ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 50 of 75 |
| A000 B302 C577 C8442 D309 E093393 E1344 F19280 G9761 H21341 H52203 I369 I70221 J682 K7031 L89200 M06812 M23203 M4841XS M71811 M84529D M87842 N468 O1214 O336XX3 O368234 O714 P913 R062 S0092XA S0303XA S069X2A S14106D S21312S S25809S S31811D S32499S S37012A S42123D S42449D S46329S S52045R S52291A S52552B S56112S S60359A S61509A S62321G S62660D S63637S S66529S S72024G S72114B S72326D S72451B S7711XD S82045J S82251P S8261XA S83521A S89309D S92044S S92426G S96802A T20219S T23229S T25739S T391X5S T444X2S T498X3S T602X4S T7805XS T83728S Z315 Z96641 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S63637S | 08 | 562-563 | S65409A | 21 | 913-914 | S66193D | 23 | 949-950 | ||
| S63638A | 08 | 562-563 | S65409A | 24 | 963-965 | S66193S | 21 | 913-914 | ||
| S63638A | 24 | 963-965 | S65409D | 23 | 949-950 | S66194A | 21 | 913-914 | ||
| S63638D | 23 | 949-950 | S65409S | 05 | 299-301 | S66194A | 24 | 963-965 | ||
| S63638S | 08 | 562-563 | S65411A | 21 | 913-914 | S66194D | 23 | 949-950 | ||
| S63639A | 08 | 562-563 | S65411A | 24 | 963-965 | S66194S | 21 | 913-914 | ||
| S63639A | 24 | 963-965 | S65411D | 23 | 949-950 | S66195A | 21 | 913-914 | ||
| S63639D | 23 | 949-950 | S65411S | 05 | 299-301 | S66195A | 24 | 963-965 | ||
| S63639S | 08 | 562-563 | S65412A | 21 | 913-914 | S66195D | 23 | 949-950 | ||
| S63641A | 08 | 562-563 | S65412A | 24 | 963-965 | S66195S | 21 | 913-914 | ||
| S63641A | 24 | 963-965 | S65412D | 23 | 949-950 | S66196A | 21 | 913-914 | ||
| S63641D | 23 | 949-950 | S65412S | 05 | 299-301 | S66196A | 24 | 963-965 | ||
| S63641S | 08 | 562-563 | S65419A | 21 | 913-914 | S66196D | 23 | 949-950 | ||
| S63642A | 08 | 562-563 | S65419A | 24 | 963-965 | S66196S | 21 | 913-914 | ||
| S63642A | 24 | 963-965 | S65419D | 23 | 949-950 | S66197A | 21 | 913-914 | ||
| S63642D | 23 | 949-950 | S65419S | 05 | 299-301 | S66197A | 24 | 963-965 | ||
| S63642S | 08 | 562-563 | S65491A | 21 | 913-914 | S66197D | 23 | 949-950 | ||
| S63649A | 08 | 562-563 | S65491A | 24 | 963-965 | S66197S | 21 | 913-914 | ||
| S63649A | 24 | 963-965 | S65491D | 23 | 949-950 | S66198A | 21 | 913-914 | ||
| S63649D | 23 | 949-950 | S65491S | 05 | 299-301 | S66198A | 24 | 963-965 | ||
| S63649S | 08 | 562-563 | S65492A | 21 | 913-914 | S66198D | 23 | 949-950 | ||
| S63650A | 08 | 562-563 | S65492A | 24 | 963-965 | S66198S | 21 | 913-914 | ||
| S63650A | 24 | 963-965 | S65492D | 23 | 949-950 | S66199A | 21 | 913-914 | ||
| S63650D | 23 | 949-950 | S65492S | 05 | 299-301 | S66199A | 24 | 963-965 | ||
| S63650S | 08 | 562-563 | S65499A | 21 | 913-914 | S66199D | 23 | 949-950 | ||
| S63651A | 08 | 562-563 | S65499A | 24 | 963-965 | S66199S | 21 | 913-914 | ||
| S63651A | 24 | 963-965 | S65499D | 23 | 949-950 | S66201A | 21 | 913-914 | ||
| S63651D | 23 | 949-950 | S65499S | 05 | 299-301 | S66201A | 24 | 963-965 | ||
| S63651S | 08 | 562-563 | S65500A | 21 | 913-914 | S66201D | 23 | 949-950 | ||
| S63652A | 08 | 562-563 | S65500A | 24 | 963-965 | S66201S | 21 | 913-914 | ||
| S63652A | 24 | 963-965 | S65500D | 23 | 949-950 | S66202A | 21 | 913-914 | ||
| S63652D | 23 | 949-950 | S65500S | 05 | 299-301 | S66202A | 24 | 963-965 | ||
| S63652S | 08 | 562-563 | S65501A | 21 | 913-914 | S66202D | 23 | 949-950 | ||
| S63653A | 08 | 562-563 | S65501A | 24 | 963-965 | S66202S | 21 | 913-914 | ||
| S63653A | 24 | 963-965 | S65501D | 23 | 949-950 | S66209A | 21 | 913-914 | ||
| S63653D | 23 | 949-950 | S65501S | 05 | 299-301 | S66209A | 24 | 963-965 | ||
| S63653S | 08 | 562-563 | S65502A | 21 | 913-914 | S66209D | 23 | 949-950 | ||
| S63654A | 08 | 562-563 | S65502A | 24 | 963-965 | S66209S | 21 | 913-914 | ||
| S63654A | 24 | 963-965 | S65502D | 23 | 949-950 | S66211A | 08 | 562-563 | ||
| S63654D | 23 | 949-950 | S65502S | 05 | 299-301 | S66211A | 24 | 963-965 | ||
| S63654S | 08 | 562-563 | S65503A | 21 | 913-914 | S66211D | 23 | 949-950 | ||
| S63655A | 08 | 562-563 | S65503A | 24 | 963-965 | S66211S | 08 | 562-563 | ||
| S63655A | 24 | 963-965 | S65503D | 23 | 949-950 | S66212A | 08 | 562-563 | ||
