
| S61501S | 09 | 604-605 | S62131S | 08 | 559-561 | S62224D | 08 | 559-561 | ||
| S61502A | 09 | 604-605 | S62132A | 08 | 562-563 | S62224G | 08 | 559-561 | ||
| S61502A | 24 | 963-965 | S62132A | 24 | 963-965 | S62224K | 08 | 564-566 | ||
| S61502D | 23 | 949-950 | S62132B | 08 | 562-563 | S62224P | 08 | 564-566 | ||
| S61502S | 09 | 604-605 | S62132B | 24 | 963-965 | S62224S | 08 | 559-561 | ||
| S61509A | 09 | 604-605 | S62132D | 08 | 559-561 | S62225A | 08 | 562-563 | ||
| S61509A | 24 | 963-965 | S62132G | 08 | 559-561 | S62225A | 24 | 963-965 | ||
| S61509D | 23 | 949-950 | S62132K | 08 | 564-566 | S62225B | 08 | 562-563 | ||
| S61509S | 09 | 604-605 | S62132P | 08 | 564-566 | S62225B | 24 | 963-965 | ||
| S61511A | 09 | 604-605 | S62132S | 08 | 559-561 | S62225D | 08 | 559-561 | ||
| S61511A | 24 | 963-965 | S62133A | 08 | 562-563 | S62225G | 08 | 559-561 | ||
| S61511D | 23 | 949-950 | S62133A | 24 | 963-965 | S62225K | 08 | 564-566 | ||
| S61511S | 09 | 604-605 | S62133B | 08 | 562-563 | S62225P | 08 | 564-566 | ||
| S61512A | 09 | 604-605 | S62133B | 24 | 963-965 | S62225S | 08 | 559-561 | ||
| S61512A | 24 | 963-965 | S62133D | 08 | 559-561 | S62226A | 08 | 562-563 | ||
| S61512D | 23 | 949-950 | S62133G | 08 | 559-561 | S62226A | 24 | 963-965 | ||
| S61512S | 09 | 604-605 | S62133K | 08 | 564-566 | S62226B | 08 | 562-563 | ||
| S61519A | 09 | 604-605 | S62133P | 08 | 564-566 | S62226B | 24 | 963-965 | ||
| S61519A | 24 | 963-965 | S62133S | 08 | 559-561 | S62226D | 08 | 559-561 | ||
| S61519D | 23 | 949-950 | S62134A | 08 | 562-563 | S62226G | 08 | 559-561 | ||
| S61519S | 09 | 604-605 | S62134A | 24 | 963-965 | S62226K | 08 | 564-566 | ||
| S61521A | 21 | 913-914 | S62134B | 08 | 562-563 | S62226P | 08 | 564-566 | ||
| S61521A | 24 | 963-965 | S62134B | 24 | 963-965 | S62226S | 08 | 559-561 | ||
| S61521D | 23 | 949-950 | S62134D | 08 | 559-561 | S62231A | 08 | 562-563 | ||
| S61521S | 09 | 604-605 | S62134G | 08 | 559-561 | S62231A | 24 | 963-965 | ||
| S61522A | 21 | 913-914 | S62134K | 08 | 564-566 | S62231B | 08 | 562-563 | ||
| S61522A | 24 | 963-965 | S62134P | 08 | 564-566 | S62231B | 24 | 963-965 | ||
| S61522D | 23 | 949-950 | S62134S | 08 | 559-561 | S62231D | 08 | 559-561 | ||
| S61522S | 09 | 604-605 | S62135A | 08 | 562-563 | S62231G | 08 | 559-561 | ||
| S61529A | 21 | 913-914 | S62135A | 24 | 963-965 | S62231K | 08 | 564-566 | ||
| S61529A | 24 | 963-965 | S62135B | 08 | 562-563 | S62231P | 08 | 564-566 | ||
| S61529D | 23 | 949-950 | S62135B | 24 | 963-965 | S62231S | 08 | 559-561 | ||
| S61529S | 09 | 604-605 | S62135D | 08 | 559-561 | S62232A | 08 | 562-563 | ||