| S63655D | 23 | 949-950 | S65503S | 05 | 299-301 | S66212A | 24 | 963-965 | ||
| S63655S | 08 | 562-563 | S65504A | 21 | 913-914 | S66212D | 23 | 949-950 | ||
| S63656A | 08 | 562-563 | S65504A | 24 | 963-965 | S66212S | 08 | 562-563 | ||
| S63656A | 24 | 963-965 | S65504D | 23 | 949-950 | S66219A | 08 | 562-563 | ||
| S63656D | 23 | 949-950 | S65504S | 05 | 299-301 | S66219A | 24 | 963-965 | ||
| S63656S | 08 | 562-563 | S65505A | 21 | 913-914 | S66219D | 23 | 949-950 | ||
| S63657A | 08 | 562-563 | S65505A | 24 | 963-965 | S66219S | 08 | 562-563 | ||
| S63657A | 24 | 963-965 | S65505D | 23 | 949-950 | S66221A | 08 | 564-566 | ||
| S63657D | 23 | 949-950 | S65505S | 05 | 299-301 | S66221A | 24 | 963-965 | ||
| S63657S | 08 | 562-563 | S65506A | 21 | 913-914 | S66221D | 23 | 949-950 | ||
| S63658A | 08 | 562-563 | S65506A | 24 | 963-965 | S66221S | 09 | 604-605 | ||
| S63658A | 24 | 963-965 | S65506D | 23 | 949-950 | S66222A | 08 | 564-566 | ||
| S63658D | 23 | 949-950 | S65506S | 05 | 299-301 | S66222A | 24 | 963-965 | ||
| S63658S | 08 | 562-563 | S65507A | 21 | 913-914 | S66222D | 23 | 949-950 | ||
| S63659A | 08 | 562-563 | S65507A | 24 | 963-965 | S66222S | 09 | 604-605 | ||
| S63659A | 24 | 963-965 | S65507D | 23 | 949-950 | S66229A | 08 | 564-566 | ||
| S63659D | 23 | 949-950 | S65507S | 05 | 299-301 | S66229A | 24 | 963-965 | ||
| S63659S | 08 | 562-563 | S65508A | 21 | 913-914 | S66229D | 23 | 949-950 | ||
| S63681A | 08 | 562-563 | S65508A | 24 | 963-965 | S66229S | 09 | 604-605 | ||
| S63681A | 24 | 963-965 | S65508D | 23 | 949-950 | S66291A | 21 | 913-914 | ||
| S63681D | 23 | 949-950 | S65508S | 05 | 299-301 | S66291A | 24 | 963-965 | ||
| S63681S | 08 | 562-563 | S65509A | 21 | 913-914 | S66291D | 23 | 949-950 | ||
| S63682A | 08 | 562-563 | S65509A | 24 | 963-965 | S66291S | 21 | 913-914 | ||
| S63682A | 24 | 963-965 | S65509D | 23 | 949-950 | S66292A | 21 | 913-914 | ||
| S63682D | 23 | 949-950 | S65509S | 05 | 299-301 | S66292A | 24 | 963-965 | ||
| S63682S | 08 | 562-563 | S65510A | 21 | 913-914 | S66292D | 23 | 949-950 | ||
| S63689A | 08 | 562-563 | S65510A | 24 | 963-965 | S66292S | 21 | 913-914 | ||
| S63689A | 24 | 963-965 | S65510D | 23 | 949-950 | S66299A | 21 | 913-914 | ||
| S63689D | 23 | 949-950 | S65510S | 05 | 299-301 | S66299A | 24 | 963-965 | ||
| S63689S | 08 | 562-563 | S65511A | 21 | 913-914 | S66299D | 23 | 949-950 | ||
| S63690A | 08 | 562-563 | S65511A | 24 | 963-965 | S66299S | 21 | 913-914 | ||
| S63690A | 24 | 963-965 | S65511D | 23 | 949-950 | S66300A | 21 | 913-914 | ||
| S63690D | 23 | 949-950 | S65511S | 05 | 299-301 | S66300A | 24 | 963-965 | ||
| S63690S | 08 | 562-563 | S65512A | 21 | 913-914 | S66300D | 23 | 949-950 | ||
| S63691A | 08 | 562-563 | S65512A | 24 | 963-965 | S66300S | 21 | 913-914 | ||
| S63691A | 24 | 963-965 | S65512D | 23 | 949-950 | S66301A | 21 | 913-914 | ||
| S63691D | 23 | 949-950 | S65512S | 05 | 299-301 | S66301A | 24 | 963-965 | ||
| S63691S | 08 | 562-563 | S65513A | 21 | 913-914 | S66301D | 23 | 949-950 | ||
| S63692A | 08 | 562-563 | S65513A | 24 | 963-965 | S66301S | 21 | 913-914 | ||
| S63692A | 24 | 963-965 | S65513D | 23 | 949-950 | S66302A | 21 | 913-914 | ||
| S63692D | 23 | 949-950 | S65513S | 05 | 299-301 | S66302A | 24 | 963-965 | ||
| S63692S | 08 | 562-563 | S65514A | 21 | 913-914 | S66302D | 23 | 949-950 | ||
| S63693A | 08 | 562-563 | S65514A | 24 | 963-965 | S66302S | 21 | 913-914 | ||
| S63693A | 24 | 963-965 | S65514D | 23 | 949-950 | S66303A | 21 | 913-914 | ||
| S63693D | 23 | 949-950 | S65514S | 05 | 299-301 | S66303A | 24 | 963-965 | ||
| S63693S | 08 | 562-563 | S65515A | 21 | 913-914 | S66303D | 23 | 949-950 | ||
| S63694A | 08 | 562-563 | S65515A | 24 | 963-965 | S66303S | 21 | 913-914 | ||
| S63694A | 24 | 963-965 | S65515D | 23 | 949-950 | S66304A | 21 | 913-914 | ||
| S63694D | 23 | 949-950 | S65515S | 05 | 299-301 | S66304A | 24 | 963-965 | ||
| S63694S | 08 | 562-563 | S65516A | 21 | 913-914 | S66304D | 23 | 949-950 | ||
| S63695A | 08 | 562-563 | S65516A | 24 | 963-965 | S66304S | 21 | 913-914 | ||
| S63695A | 24 | 963-965 | S65516D | 23 | 949-950 | S66305A | 21 | 913-914 | ||
| S63695D | 23 | 949-950 | S65516S | 05 | 299-301 | S66305A | 24 | 963-965 | ||
| S63695S | 08 | 562-563 | S65517A | 21 | 913-914 | S66305D | 23 | 949-950 | ||
| S63696A | 08 | 562-563 | S65517A | 24 | 963-965 | S66305S | 21 | 913-914 | ||
| S63696A | 24 | 963-965 | S65517D | 23 | 949-950 | S66306A | 21 | 913-914 | ||
| S63696D | 23 | 949-950 | S65517S | 05 | 299-301 | S66306A | 24 | 963-965 | ||
| S63696S | 08 | 562-563 | S65518A | 21 | 913-914 | S66306D | 23 | 949-950 | ||
| S63697A | 08 | 562-563 | S65518A | 24 | 963-965 | S66306S | 21 | 913-914 | ||
| S63697A | 24 | 963-965 | S65518D | 23 | 949-950 | S66307A | 21 | 913-914 | ||
| S63697D | 23 | 949-950 | S65518S | 05 | 299-301 | S66307A | 24 | 963-965 | ||
| S63697S | 08 | 562-563 | S65519A | 21 | 913-914 | S66307D | 23 | 949-950 | ||
| S63698A | 08 | 562-563 | S65519A | 24 | 963-965 | S66307S | 21 | 913-914 | ||
| S63698A | 24 | 963-965 | S65519D | 23 | 949-950 | S66308A | 21 | 913-914 | ||
| S63698D | 23 | 949-950 | S65519S | 05 | 299-301 | S66308A | 24 | 963-965 | ||
| S63698S | 08 | 562-563 | S65590A | 21 | 913-914 | S66308D | 23 | 949-950 | ||
| S63699A | 08 | 562-563 | S65590A | 24 | 963-965 | S66308S | 21 | 913-914 | ||
| S63699A | 24 | 963-965 | S65590D | 23 | 949-950 | S66309A | 21 | 913-914 | ||
| S63699D | 23 | 949-950 | S65590S | 05 | 299-301 | S66309A | 24 | 963-965 | ||
| S63699S | 08 | 562-563 | S65591A | 21 | 913-914 | S66309D | 23 | 949-950 | ||
| S638X1A | 08 | 562-563 | S65591A | 24 | 963-965 | S66309S | 21 | 913-914 | ||
| S638X1A | 24 | 963-965 | S65591D | 23 | 949-950 | S66310A | 08 | 562-563 | ||
| S638X1D | 23 | 949-950 | S65591S | 05 | 299-301 | S66310A | 24 | 963-965 | ||
| S638X1S | 08 | 562-563 | S65592A | 21 | 913-914 | S66310D | 23 | 949-950 | ||
| S638X2A | 08 | 562-563 | S65592A | 24 | 963-965 | S66310S | 08 | 562-563 | ||
| S638X2A | 24 | 963-965 | S65592D | 23 | 949-950 | S66311A | 08 | 562-563 | ||
| S638X2D | 23 | 949-950 | S65592S | 05 | 299-301 | S66311A | 24 | 963-965 | ||
| S638X2S | 08 | 562-563 | S65593A | 21 | 913-914 | S66311D | 23 | 949-950 | ||
| S638X9A | 08 | 562-563 | S65593A | 24 | 963-965 | S66311S | 08 | 562-563 | ||
| S638X9A | 24 | 963-965 | S65593D | 23 | 949-950 | S66312A | 08 | 562-563 | ||
| S638X9D | 23 | 949-950 | S65593S | 05 | 299-301 | S66312A | 24 | 963-965 | ||
| S638X9S | 08 | 562-563 | S65594A | 21 | 913-914 | S66312D | 23 | 949-950 | ||
| S6390XA | 08 | 562-563 | S65594A | 24 | 963-965 | S66312S | 08 | 562-563 | ||
| S6390XA | 24 | 963-965 | S65594D | 23 | 949-950 | S66313A | 08 | 562-563 | ||
| S6390XD | 23 | 949-950 | S65594S | 05 | 299-301 | S66313A | 24 | 963-965 | ||
| S6390XS | 08 | 562-563 | S65595A | 21 | 913-914 | S66313D | 23 | 949-950 | ||
| S6391XA | 08 | 562-563 | S65595A | 24 | 963-965 | S66313S | 08 | 562-563 | ||
| S6391XA | 24 | 963-965 | S65595D | 23 | 949-950 | S66314A | 08 | 562-563 | ||
| S6391XD | 23 | 949-950 | S65595S | 05 | 299-301 | S66314A | 24 | 963-965 | ||
| S6391XS | 08 | 562-563 | S65596A | 21 | 913-914 | S66314D | 23 | 949-950 | ||
| S6392XA | 08 | 562-563 | S65596A | 24 | 963-965 | S66314S | 08 | 562-563 | ||
| S6392XA | 24 | 963-965 | S65596D | 23 | 949-950 | S66315A | 08 | 562-563 | ||
| S6392XD | 23 | 949-950 | S65596S | 05 | 299-301 | S66315A | 24 | 963-965 | ||
| S6392XS | 08 | 562-563 | S65597A | 21 | 913-914 | S66315D | 23 | 949-950 | ||
| S6400XA | 01 | 073-074 | S65597A | 24 | 963-965 | S66315S | 08 | 562-563 | ||
| S6400XA | 24 | 963-965 | S65597D | 23 | 949-950 | S66316A | 08 | 562-563 | ||
| S6400XD | 23 | 949-950 | S65597S | 05 | 299-301 | S66316A | 24 | 963-965 | ||
| S6400XS | 01 | 091-093 | S65598A | 21 | 913-914 | S66316D | 23 | 949-950 | ||
| S6401XA | 01 | 073-074 | S65598A | 24 | 963-965 | S66316S | 08 | 562-563 | ||
| S6401XA | 24 | 963-965 | S65598D | 23 | 949-950 | S66317A | 08 | 562-563 | ||
| S6401XD | 23 | 949-950 | S65598S | 05 | 299-301 | S66317A | 24 | 963-965 | ||
| S6401XS | 01 | 091-093 | S65599A | 21 | 913-914 | S66317D | 23 | 949-950 | ||