| S61531A | 09 | 604-605 | S62135G | 08 | 559-561 | S62232A | 24 | 963-965 | ||
| S61531A | 24 | 963-965 | S62135K | 08 | 564-566 | S62232B | 08 | 562-563 | ||
| S61531D | 23 | 949-950 | S62135P | 08 | 564-566 | S62232B | 24 | 963-965 | ||
| S61531S | 09 | 604-605 | S62135S | 08 | 559-561 | S62232D | 08 | 559-561 | ||
| S61532A | 09 | 604-605 | S62136A | 08 | 562-563 | S62232G | 08 | 559-561 | ||
| S61532A | 24 | 963-965 | S62136A | 24 | 963-965 | S62232K | 08 | 564-566 | ||
| S61532D | 23 | 949-950 | S62136B | 08 | 562-563 | S62232P | 08 | 564-566 | ||
| S61532S | 09 | 604-605 | S62136B | 24 | 963-965 | S62232S | 08 | 559-561 | ||
| S61539A | 09 | 604-605 | S62136D | 08 | 559-561 | S62233A | 08 | 562-563 | ||
| S61539A | 24 | 963-965 | S62136G | 08 | 559-561 | S62233A | 24 | 963-965 | ||
| S61539D | 23 | 949-950 | S62136K | 08 | 564-566 | S62233B | 08 | 562-563 | ||
| S61539S | 09 | 604-605 | S62136P | 08 | 564-566 | S62233B | 24 | 963-965 | ||
| S61541A | 21 | 913-914 | S62136S | 08 | 559-561 | S62233D | 08 | 559-561 | ||
| S61541A | 24 | 963-965 | S62141A | 08 | 562-563 | S62233G | 08 | 559-561 | ||
| S61541D | 23 | 949-950 | S62141A | 24 | 963-965 | S62233K | 08 | 564-566 | ||
| S61541S | 09 | 604-605 | S62141B | 08 | 562-563 | S62233P | 08 | 564-566 | ||
| S61542A | 21 | 913-914 | S62141B | 24 | 963-965 | S62233S | 08 | 559-561 | ||
| S61542A | 24 | 963-965 | S62141D | 08 | 559-561 | S62234A | 08 | 562-563 | ||
| S61542D | 23 | 949-950 | S62141G | 08 | 559-561 | S62234A | 24 | 963-965 | ||
| S61542S | 09 | 604-605 | S62141K | 08 | 564-566 | S62234B | 08 | 562-563 | ||
| S61549A | 21 | 913-914 | S62141P | 08 | 564-566 | S62234B | 24 | 963-965 | ||
| S61549A | 24 | 963-965 | S62141S | 08 | 559-561 | S62234D | 08 | 559-561 | ||
| S61549D | 23 | 949-950 | S62142A | 08 | 562-563 | S62234G | 08 | 559-561 | ||
| S61549S | 09 | 604-605 | S62142A | 24 | 963-965 | S62234K | 08 | 564-566 | ||
| S61551A | 09 | 604-605 | S62142B | 08 | 562-563 | S62234P | 08 | 564-566 | ||
| S61551A | 24 | 963-965 | S62142B | 24 | 963-965 | S62234S | 08 | 559-561 | ||
| S61551D | 23 | 949-950 | S62142D | 08 | 559-561 | S62235A | 08 | 562-563 | ||
| S61551S | 09 | 604-605 | S62142G | 08 | 559-561 | S62235A | 24 | 963-965 | ||
| S61552A | 09 | 604-605 | S62142K | 08 | 564-566 | S62235B | 08 | 562-563 | ||
| S61552A | 24 | 963-965 | S62142P | 08 | 564-566 | S62235B | 24 | 963-965 | ||
| S61552D | 23 | 949-950 | S62142S | 08 | 559-561 | S62235D | 08 | 559-561 | ||
| S61552S | 09 | 604-605 | S62143A | 08 | 562-563 | S62235G | 08 | 559-561 | ||