| S6402XA | 01 | 073-074 | S65599A | 24 | 963-965 | S66317S | 08 | 562-563 | ||
| S6402XA | 24 | 963-965 | S65599D | 23 | 949-950 | S66318A | 08 | 562-563 | ||
| S6402XD | 23 | 949-950 | S65599S | 05 | 299-301 | S66318A | 24 | 963-965 | ||
| S6402XS | 01 | 091-093 | S65801A | 21 | 913-914 | S66318D | 23 | 949-950 | ||
| S6410XA | 01 | 073-074 | S65801A | 24 | 963-965 | S66318S | 08 | 562-563 | ||
| S6410XA | 24 | 963-965 | S65801D | 23 | 949-950 | S66319A | 08 | 562-563 | ||
| S6410XD | 23 | 949-950 | S65801S | 05 | 299-301 | S66319A | 24 | 963-965 | ||
| S6410XS | 01 | 091-093 | S65802A | 21 | 913-914 | S66319D | 23 | 949-950 | ||
| S6411XA | 01 | 073-074 | S65802A | 24 | 963-965 | S66319S | 08 | 562-563 | ||
| S6411XA | 24 | 963-965 | S65802D | 23 | 949-950 | S66320A | 08 | 564-566 | ||
| S6411XD | 23 | 949-950 | S65802S | 05 | 299-301 | S66320A | 24 | 963-965 | ||
| S6411XS | 01 | 091-093 | S65809A | 21 | 913-914 | S66320D | 23 | 949-950 | ||
| S6412XA | 01 | 073-074 | S65809A | 24 | 963-965 | S66320S | 09 | 604-605 | ||
| S6412XA | 24 | 963-965 | S65809D | 23 | 949-950 | S66321A | 08 | 564-566 | ||
| S6412XD | 23 | 949-950 | S65809S | 05 | 299-301 | S66321A | 24 | 963-965 | ||
| S6412XS | 01 | 091-093 | S65811A | 21 | 913-914 | S66321D | 23 | 949-950 | ||
| S6420XA | 01 | 073-074 | S65811A | 24 | 963-965 | S66321S | 09 | 604-605 | ||
| S6420XA | 24 | 963-965 | S65811D | 23 | 949-950 | S66322A | 08 | 564-566 | ||
| S6420XD | 23 | 949-950 | S65811S | 05 | 299-301 | S66322A | 24 | 963-965 | ||
| S6420XS | 01 | 091-093 | S65812A | 21 | 913-914 | S66322D | 23 | 949-950 | ||
| S6421XA | 01 | 073-074 | S65812A | 24 | 963-965 | S66322S | 09 | 604-605 | ||
| S6421XA | 24 | 963-965 | S65812D | 23 | 949-950 | S66323A | 08 | 564-566 | ||
| S6421XD | 23 | 949-950 | S65812S | 05 | 299-301 | S66323A | 24 | 963-965 | ||
| S6421XS | 01 | 091-093 | S65819A | 21 | 913-914 | S66323D | 23 | 949-950 | ||
| S6422XA | 01 | 073-074 | S65819A | 24 | 963-965 | S66323S | 09 | 604-605 | ||
| S6422XA | 24 | 963-965 | S65819D | 23 | 949-950 | S66324A | 08 | 564-566 | ||
| S6422XD | 23 | 949-950 | S65819S | 05 | 299-301 | S66324A | 24 | 963-965 | ||
| S6422XS | 01 | 091-093 | S65891A | 21 | 913-914 | S66324D | 23 | 949-950 | ||
| S6430XA | 01 | 073-074 | S65891A | 24 | 963-965 | S66324S | 09 | 604-605 | ||
| S6430XA | 24 | 963-965 | S65891D | 23 | 949-950 | S66325A | 08 | 564-566 | ||
| S6430XD | 23 | 949-950 | S65891S | 05 | 299-301 | S66325A | 24 | 963-965 | ||
| S6430XS | 01 | 091-093 | S65892A | 21 | 913-914 | S66325D | 23 | 949-950 | ||
| S6431XA | 01 | 073-074 | S65892A | 24 | 963-965 | S66325S | 09 | 604-605 | ||
| S6431XA | 24 | 963-965 | S65892D | 23 | 949-950 | S66326A | 08 | 564-566 | ||
| S6431XD | 23 | 949-950 | S65892S | 05 | 299-301 | S66326A | 24 | 963-965 | ||
| S6431XS | 01 | 091-093 | S65899A | 21 | 913-914 | S66326D | 23 | 949-950 | ||
| S6432XA | 01 | 073-074 | S65899A | 24 | 963-965 | S66326S | 09 | 604-605 | ||
| S6432XA | 24 | 963-965 | S65899D | 23 | 949-950 | S66327A | 08 | 564-566 | ||
| S6432XD | 23 | 949-950 | S65899S | 05 | 299-301 | S66327A | 24 | 963-965 | ||
| S6432XS | 01 | 091-093 | S65901A | 21 | 913-914 | S66327D | 23 | 949-950 | ||
| S6440XA | 01 | 073-074 | S65901A | 24 | 963-965 | S66327S | 09 | 604-605 | ||
| S6440XA | 24 | 963-965 | S65901D | 23 | 949-950 | S66328A | 08 | 564-566 | ||
| S6440XD | 23 | 949-950 | S65901S | 05 | 299-301 | S66328A | 24 | 963-965 | ||
| S6440XS | 01 | 091-093 | S65902A | 21 | 913-914 | S66328D | 23 | 949-950 | ||
| S64490A | 01 | 073-074 | S65902A | 24 | 963-965 | S66328S | 09 | 604-605 | ||
| S64490A | 24 | 963-965 | S65902D | 23 | 949-950 | S66329A | 08 | 564-566 | ||
| S64490D | 23 | 949-950 | S65902S | 05 | 299-301 | S66329A | 24 | 963-965 | ||
| S64490S | 01 | 091-093 | S65909A | 21 | 913-914 | S66329D | 23 | 949-950 | ||
| S64491A | 01 | 073-074 | S65909A | 24 | 963-965 | S66329S | 09 | 604-605 | ||
| S64491A | 24 | 963-965 | S65909D | 23 | 949-950 | S66390A | 21 | 913-914 | ||
| S64491D | 23 | 949-950 | S65909S | 05 | 299-301 | S66390A | 24 | 963-965 | ||
| S64491S | 01 | 091-093 | S65911A | 21 | 913-914 | S66390D | 23 | 949-950 | ||
| S64492A | 01 | 073-074 | S65911A | 24 | 963-965 | S66390S | 21 | 913-914 | ||
| S64492A | 24 | 963-965 | S65911D | 23 | 949-950 | S66391A | 21 | 913-914 | ||
| S64492D | 23 | 949-950 | S65911S | 05 | 299-301 | S66391A | 24 | 963-965 | ||
| S64492S | 01 | 091-093 | S65912A | 21 | 913-914 | S66391D | 23 | 949-950 | ||
| S64493A | 01 | 073-074 | S65912A | 24 | 963-965 | S66391S | 21 | 913-914 | ||
| S64493A | 24 | 963-965 | S65912D | 23 | 949-950 | S66392A | 21 | 913-914 | ||
| S64493D | 23 | 949-950 | S65912S | 05 | 299-301 | S66392A | 24 | 963-965 | ||
| S64493S | 01 | 091-093 | S65919A | 21 | 913-914 | S66392D | 23 | 949-950 | ||
| S64494A | 01 | 073-074 | S65919A | 24 | 963-965 | S66392S | 21 | 913-914 | ||
| S64494A | 24 | 963-965 | S65919D | 23 | 949-950 | S66393A | 21 | 913-914 | ||
| S64494D | 23 | 949-950 | S65919S | 05 | 299-301 | S66393A | 24 | 963-965 | ||
| S64494S | 01 | 091-093 | S65991A | 21 | 913-914 | S66393D | 23 | 949-950 | ||
| S64495A | 01 | 073-074 | S65991A | 24 | 963-965 | S66393S | 21 | 913-914 | ||
| S64495A | 24 | 963-965 | S65991D | 23 | 949-950 | S66394A | 21 | 913-914 | ||
| S64495D | 23 | 949-950 | S65991S | 05 | 299-301 | S66394A | 24 | 963-965 | ||
| S64495S | 01 | 091-093 | S65992A | 21 | 913-914 | S66394D | 23 | 949-950 | ||
| S64496A | 01 | 073-074 | S65992A | 24 | 963-965 | S66394S | 21 | 913-914 | ||
| S64496A | 24 | 963-965 | S65992D | 23 | 949-950 | S66395A | 21 | 913-914 | ||
| S64496D | 23 | 949-950 | S65992S | 05 | 299-301 | S66395A | 24 | 963-965 | ||
| S64496S | 01 | 091-093 | S65999A | 21 | 913-914 | S66395D | 23 | 949-950 | ||
| S64497A | 01 | 073-074 | S65999A | 24 | 963-965 | S66395S | 21 | 913-914 | ||
| S64497A | 24 | 963-965 | S65999D | 23 | 949-950 | S66396A | 21 | 913-914 | ||
| S64497D | 23 | 949-950 | S65999S | 05 | 299-301 | S66396A | 24 | 963-965 | ||
| S64497S | 01 | 091-093 | S66001A | 21 | 913-914 | S66396D | 23 | 949-950 | ||
| S64498A | 01 | 073-074 | S66001A | 24 | 963-965 | S66396S | 21 | 913-914 | ||
| S64498A | 24 | 963-965 | S66001D | 23 | 949-950 | S66397A | 21 | 913-914 | ||
| S64498D | 23 | 949-950 | S66001S | 21 | 913-914 | S66397A | 24 | 963-965 | ||
| S64498S | 01 | 091-093 | S66002A | 21 | 913-914 | S66397D | 23 | 949-950 | ||
| S648X1A | 01 | 073-074 | S66002A | 24 | 963-965 | S66397S | 21 | 913-914 | ||
| S648X1A | 24 | 963-965 | S66002D | 23 | 949-950 | S66398A | 21 | 913-914 | ||
| S648X1D | 23 | 949-950 | S66002S | 21 | 913-914 | S66398A | 24 | 963-965 | ||
| S648X1S | 01 | 091-093 | S66009A | 21 | 913-914 | S66398D | 23 | 949-950 | ||
| S648X2A | 01 | 073-074 | S66009A | 24 | 963-965 | S66398S | 21 | 913-914 | ||
| S648X2A | 24 | 963-965 | S66009D | 23 | 949-950 | S66399A | 21 | 913-914 | ||
| S648X2D | 23 | 949-950 | S66009S | 21 | 913-914 | S66399A | 24 | 963-965 | ||
| S648X2S | 01 | 091-093 | S66011A | 08 | 562-563 | S66399D | 23 | 949-950 | ||
| S648X9A | 01 | 073-074 | S66011A | 24 | 963-965 | S66399S | 21 | 913-914 | ||
| S648X9A | 24 | 963-965 | S66011D | 23 | 949-950 | S66401A | 21 | 913-914 | ||
| S648X9D | 23 | 949-950 | S66011S | 08 | 562-563 | S66401A | 24 | 963-965 | ||
| S648X9S | 01 | 091-093 | S66012A | 08 | 562-563 | S66401D | 23 | 949-950 | ||
| S6490XA | 01 | 073-074 | S66012A | 24 | 963-965 | S66401S | 21 | 913-914 | ||
| S6490XA | 24 | 963-965 | S66012D | 23 | 949-950 | S66402A | 21 | 913-914 | ||
| S6490XD | 23 | 949-950 | S66012S | 08 | 562-563 | S66402A | 24 | 963-965 | ||
| S6490XS | 01 | 091-093 | S66019A | 08 | 562-563 | S66402D | 23 | 949-950 | ||
| S6491XA | 01 | 073-074 | S66019A | 24 | 963-965 | S66402S | 21 | 913-914 | ||
| S6491XA | 24 | 963-965 | S66019D | 23 | 949-950 | S66409A | 21 | 913-914 | ||
| S6491XD | 23 | 949-950 | S66019S | 08 | 562-563 | S66409A | 24 | 963-965 | ||
| S6491XS | 01 | 091-093 | S66021A | 08 | 564-566 | S66409D | 23 | 949-950 | ||
| S6492XA | 01 | 073-074 | S66021A | 24 | 963-965 | S66409S | 21 | 913-914 | ||
| S6492XA | 24 | 963-965 | S66021D | 23 | 949-950 | S66411A | 08 | 562-563 | ||
| S6492XD | 23 | 949-950 | S66021S | 09 | 604-605 | S66411A | 24 | 963-965 | ||