| S61559A | 09 | 604-605 | S62143A | 24 | 963-965 | S62235K | 08 | 564-566 | ||
| S61559A | 24 | 963-965 | S62143B | 08 | 562-563 | S62235P | 08 | 564-566 | ||
| S61559D | 23 | 949-950 | S62143B | 24 | 963-965 | S62235S | 08 | 559-561 | ||
| S61559S | 09 | 604-605 | S62143D | 08 | 559-561 | S62236A | 08 | 562-563 | ||
| S62001A | 08 | 562-563 | S62143G | 08 | 559-561 | S62236A | 24 | 963-965 | ||
| S62001A | 24 | 963-965 | S62143K | 08 | 564-566 | S62236B | 08 | 562-563 | ||
| S62001B | 08 | 562-563 | S62143P | 08 | 564-566 | S62236B | 24 | 963-965 | ||
| S62001B | 24 | 963-965 | S62143S | 08 | 559-561 | S62236D | 08 | 559-561 | ||
| S62001D | 08 | 559-561 | S62144A | 08 | 562-563 | S62236G | 08 | 559-561 | ||
| S62001G | 08 | 559-561 | S62144A | 24 | 963-965 | S62236K | 08 | 564-566 | ||
| S62001K | 08 | 564-566 | S62144B | 08 | 562-563 | S62236P | 08 | 564-566 | ||
| S62001P | 08 | 564-566 | S62144B | 24 | 963-965 | S62236S | 08 | 559-561 | ||
| S62001S | 08 | 559-561 | S62144D | 08 | 559-561 | S62241A | 08 | 562-563 | ||
| S62002A | 08 | 562-563 | S62144G | 08 | 559-561 | S62241A | 24 | 963-965 | ||
| S62002A | 24 | 963-965 | S62144K | 08 | 564-566 | S62241B | 08 | 562-563 | ||
| S62002B | 08 | 562-563 | S62144P | 08 | 564-566 | S62241B | 24 | 963-965 | ||
| S62002B | 24 | 963-965 | S62144S | 08 | 559-561 | S62241D | 08 | 559-561 | ||
| S62002D | 08 | 559-561 | S62145A | 08 | 562-563 | S62241G | 08 | 559-561 | ||
| S62002G | 08 | 559-561 | S62145A | 24 | 963-965 | S62241K | 08 | 564-566 | ||
| S62002K | 08 | 564-566 | S62145B | 08 | 562-563 | S62241P | 08 | 564-566 | ||
| S62002P | 08 | 564-566 | S62145B | 24 | 963-965 | S62241S | 08 | 559-561 | ||
| S62002S | 08 | 559-561 | S62145D | 08 | 559-561 | S62242A | 08 | 562-563 | ||
| S62009A | 08 | 562-563 | S62145G | 08 | 559-561 | S62242A | 24 | 963-965 | ||
| S62009A | 24 | 963-965 | S62145K | 08 | 564-566 | S62242B | 08 | 562-563 | ||
| S62009B | 08 | 562-563 | S62145P | 08 | 564-566 | S62242B | 24 | 963-965 | ||
| S62009B | 24 | 963-965 | S62145S | 08 | 559-561 | S62242D | 08 | 559-561 | ||
| S62009D | 08 | 559-561 | S62146A | 08 | 562-563 | S62242G | 08 | 559-561 | ||
| S62009G | 08 | 559-561 | S62146A | 24 | 963-965 | S62242K | 08 | 564-566 | ||
| S62009K | 08 | 564-566 | S62146B | 08 | 562-563 | S62242P | 08 | 564-566 | ||
| S62009P | 08 | 564-566 | S62146B | 24 | 963-965 | S62242S | 08 | 559-561 | ||
| S62009S | 08 | 559-561 | S62146D | 08 | 559-561 | S62243A | 08 | 562-563 | ||
| S62011A | 08 | 562-563 | S62146G | 08 | 559-561 | S62243A | 24 | 963-965 | ||
| S62011A | 24 | 963-965 | S62146K | 08 | 564-566 | S62243B | 08 | 562-563 | ||