| S6492XS | 01 | 091-093 | S66022A | 08 | 564-566 | S66411D | 23 | 949-950 | ||
| S65001A | 21 | 913-914 | S66022A | 24 | 963-965 | S66411S | 08 | 562-563 | ||
| S65001A | 24 | 963-965 | S66022D | 23 | 949-950 | S66412A | 08 | 562-563 | ||
| S65001D | 23 | 949-950 | S66022S | 09 | 604-605 | S66412A | 24 | 963-965 | ||
| S65001S | 05 | 299-301 | S66029A | 08 | 564-566 | S66412D | 23 | 949-950 | ||
| S65002A | 21 | 913-914 | S66029A | 24 | 963-965 | S66412S | 08 | 562-563 | ||
| S65002A | 24 | 963-965 | S66029D | 23 | 949-950 | S66419A | 08 | 562-563 | ||
| S65002D | 23 | 949-950 | S66029S | 09 | 604-605 | S66419A | 24 | 963-965 | ||
| S65002S | 05 | 299-301 | S66091A | 21 | 913-914 | S66419D | 23 | 949-950 | ||
| S65009A | 21 | 913-914 | S66091A | 24 | 963-965 | S66419S | 08 | 562-563 | ||
| S65009A | 24 | 963-965 | S66091D | 23 | 949-950 | S66421A | 08 | 564-566 | ||
| S65009D | 23 | 949-950 | S66091S | 21 | 913-914 | S66421A | 24 | 963-965 | ||
| S65009S | 05 | 299-301 | S66092A | 21 | 913-914 | S66421D | 23 | 949-950 | ||
| S65011A | 21 | 913-914 | S66092A | 24 | 963-965 | S66421S | 09 | 604-605 | ||
| S65011A | 24 | 963-965 | S66092D | 23 | 949-950 | S66422A | 08 | 564-566 | ||
| S65011D | 23 | 949-950 | S66092S | 21 | 913-914 | S66422A | 24 | 963-965 | ||
| S65011S | 05 | 299-301 | S66099A | 21 | 913-914 | S66422D | 23 | 949-950 | ||
| S65012A | 21 | 913-914 | S66099A | 24 | 963-965 | S66422S | 09 | 604-605 | ||
| S65012A | 24 | 963-965 | S66099D | 23 | 949-950 | S66429A | 08 | 564-566 | ||
| S65012D | 23 | 949-950 | S66099S | 21 | 913-914 | S66429A | 24 | 963-965 | ||
| S65012S | 05 | 299-301 | S66100A | 21 | 913-914 | S66429D | 23 | 949-950 | ||
| S65019A | 21 | 913-914 | S66100A | 24 | 963-965 | S66429S | 09 | 604-605 | ||
| S65019A | 24 | 963-965 | S66100D | 23 | 949-950 | S66491A | 21 | 913-914 | ||
| S65019D | 23 | 949-950 | S66100S | 21 | 913-914 | S66491A | 24 | 963-965 | ||
| S65019S | 05 | 299-301 | S66101A | 21 | 913-914 | S66491D | 23 | 949-950 | ||
| S65091A | 21 | 913-914 | S66101A | 24 | 963-965 | S66491S | 21 | 913-914 | ||
| S65091A | 24 | 963-965 | S66101D | 23 | 949-950 | S66492A | 21 | 913-914 | ||
| S65091D | 23 | 949-950 | S66101S | 21 | 913-914 | S66492A | 24 | 963-965 | ||
| S65091S | 05 | 299-301 | S66102A | 21 | 913-914 | S66492D | 23 | 949-950 | ||
| S65092A | 21 | 913-914 | S66102A | 24 | 963-965 | S66492S | 21 | 913-914 | ||
| S65092A | 24 | 963-965 | S66102D | 23 | 949-950 | S66499A | 21 | 913-914 | ||
| S65092D | 23 | 949-950 | S66102S | 21 | 913-914 | S66499A | 24 | 963-965 | ||
| S65092S | 05 | 299-301 | S66103A | 21 | 913-914 | S66499D | 23 | 949-950 | ||
| S65099A | 21 | 913-914 | S66103A | 24 | 963-965 | S66499S | 21 | 913-914 | ||
| S65099A | 24 | 963-965 | S66103D | 23 | 949-950 | S66500A | 21 | 913-914 | ||
| S65099D | 23 | 949-950 | S66103S | 21 | 913-914 | S66500A | 24 | 963-965 | ||
| S65099S | 05 | 299-301 | S66104A | 21 | 913-914 | S66500D | 23 | 949-950 | ||
| S65101A | 21 | 913-914 | S66104A | 24 | 963-965 | S66500S | 21 | 913-914 | ||
| S65101A | 24 | 963-965 | S66104D | 23 | 949-950 | S66501A | 21 | 913-914 | ||
| S65101D | 23 | 949-950 | S66104S | 21 | 913-914 | S66501A | 24 | 963-965 | ||
| S65101S | 05 | 299-301 | S66105A | 21 | 913-914 | S66501D | 23 | 949-950 | ||
| S65102A | 21 | 913-914 | S66105A | 24 | 963-965 | S66501S | 21 | 913-914 | ||
| S65102A | 24 | 963-965 | S66105D | 23 | 949-950 | S66502A | 21 | 913-914 | ||
| S65102D | 23 | 949-950 | S66105S | 21 | 913-914 | S66502A | 24 | 963-965 | ||
| S65102S | 05 | 299-301 | S66106A | 21 | 913-914 | S66502D | 23 | 949-950 | ||
| S65109A | 21 | 913-914 | S66106A | 24 | 963-965 | S66502S | 21 | 913-914 | ||
| S65109A | 24 | 963-965 | S66106D | 23 | 949-950 | S66503A | 21 | 913-914 | ||
| S65109D | 23 | 949-950 | S66106S | 21 | 913-914 | S66503A | 24 | 963-965 | ||
| S65109S | 05 | 299-301 | S66107A | 21 | 913-914 | S66503D | 23 | 949-950 | ||
| S65111A | 21 | 913-914 | S66107A | 24 | 963-965 | S66503S | 21 | 913-914 | ||
| S65111A | 24 | 963-965 | S66107D | 23 | 949-950 | S66504A | 21 | 913-914 | ||
| S65111D | 23 | 949-950 | S66107S | 21 | 913-914 | S66504A | 24 | 963-965 | ||
| S65111S | 05 | 299-301 | S66108A | 21 | 913-914 | S66504D | 23 | 949-950 | ||
| S65112A | 21 | 913-914 | S66108A | 24 | 963-965 | S66504S | 21 | 913-914 | ||
| S65112A | 24 | 963-965 | S66108D | 23 | 949-950 | S66505A | 21 | 913-914 | ||
| S65112D | 23 | 949-950 | S66108S | 21 | 913-914 | S66505A | 24 | 963-965 | ||
| S65112S | 05 | 299-301 | S66109A | 21 | 913-914 | S66505D | 23 | 949-950 | ||
| S65119A | 21 | 913-914 | S66109A | 24 | 963-965 | S66505S | 21 | 913-914 | ||
| S65119A | 24 | 963-965 | S66109D | 23 | 949-950 | S66506A | 21 | 913-914 | ||
| S65119D | 23 | 949-950 | S66109S | 21 | 913-914 | S66506A | 24 | 963-965 | ||
| S65119S | 05 | 299-301 | S66110A | 08 | 562-563 | S66506D | 23 | 949-950 | ||
| S65191A | 21 | 913-914 | S66110A | 24 | 963-965 | S66506S | 21 | 913-914 | ||
| S65191A | 24 | 963-965 | S66110D | 23 | 949-950 | S66507A | 21 | 913-914 | ||
| S65191D | 23 | 949-950 | S66110S | 08 | 562-563 | S66507A | 24 | 963-965 | ||
| S65191S | 05 | 299-301 | S66111A | 08 | 562-563 | S66507D | 23 | 949-950 | ||
| S65192A | 21 | 913-914 | S66111A | 24 | 963-965 | S66507S | 21 | 913-914 | ||
| S65192A | 24 | 963-965 | S66111D | 23 | 949-950 | S66508A | 21 | 913-914 | ||
| S65192D | 23 | 949-950 | S66111S | 08 | 562-563 | S66508A | 24 | 963-965 | ||
| S65192S | 05 | 299-301 | S66112A | 08 | 562-563 | S66508D | 23 | 949-950 | ||
| S65199A | 21 | 913-914 | S66112A | 24 | 963-965 | S66508S | 21 | 913-914 | ||
| S65199A | 24 | 963-965 | S66112D | 23 | 949-950 | S66509A | 21 | 913-914 | ||
| S65199D | 23 | 949-950 | S66112S | 08 | 562-563 | S66509A | 24 | 963-965 | ||
| S65199S | 05 | 299-301 | S66113A | 08 | 562-563 | S66509D | 23 | 949-950 | ||
| S65201A | 21 | 913-914 | S66113A | 24 | 963-965 | S66509S | 21 | 913-914 | ||
| S65201A | 24 | 963-965 | S66113D | 23 | 949-950 | S66510A | 08 | 562-563 | ||
| S65201D | 23 | 949-950 | S66113S | 08 | 562-563 | S66510A | 24 | 963-965 | ||
| S65201S | 05 | 299-301 | S66114A | 08 | 562-563 | S66510D | 23 | 949-950 | ||
| S65202A | 21 | 913-914 | S66114A | 24 | 963-965 | S66510S | 08 | 562-563 | ||
| S65202A | 24 | 963-965 | S66114D | 23 | 949-950 | S66511A | 08 | 562-563 | ||
| S65202D | 23 | 949-950 | S66114S | 08 | 562-563 | S66511A | 24 | 963-965 | ||
| S65202S | 05 | 299-301 | S66115A | 08 | 562-563 | S66511D | 23 | 949-950 | ||
| S65209A | 21 | 913-914 | S66115A | 24 | 963-965 | S66511S | 08 | 562-563 | ||
| S65209A | 24 | 963-965 | S66115D | 23 | 949-950 | S66512A | 08 | 562-563 | ||
| S65209D | 23 | 949-950 | S66115S | 08 | 562-563 | S66512A | 24 | 963-965 | ||
| S65209S | 05 | 299-301 | S66116A | 08 | 562-563 | S66512D | 23 | 949-950 | ||
| S65211A | 21 | 913-914 | S66116A | 24 | 963-965 | S66512S | 08 | 562-563 | ||
| S65211A | 24 | 963-965 | S66116D | 23 | 949-950 | S66513A | 08 | 562-563 | ||
| S65211D | 23 | 949-950 | S66116S | 08 | 562-563 | S66513A | 24 | 963-965 | ||
| S65211S | 05 | 299-301 | S66117A | 08 | 562-563 | S66513D | 23 | 949-950 | ||
| S65212A | 21 | 913-914 | S66117A | 24 | 963-965 | S66513S | 08 | 562-563 | ||
| S65212A | 24 | 963-965 | S66117D | 23 | 949-950 | S66514A | 08 | 562-563 | ||
| S65212D | 23 | 949-950 | S66117S | 08 | 562-563 | S66514A | 24 | 963-965 | ||
| S65212S | 05 | 299-301 | S66118A | 08 | 562-563 | S66514D | 23 | 949-950 | ||
| S65219A | 21 | 913-914 | S66118A | 24 | 963-965 | S66514S | 08 | 562-563 | ||
| S65219A | 24 | 963-965 | S66118D | 23 | 949-950 | S66515A | 08 | 562-563 | ||
| S65219D | 23 | 949-950 | S66118S | 08 | 562-563 | S66515A | 24 | 963-965 | ||
| S65219S | 05 | 299-301 | S66119A | 08 | 562-563 | S66515D | 23 | 949-950 | ||
| S65291A | 21 | 913-914 | S66119A | 24 | 963-965 | S66515S | 08 | 562-563 | ||
| S65291A | 24 | 963-965 | S66119D | 23 | 949-950 | S66516A | 08 | 562-563 | ||
| S65291D | 23 | 949-950 | S66119S | 08 | 562-563 | S66516A | 24 | 963-965 | ||
| S65291S | 05 | 299-301 | S66120A | 08 | 564-566 | S66516D | 23 | 949-950 | ||
| S65292A | 21 | 913-914 | S66120A | 24 | 963-965 | S66516S | 08 | 562-563 | ||
| S65292A | 24 | 963-965 | S66120D | 23 | 949-950 | S66517A | 08 | 562-563 | ||