| S62011B | 08 | 562-563 | S62146P | 08 | 564-566 | S62243B | 24 | 963-965 | ||
| S62011B | 24 | 963-965 | S62146S | 08 | 559-561 | S62243D | 08 | 559-561 | ||
| S62011D | 08 | 559-561 | S62151A | 08 | 562-563 | S62243G | 08 | 559-561 | ||
| S62011G | 08 | 559-561 | S62151A | 24 | 963-965 | S62243K | 08 | 564-566 | ||
| S62011K | 08 | 564-566 | S62151B | 08 | 562-563 | S62243P | 08 | 564-566 | ||
| S62011P | 08 | 564-566 | S62151B | 24 | 963-965 | S62243S | 08 | 559-561 | ||
| S62011S | 08 | 559-561 | S62151D | 08 | 559-561 | S62244A | 08 | 562-563 | ||
| S62012A | 08 | 562-563 | S62151G | 08 | 559-561 | S62244A | 24 | 963-965 | ||
| S62012A | 24 | 963-965 | S62151K | 08 | 564-566 | S62244B | 08 | 562-563 | ||
| S62012B | 08 | 562-563 | S62151P | 08 | 564-566 | S62244B | 24 | 963-965 | ||
| S62012B | 24 | 963-965 | S62151S | 08 | 559-561 | S62244D | 08 | 559-561 | ||
| S62012D | 08 | 559-561 | S62152A | 08 | 562-563 | S62244G | 08 | 559-561 | ||
| S62012G | 08 | 559-561 | S62152A | 24 | 963-965 | S62244K | 08 | 564-566 | ||
| S62012K | 08 | 564-566 | S62152B | 08 | 562-563 | S62244P | 08 | 564-566 | ||
| S62012P | 08 | 564-566 | S62152B | 24 | 963-965 | S62244S | 08 | 559-561 | ||
| S62012S | 08 | 559-561 | S62152D | 08 | 559-561 | S62245A | 08 | 562-563 | ||
| S62013A | 08 | 562-563 | S62152G | 08 | 559-561 | S62245A | 24 | 963-965 | ||
| S62013A | 24 | 963-965 | S62152K | 08 | 564-566 | S62245B | 08 | 562-563 | ||
| S62013B | 08 | 562-563 | S62152P | 08 | 564-566 | S62245B | 24 | 963-965 | ||
| S62013B | 24 | 963-965 | S62152S | 08 | 559-561 | S62245D | 08 | 559-561 | ||
| S62013D | 08 | 559-561 | S62153A | 08 | 562-563 | S62245G | 08 | 559-561 | ||
| S62013G | 08 | 559-561 | S62153A | 24 | 963-965 | S62245K | 08 | 564-566 | ||
| S62013K | 08 | 564-566 | S62153B | 08 | 562-563 | S62245P | 08 | 564-566 | ||
| S62013P | 08 | 564-566 | S62153B | 24 | 963-965 | S62245S | 08 | 559-561 | ||
| S62013S | 08 | 559-561 | S62153D | 08 | 559-561 | S62246A | 08 | 562-563 | ||
| S62014A | 08 | 562-563 | S62153G | 08 | 559-561 | S62246A | 24 | 963-965 | ||
| S62014A | 24 | 963-965 | S62153K | 08 | 564-566 | S62246B | 08 | 562-563 | ||
| S62014B | 08 | 562-563 | S62153P | 08 | 564-566 | S62246B | 24 | 963-965 | ||
| S62014B | 24 | 963-965 | S62153S | 08 | 559-561 | S62246D | 08 | 559-561 | ||
| S62014D | 08 | 559-561 | S62154A | 08 | 562-563 | S62246G | 08 | 559-561 | ||
| S62014G | 08 | 559-561 | S62154A | 24 | 963-965 | S62246K | 08 | 564-566 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 16:20:17 CMS, code-revision=332, description-revision=1327 |