| S65292D | 23 | 949-950 | S66120S | 09 | 604-605 | S66517A | 24 | 963-965 | ||
| S65292S | 05 | 299-301 | S66121A | 08 | 564-566 | S66517D | 23 | 949-950 | ||
| S65299A | 21 | 913-914 | S66121A | 24 | 963-965 | S66517S | 08 | 562-563 | ||
| S65299A | 24 | 963-965 | S66121D | 23 | 949-950 | S66518A | 08 | 562-563 | ||
| S65299D | 23 | 949-950 | S66121S | 09 | 604-605 | S66518A | 24 | 963-965 | ||
| S65299S | 05 | 299-301 | S66122A | 08 | 564-566 | S66518D | 23 | 949-950 | ||
| S65301A | 21 | 913-914 | S66122A | 24 | 963-965 | S66518S | 08 | 562-563 | ||
| S65301A | 24 | 963-965 | S66122D | 23 | 949-950 | S66519A | 08 | 562-563 | ||
| S65301D | 23 | 949-950 | S66122S | 09 | 604-605 | S66519A | 24 | 963-965 | ||
| S65301S | 05 | 299-301 | S66123A | 08 | 564-566 | S66519D | 23 | 949-950 | ||
| S65302A | 21 | 913-914 | S66123A | 24 | 963-965 | S66519S | 08 | 562-563 | ||
| S65302A | 24 | 963-965 | S66123D | 23 | 949-950 | S66520A | 08 | 564-566 | ||
| S65302D | 23 | 949-950 | S66123S | 09 | 604-605 | S66520A | 24 | 963-965 | ||
| S65302S | 05 | 299-301 | S66124A | 08 | 564-566 | S66520D | 23 | 949-950 | ||
| S65309A | 21 | 913-914 | S66124A | 24 | 963-965 | S66520S | 09 | 604-605 | ||
| S65309A | 24 | 963-965 | S66124D | 23 | 949-950 | S66521A | 08 | 564-566 | ||
| S65309D | 23 | 949-950 | S66124S | 09 | 604-605 | S66521A | 24 | 963-965 | ||
| S65309S | 05 | 299-301 | S66125A | 08 | 564-566 | S66521D | 23 | 949-950 | ||
| S65311A | 21 | 913-914 | S66125A | 24 | 963-965 | S66521S | 09 | 604-605 | ||
| S65311A | 24 | 963-965 | S66125D | 23 | 949-950 | S66522A | 08 | 564-566 | ||
| S65311D | 23 | 949-950 | S66125S | 09 | 604-605 | S66522A | 24 | 963-965 | ||
| S65311S | 05 | 299-301 | S66126A | 08 | 564-566 | S66522D | 23 | 949-950 | ||
| S65312A | 21 | 913-914 | S66126A | 24 | 963-965 | S66522S | 09 | 604-605 | ||
| S65312A | 24 | 963-965 | S66126D | 23 | 949-950 | S66523A | 08 | 564-566 | ||
| S65312D | 23 | 949-950 | S66126S | 09 | 604-605 | S66523A | 24 | 963-965 | ||
| S65312S | 05 | 299-301 | S66127A | 08 | 564-566 | S66523D | 23 | 949-950 | ||
| S65319A | 21 | 913-914 | S66127A | 24 | 963-965 | S66523S | 09 | 604-605 | ||
| S65319A | 24 | 963-965 | S66127D | 23 | 949-950 | S66524A | 08 | 564-566 | ||
| S65319D | 23 | 949-950 | S66127S | 09 | 604-605 | S66524A | 24 | 963-965 | ||
| S65319S | 05 | 299-301 | S66128A | 08 | 564-566 | S66524D | 23 | 949-950 | ||
| S65391A | 21 | 913-914 | S66128A | 24 | 963-965 | S66524S | 09 | 604-605 | ||
| S65391A | 24 | 963-965 | S66128D | 23 | 949-950 | S66525A | 08 | 564-566 | ||
| S65391D | 23 | 949-950 | S66128S | 09 | 604-605 | S66525A | 24 | 963-965 | ||
| S65391S | 05 | 299-301 | S66129A | 08 | 564-566 | S66525D | 23 | 949-950 | ||
| S65392A | 21 | 913-914 | S66129A | 24 | 963-965 | S66525S | 09 | 604-605 | ||
| S65392A | 24 | 963-965 | S66129D | 23 | 949-950 | S66526A | 08 | 564-566 | ||
| S65392D | 23 | 949-950 | S66129S | 09 | 604-605 | S66526A | 24 | 963-965 | ||
| S65392S | 05 | 299-301 | S66190A | 21 | 913-914 | S66526D | 23 | 949-950 | ||
| S65399A | 21 | 913-914 | S66190A | 24 | 963-965 | S66526S | 09 | 604-605 | ||
| S65399A | 24 | 963-965 | S66190D | 23 | 949-950 | S66527A | 08 | 564-566 | ||
| S65399D | 23 | 949-950 | S66190S | 21 | 913-914 | S66527A | 24 | 963-965 | ||
| S65399S | 05 | 299-301 | S66191A | 21 | 913-914 | S66527D | 23 | 949-950 | ||
| S65401A | 21 | 913-914 | S66191A | 24 | 963-965 | S66527S | 09 | 604-605 | ||
| S65401A | 24 | 963-965 | S66191D | 23 | 949-950 | S66528A | 08 | 564-566 | ||
| S65401D | 23 | 949-950 | S66191S | 21 | 913-914 | S66528A | 24 | 963-965 | ||
| S65401S | 05 | 299-301 | S66192A | 21 | 913-914 | S66528D | 23 | 949-950 | ||
| S65402A | 21 | 913-914 | S66192A | 24 | 963-965 | S66528S | 09 | 604-605 | ||
| S65402A | 24 | 963-965 | S66192D | 23 | 949-950 | S66529A | 08 | 564-566 | ||
| S65402D | 23 | 949-950 | S66192S | 21 | 913-914 | S66529A | 24 | 963-965 | ||
| S65402S | 05 | 299-301 | S66193A | 21 | 913-914 | S66529D | 23 | 949-950 | ||
| S66193A | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |