ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 41 of 75 |
| A000 B309 C673 C8441 D220 E0901 E133541 F16280 G809 H18043 H44659 H9554 I673 J1282 K51211 L282 L98A229 M13179 M2650 M62229 M80851P M84673P M929 N99524 O3100X3 O360995 O43892 P0489 Q6680 R928 S0242XD S06369A S12230G S20302D S23163D S31041S S32409G S35404S S40822A S42322P S43491D S50911D S52231N S52363P S53106A S59029A S61151D S62173S S62523D S63255S S65999S S70311S S72059B S72142K S72366J S73122A S81021D S82146S S82431R S82872Q S86219S S91103S S92226D S93325A S99142B T2220XS T24119A T362X2D T420X1A T465X3S T523X1A T63463S T81501D T8482XS Z5301 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S43491D | 23 | 949-950 | S46022D | 23 | 949-950 | S49029D | 08 | 559-561 | ||
| S43491S | 08 | 562-563 | S46022S | 09 | 604-605 | S49029G | 08 | 559-561 | ||
| S43492A | 08 | 562-563 | S46029A | 08 | 564-566 | S49029K | 08 | 564-566 | ||
| S43492A | 24 | 963-965 | S46029A | 24 | 963-965 | S49029P | 08 | 564-566 | ||
| S43492D | 23 | 949-950 | S46029D | 23 | 949-950 | S49029S | 08 | 559-561 | ||
| S43492S | 08 | 562-563 | S46029S | 09 | 604-605 | S49031A | 08 | 562-563 | ||
| S43499A | 08 | 562-563 | S46091A | 21 | 913-914 | S49031A | 24 | 963-965 | ||
| S43499A | 24 | 963-965 | S46091A | 24 | 963-965 | S49031D | 08 | 559-561 | ||
| S43499D | 23 | 949-950 | S46091D | 23 | 949-950 | S49031G | 08 | 559-561 | ||
| S43499S | 08 | 562-563 | S46091S | 21 | 913-914 | S49031K | 08 | 564-566 | ||
| S4350XA | 08 | 562-563 | S46092A | 21 | 913-914 | S49031P | 08 | 564-566 | ||
| S4350XA | 24 | 963-965 | S46092A | 24 | 963-965 | S49031S | 08 | 559-561 | ||
| S4350XD | 23 | 949-950 | S46092D | 23 | 949-950 | S49032A | 08 | 562-563 | ||
| S4350XS | 08 | 562-563 | S46092S | 21 | 913-914 | S49032A | 24 | 963-965 | ||
| S4351XA | 08 | 562-563 | S46099A | 21 | 913-914 | S49032D | 08 | 559-561 | ||
| S4351XA | 24 | 963-965 | S46099A | 24 | 963-965 | S49032G | 08 | 559-561 | ||
| S4351XD | 23 | 949-950 | S46099D | 23 | 949-950 | S49032K | 08 | 564-566 | ||
| S4351XS | 08 | 562-563 | S46099S | 21 | 913-914 | S49032P | 08 | 564-566 | ||
| S4352XA | 08 | 562-563 | S46101A | 21 | 913-914 | S49032S | 08 | 559-561 | ||
| S4352XA | 24 | 963-965 | S46101A | 24 | 963-965 | S49039A | 08 | 562-563 | ||
| S4352XD | 23 | 949-950 | S46101D | 23 | 949-950 | S49039A | 24 | 963-965 | ||
| S4352XS | 08 | 562-563 | S46101S | 21 | 913-914 | S49039D | 08 | 559-561 | ||
| S4360XA | 08 | 562-563 | S46102A | 21 | 913-914 | S49039G | 08 | 559-561 | ||
| S4360XA | 24 | 963-965 | S46102A | 24 | 963-965 | S49039K | 08 | 564-566 | ||
| S4360XD | 23 | 949-950 | S46102D | 23 | 949-950 | S49039P | 08 | 564-566 | ||
| S4360XS | 08 | 562-563 | S46102S | 21 | 913-914 | S49039S | 08 | 559-561 | ||
| S4361XA | 08 | 562-563 | S46109A | 21 | 913-914 | S49041A | 08 | 562-563 | ||
| S4361XA | 24 | 963-965 | S46109A | 24 | 963-965 | S49041A | 24 | 963-965 | ||
| S4361XD | 23 | 949-950 | S46109D | 23 | 949-950 | S49041D | 08 | 559-561 | ||
| S4361XS | 08 | 562-563 | S46109S | 21 | 913-914 | S49041G | 08 | 559-561 | ||
| S4362XA | 08 | 562-563 | S46111A | 08 | 562-563 | S49041K | 08 | 564-566 | ||
| S4362XA | 24 | 963-965 | S46111A | 24 | 963-965 | S49041P | 08 | 564-566 | ||
| S4362XD | 23 | 949-950 | S46111D | 23 | 949-950 | S49041S | 08 | 559-561 | ||
| S4362XS | 08 | 562-563 | S46111S | 08 | 562-563 | S49042A | 08 | 562-563 | ||
| S4380XA | 08 | 562-563 | S46112A | 08 | 562-563 | S49042A | 24 | 963-965 | ||
| S4380XA | 24 | 963-965 | S46112A | 24 | 963-965 | S49042D | 08 | 559-561 | ||
| S4380XD | 23 | 949-950 | S46112D | 23 | 949-950 | S49042G | 08 | 559-561 | ||
| S4380XS | 08 | 562-563 | S46112S | 08 | 562-563 | S49042K | 08 | 564-566 | ||
| S4381XA | 08 | 562-563 | S46119A | 08 | 562-563 | S49042P | 08 | 564-566 | ||
| S4381XA | 24 | 963-965 | S46119A | 24 | 963-965 | S49042S | 08 | 559-561 | ||
| S4381XD | 23 | 949-950 | S46119D | 23 | 949-950 | S49049A | 08 | 562-563 | ||
| S4381XS | 08 | 562-563 | S46119S | 08 | 562-563 | S49049A | 24 | 963-965 | ||
| S4382XA | 08 | 562-563 | S46121A | 08 | 564-566 | S49049D | 08 | 559-561 | ||
| S4382XA | 24 | 963-965 | S46121A | 24 | 963-965 | S49049G | 08 | 559-561 | ||
| S4382XD | 23 | 949-950 | S46121D | 23 | 949-950 | S49049K | 08 | 564-566 | ||
| S4382XS | 08 | 562-563 | S46121S | 09 | 604-605 | S49049P | 08 | 564-566 | ||
| S4390XA | 08 | 562-563 | S46122A | 08 | 564-566 | S49049S | 08 | 559-561 | ||
| S4390XA | 24 | 963-965 | S46122A | 24 | 963-965 | S49091A | 08 | 562-563 | ||
| S4390XD | 23 | 949-950 | S46122D | 23 | 949-950 | S49091A | 24 | 963-965 | ||
| S4390XS | 08 | 562-563 | S46122S | 09 | 604-605 | S49091D | 08 | 559-561 | ||
| S4391XA | 08 | 562-563 | S46129A | 08 | 564-566 | S49091G | 08 | 559-561 | ||
| S4391XA | 24 | 963-965 | S46129A | 24 | 963-965 | S49091K | 08 | 564-566 | ||
| S4391XD | 23 | 949-950 | S46129D | 23 | 949-950 | S49091P | 08 | 564-566 | ||
| S4391XS | 08 | 562-563 | S46129S | 09 | 604-605 | S49091S | 08 | 559-561 | ||
| S4392XA | 08 | 562-563 | S46191A | 21 | 913-914 | S49092A | 08 | 562-563 | ||
| S4392XA | 24 | 963-965 | S46191A | 24 | 963-965 | S49092A | 24 | 963-965 | ||
| S4392XD | 23 | 949-950 | S46191D | 23 | 949-950 | S49092D | 08 | 559-561 | ||
| S4392XS | 08 | 562-563 | S46191S | 21 | 913-914 | S49092G | 08 | 559-561 | ||
| S4400XA | 01 | 073-074 | S46192A | 21 | 913-914 | S49092K | 08 | 564-566 | ||
| S4400XA | 24 | 963-965 | S46192A | 24 | 963-965 | S49092P | 08 | 564-566 | ||
| S4400XD | 23 | 949-950 | S46192D | 23 | 949-950 | S49092S | 08 | 559-561 | ||
| S4400XS | 01 | 091-093 | S46192S | 21 | 913-914 | S49099A | 08 | 562-563 | ||
| S4401XA | 01 | 073-074 | S46199A | 21 | 913-914 | S49099A | 24 | 963-965 | ||
| S4401XA | 24 | 963-965 | S46199A | 24 | 963-965 | S49099D | 08 | 559-561 | ||
| S4401XD | 23 | 949-950 | S46199D | 23 | 949-950 | S49099G | 08 | 559-561 | ||
| S4401XS | 01 | 091-093 | S46199S | 21 | 913-914 | S49099K | 08 | 564-566 | ||
| S4402XA | 01 | 073-074 | S46201A | 21 | 913-914 | S49099P | 08 | 564-566 | ||
| S4402XA | 24 | 963-965 | S46201A | 24 | 963-965 | S49099S | 08 | 559-561 | ||
| S4402XD | 23 | 949-950 | S46201D | 23 | 949-950 | S49101A | 08 | 562-563 | ||
| S4402XS | 01 | 091-093 | S46201S | 21 | 913-914 | S49101A | 24 | 963-965 | ||
| S4410XA | 01 | 073-074 | S46202A | 21 | 913-914 | S49101D | 08 | 559-561 | ||
| S4410XA | 24 | 963-965 | S46202A | 24 | 963-965 | S49101G | 08 | 559-561 | ||
| S4410XD | 23 | 949-950 | S46202D | 23 | 949-950 | S49101K | 08 | 564-566 | ||
| S4410XS | 01 | 091-093 | S46202S | 21 | 913-914 | S49101P | 08 | 564-566 | ||
| S4411XA | 01 | 073-074 | S46209A | 21 | 913-914 | S49101S | 08 | 559-561 | ||
| S4411XA | 24 | 963-965 | S46209A | 24 | 963-965 | S49102A | 08 | 562-563 | ||
| S4411XD | 23 | 949-950 | S46209D | 23 | 949-950 | S49102A | 24 | 963-965 | ||
| S4411XS | 01 | 091-093 | S46209S | 21 | 913-914 | S49102D | 08 | 559-561 | ||
| S4412XA | 01 | 073-074 | S46211A | 08 | 562-563 | S49102G | 08 | 559-561 | ||
| S4412XA | 24 | 963-965 | S46211A | 24 | 963-965 | S49102K | 08 | 564-566 | ||
| S4412XD | 23 | 949-950 | S46211D | 23 | 949-950 | S49102P | 08 | 564-566 | ||
| S4412XS | 01 | 091-093 | S46211S | 08 | 562-563 | S49102S | 08 | 559-561 | ||
| S4420XA | 01 | 073-074 | S46212A | 08 | 562-563 | S49109A | 08 | 562-563 | ||
| S4420XA | 24 | 963-965 | S46212A | 24 | 963-965 | S49109A | 24 | 963-965 | ||
| S4420XD | 23 | 949-950 | S46212D | 23 | 949-950 | S49109D | 08 | 559-561 | ||
| S4420XS | 01 | 091-093 | S46212S | 08 | 562-563 | S49109G | 08 | 559-561 | ||
| S4421XA | 01 | 073-074 | S46219A | 08 | 562-563 | S49109K | 08 | 564-566 | ||
| S4421XA | 24 | 963-965 | S46219A | 24 | 963-965 | S49109P | 08 | 564-566 | ||
| S4421XD | 23 | 949-950 | S46219D | 23 | 949-950 | S49109S | 08 | 559-561 | ||
| S4421XS | 01 | 091-093 | S46219S | 08 | 562-563 | S49111A | 08 | 562-563 | ||
| S4422XA | 01 | 073-074 | S46221A | 08 | 564-566 | S49111A | 24 | 963-965 | ||
| S4422XA | 24 | 963-965 | S46221A | 24 | 963-965 | S49111D | 08 | 559-561 | ||
| S4422XD | 23 | 949-950 | S46221D | 23 | 949-950 | S49111G | 08 | 559-561 | ||
| S4422XS | 01 | 091-093 | S46221S | 09 | 604-605 | S49111K | 08 | 564-566 | ||
| S4430XA | 01 | 073-074 | S46222A | 08 | 564-566 | S49111P | 08 | 564-566 | ||
| S4430XA | 24 | 963-965 | S46222A | 24 | 963-965 | S49111S | 08 | 559-561 | ||
| S4430XD | 23 | 949-950 | S46222D | 23 | 949-950 | S49112A | 08 | 562-563 | ||
| S4430XS | 01 | 091-093 | S46222S | 09 | 604-605 | S49112A | 24 | 963-965 | ||
| S4431XA | 01 | 073-074 | S46229A | 08 | 564-566 | S49112D | 08 | 559-561 | ||
| S4431XA | 24 | 963-965 | S46229A | 24 | 963-965 | S49112G | 08 | 559-561 | ||
| S4431XD | 23 | 949-950 | S46229D | 23 | 949-950 | S49112K | 08 | 564-566 | ||
| S4431XS | 01 | 091-093 | S46229S | 09 | 604-605 | S49112P | 08 | 564-566 | ||
| S4432XA | 01 | 073-074 | S46291A | 21 | 913-914 | S49112S | 08 | 559-561 | ||
| S4432XA | 24 | 963-965 | S46291A | 24 | 963-965 | S49119A | 08 | 562-563 | ||
| S4432XD | 23 | 949-950 | S46291D | 23 | 949-950 | S49119A | 24 | 963-965 | ||
| S4432XS | 01 | 091-093 | S46291S | 21 | 913-914 | S49119D | 08 | 559-561 | ||
| S4440XA | 01 | 073-074 | S46292A | 21 | 913-914 | S49119G | 08 | 559-561 | ||
| S4440XA | 24 | 963-965 | S46292A | 24 | 963-965 | S49119K | 08 | 564-566 | ||
| S4440XD | 23 | 949-950 | S46292D | 23 | 949-950 | S49119P | 08 | 564-566 | ||
| S4440XS | 01 | 091-093 | S46292S | 21 | 913-914 | S49119S | 08 | 559-561 | ||
| S4441XA | 01 | 073-074 | S46299A | 21 | 913-914 | S49121A | 08 | 562-563 | ||
| S4441XA | 24 | 963-965 | S46299A | 24 | 963-965 | S49121A | 24 | 963-965 | ||
| S4441XD | 23 | 949-950 | S46299D | 23 | 949-950 | S49121D | 08 | 559-561 | ||
| S4441XS | 01 | 091-093 | S46299S | 21 | 913-914 | S49121G | 08 | 559-561 | ||
| S4442XA | 01 | 073-074 | S46301A | 21 | 913-914 | S49121K | 08 | 564-566 | ||
| S4442XA | 24 | 963-965 | S46301A | 24 | 963-965 | S49121P | 08 | 564-566 | ||
| S4442XD | 23 | 949-950 | S46301D | 23 | 949-950 | S49121S | 08 | 559-561 | ||
| S4442XS | 01 | 091-093 | S46301S | 21 | 913-914 | S49122A | 08 | 562-563 | ||
| S4450XA | 01 | 073-074 | S46302A | 21 | 913-914 | S49122A | 24 | 963-965 | ||
| S4450XA | 24 | 963-965 | S46302A | 24 | 963-965 | S49122D | 08 | 559-561 | ||
| S4450XD | 23 | 949-950 | S46302D | 23 | 949-950 | S49122G | 08 | 559-561 | ||
| S4450XS | 01 | 091-093 | S46302S | 21 | 913-914 | S49122K | 08 | 564-566 | ||
| S4451XA | 01 | 073-074 | S46309A | 21 | 913-914 | S49122P | 08 | 564-566 | ||
| S4451XA | 24 | 963-965 | S46309A | 24 | 963-965 | S49122S | 08 | 559-561 | ||
| S4451XD | 23 | 949-950 | S46309D | 23 | 949-950 | S49129A | 08 | 562-563 | ||
| S4451XS | 01 | 091-093 | S46309S | 21 | 913-914 | S49129A | 24 | 963-965 | ||
| S4452XA | 01 | 073-074 | S46311A | 08 | 562-563 | S49129D | 08 | 559-561 | ||
| S4452XA | 24 | 963-965 | S46311A | 24 | 963-965 | S49129G | 08 | 559-561 | ||
| S4452XD | 23 | 949-950 | S46311D | 23 | 949-950 | S49129K | 08 | 564-566 | ||
| S4452XS | 01 | 091-093 | S46311S | 08 | 562-563 | S49129P | 08 | 564-566 | ||
| S448X1A | 01 | 073-074 | S46312A | 08 | 562-563 | S49129S | 08 | 559-561 | ||
| S448X1A | 24 | 963-965 | S46312A | 24 | 963-965 | S49131A | 08 | 562-563 | ||
| S448X1D | 23 | 949-950 | S46312D | 23 | 949-950 | S49131A | 24 | 963-965 | ||
| S448X1S | 01 | 091-093 | S46312S | 08 | 562-563 | S49131D | 08 | 559-561 | ||
| S448X2A | 01 | 073-074 | S46319A | 08 | 562-563 | S49131G | 08 | 559-561 | ||
| S448X2A | 24 | 963-965 | S46319A | 24 | 963-965 | S49131K | 08 | 564-566 | ||
| S448X2D | 23 | 949-950 | S46319D | 23 | 949-950 | S49131P | 08 | 564-566 | ||
| S448X2S | 01 | 091-093 | S46319S | 08 | 562-563 | S49131S | 08 | 559-561 | ||
| S448X9A | 01 | 073-074 | S46321A | 08 | 564-566 | S49132A | 08 | 562-563 | ||
| S448X9A | 24 | 963-965 | S46321A | 24 | 963-965 | S49132A | 24 | 963-965 | ||
| S448X9D | 23 | 949-950 | S46321D | 23 | 949-950 | S49132D | 08 | 559-561 | ||
| S448X9S | 01 | 091-093 | S46321S | 09 | 604-605 | S49132G | 08 | 559-561 | ||
| S4490XA | 01 | 073-074 | S46322A | 08 | 564-566 | S49132K | 08 | 564-566 | ||
| S4490XA | 24 | 963-965 | S46322A | 24 | 963-965 | S49132P | 08 | 564-566 | ||
| S4490XD | 23 | 949-950 | S46322D | 23 | 949-950 | S49132S | 08 | 559-561 | ||
| S4490XS | 01 | 091-093 | S46322S | 09 | 604-605 | S49139A | 08 | 562-563 | ||
| S4491XA | 01 | 073-074 | S46329A | 08 | 564-566 | S49139A | 24 | 963-965 | ||
| S4491XA | 24 | 963-965 | S46329A | 24 | 963-965 | S49139D | 08 | 559-561 | ||
| S4491XD | 23 | 949-950 | S46329D | 23 | 949-950 | S49139G | 08 | 559-561 | ||
| S4491XS | 01 | 091-093 | S46329S | 09 | 604-605 | S49139K | 08 | 564-566 | ||
| S4492XA | 01 | 073-074 | S46391A | 21 | 913-914 | S49139P | 08 | 564-566 | ||
| S4492XA | 24 | 963-965 | S46391A | 24 | 963-965 | S49139S | 08 | 559-561 | ||
| S4492XD | 23 | 949-950 | S46391D | 23 | 949-950 | S49141A | 08 | 562-563 | ||
| S4492XS | 01 | 091-093 | S46391S | 21 | 913-914 | S49141A | 24 | 963-965 | ||
| S45001A | 21 | 913-914 | S46392A | 21 | 913-914 | S49141D | 08 | 559-561 | ||
| S45001A | 24 | 963-965 | S46392A | 24 | 963-965 | S49141G | 08 | 559-561 | ||
| S45001D | 23 | 949-950 | S46392D | 23 | 949-950 | S49141K | 08 | 564-566 | ||
| S45001S | 05 | 299-301 | S46392S | 21 | 913-914 | S49141P | 08 | 564-566 | ||
| S45002A | 21 | 913-914 | S46399A | 21 | 913-914 | S49141S | 08 | 559-561 | ||
| S45002A | 24 | 963-965 | S46399A | 24 | 963-965 | S49142A | 08 | 562-563 | ||
| S45002D | 23 | 949-950 | S46399D | 23 | 949-950 | S49142A | 24 | 963-965 | ||
| S45002S | 05 | 299-301 | S46399S | 21 | 913-914 | S49142D | 08 | 559-561 | ||
| S45009A | 21 | 913-914 | S46801A | 21 | 913-914 | S49142G | 08 | 559-561 | ||
| S45009A | 24 | 963-965 | S46801A | 24 | 963-965 | S49142K | 08 | 564-566 | ||
| S45009D | 23 | 949-950 | S46801D | 23 | 949-950 | S49142P | 08 | 564-566 | ||
| S45009S | 05 | 299-301 | S46801S | 21 | 913-914 | S49142S | 08 | 559-561 | ||
| S45011A | 21 | 913-914 | S46802A | 21 | 913-914 | S49149A | 08 | 562-563 | ||
| S45011A | 24 | 963-965 | S46802A | 24 | 963-965 | S49149A | 24 | 963-965 | ||
| S45011D | 23 | 949-950 | S46802D | 23 | 949-950 | S49149D | 08 | 559-561 | ||
| S45011S | 05 | 299-301 | S46802S | 21 | 913-914 | S49149G | 08 | 559-561 | ||
| S45012A | 21 | 913-914 | S46809A | 21 | 913-914 | S49149K | 08 | 564-566 | ||
| S45012A | 24 | 963-965 | S46809A | 24 | 963-965 | S49149P | 08 | 564-566 | ||
| S45012D | 23 | 949-950 | S46809D | 23 | 949-950 | S49149S | 08 | 559-561 | ||
| S45012S | 05 | 299-301 | S46809S | 21 | 913-914 | S49191A | 08 | 562-563 | ||
| S45019A | 21 | 913-914 | S46811A | 08 | 562-563 | S49191A | 24 | 963-965 | ||
| S45019A | 24 | 963-965 | S46811A | 24 | 963-965 | S49191D | 08 | 559-561 | ||
| S45019D | 23 | 949-950 | S46811D | 23 | 949-950 | S49191G | 08 | 559-561 | ||
| S45019S | 05 | 299-301 | S46811S | 08 | 562-563 | S49191K | 08 | 564-566 | ||
| S45091A | 21 | 913-914 | S46812A | 08 | 562-563 | S49191P | 08 | 564-566 | ||
| S45091A | 24 | 963-965 | S46812A | 24 | 963-965 | S49191S | 08 | 559-561 | ||
| S45091D | 23 | 949-950 | S46812D | 23 | 949-950 | S49192A | 08 | 562-563 | ||
| S45091S | 05 | 299-301 | S46812S | 08 | 562-563 | S49192A | 24 | 963-965 | ||
| S45092A | 21 | 913-914 | S46819A | 08 | 562-563 | S49192D | 08 | 559-561 | ||
| S45092A | 24 | 963-965 | S46819A | 24 | 963-965 | S49192G | 08 | 559-561 | ||
| S45092D | 23 | 949-950 | S46819D | 23 | 949-950 | S49192K | 08 | 564-566 | ||
| S45092S | 05 | 299-301 | S46819S | 08 | 562-563 | S49192P | 08 | 564-566 | ||
| S45099A | 21 | 913-914 | S46821A | 08 | 564-566 | S49192S | 08 | 559-561 | ||
| S45099A | 24 | 963-965 | S46821A | 24 | 963-965 | S49199A | 08 | 562-563 | ||
| S45099D | 23 | 949-950 | S46821D | 23 | 949-950 | S49199A | 24 | 963-965 | ||
| S45099S | 05 | 299-301 | S46821S | 09 | 604-605 | S49199D | 08 | 559-561 | ||
| S45101A | 21 | 913-914 | S46822A | 08 | 564-566 | S49199G | 08 | 559-561 | ||
| S45101A | 24 | 963-965 | S46822A | 24 | 963-965 | S49199K | 08 | 564-566 | ||
| S45101D | 23 | 949-950 | S46822D | 23 | 949-950 | S49199P | 08 | 564-566 | ||
| S45101S | 05 | 299-301 | S46822S | 09 | 604-605 | S49199S | 08 | 559-561 | ||
| S45102A | 21 | 913-914 | S46829A | 08 | 564-566 | S4980XA | 21 | 913-914 | ||
| S45102A | 24 | 963-965 | S46829A | 24 | 963-965 | S4980XA | 24 | 963-965 | ||
| S45102D | 23 | 949-950 | S46829D | 23 | 949-950 | S4980XD | 23 | 949-950 | ||
| S45102S | 05 | 299-301 | S46829S | 09 | 604-605 | S4980XS | 21 | 913-914 | ||
| S45109A | 21 | 913-914 | S46891A | 21 | 913-914 | S4981XA | 21 | 913-914 | ||
| S45109A | 24 | 963-965 | S46891A | 24 | 963-965 | S4981XA | 24 | 963-965 | ||
| S45109D | 23 | 949-950 | S46891D | 23 | 949-950 | S4981XD | 23 | 949-950 | ||
| S45109S | 05 | 299-301 | S46891S | 21 | 913-914 | S4981XS | 21 | 913-914 | ||
| S45111A | 21 | 913-914 | S46892A | 21 | 913-914 | S4982XA | 21 | 913-914 | ||
| S45111A | 24 | 963-965 | S46892A | 24 | 963-965 | S4982XA | 24 | 963-965 | ||
| S45111D | 23 | 949-950 | S46892D | 23 | 949-950 | S4982XD | 23 | 949-950 | ||
| S45111S | 05 | 299-301 | S46892S | 21 | 913-914 | S4982XS | 21 | 913-914 | ||
| S45112A | 21 | 913-914 | S46899A | 21 | 913-914 | S4990XA | 21 | 913-914 | ||
| S45112A | 24 | 963-965 | S46899A | 24 | 963-965 | S4990XA | 24 | 963-965 | ||
| S45112D | 23 | 949-950 | S46899D | 23 | 949-950 | S4990XD | 23 | 949-950 | ||
| S45112S | 05 | 299-301 | S46899S | 21 | 913-914 | S4990XS | 21 | 913-914 | ||
| S45119A | 21 | 913-914 | S46901A | 21 | 913-914 | S4991XA | 21 | 913-914 | ||
| S45119A | 24 | 963-965 | S46901A | 24 | 963-965 | S4991XA | 24 | 963-965 | ||
| S45119D | 23 | 949-950 | S46901D | 23 | 949-950 | S4991XD | 23 | 949-950 | ||
| S45119S | 05 | 299-301 | S46901S | 21 | 913-914 | S4991XS | 21 | 913-914 | ||
| S45191A | 21 | 913-914 | S46902A | 21 | 913-914 | S4992XA | 21 | 913-914 | ||
| S45191A | 24 | 963-965 | S46902A | 24 | 963-965 | S4992XA | 24 | 963-965 | ||
| S45191D | 23 | 949-950 | S46902D | 23 | 949-950 | S4992XD | 23 | 949-950 | ||
| S45191S | 05 | 299-301 | S46902S | 21 | 913-914 | S4992XS | 21 | 913-914 | ||
| S45192A | 21 | 913-914 | S46909A | 21 | 913-914 | S5000XA | 09 | 604-605 | ||
| S45192A | 24 | 963-965 | S46909A | 24 | 963-965 | S5000XA | 24 | 963-965 | ||
| S45192D | 23 | 949-950 | S46909D | 23 | 949-950 | S5000XD | 23 | 949-950 | ||
| S45192S | 05 | 299-301 | S46909S | 21 | 913-914 | S5000XS | 09 | 604-605 | ||
| S45199A | 21 | 913-914 | S46911A | 08 | 562-563 | S5001XA | 09 | 604-605 | ||
| S45199A | 24 | 963-965 | S46911A | 24 | 963-965 | S5001XA | 24 | 963-965 | ||
| S45199D | 23 | 949-950 | S46911D | 23 | 949-950 | S5001XD | 23 | 949-950 | ||
| S45199S | 05 | 299-301 | S46911S | 08 | 562-563 | S5001XS | 09 | 604-605 | ||
| S45201A | 21 | 913-914 | S46912A | 08 | 562-563 | S5002XA | 09 | 604-605 | ||
| S45201A | 24 | 963-965 | S46912A | 24 | 963-965 | S5002XA | 24 | 963-965 | ||
| S45201D | 23 | 949-950 | S46912D | 23 | 949-950 | S5002XD | 23 | 949-950 | ||
| S45201S | 05 | 299-301 | S46912S | 08 | 562-563 | S5002XS | 09 | 604-605 | ||
| S45202A | 21 | 913-914 | S46919A | 08 | 562-563 | S5010XA | 09 | 604-605 | ||
| S45202A | 24 | 963-965 | S46919A | 24 | 963-965 | S5010XA | 24 | 963-965 | ||
| S45202D | 23 | 949-950 | S46919D | 23 | 949-950 | S5010XD | 23 | 949-950 | ||
| S45202S | 05 | 299-301 | S46919S | 08 | 562-563 | S5010XS | 09 | 604-605 | ||
| S45209A | 21 | 913-914 | S46921A | 08 | 564-566 | S5011XA | 09 | 604-605 | ||
| S45209A | 24 | 963-965 | S46921A | 24 | 963-965 | S5011XA | 24 | 963-965 | ||
| S45209D | 23 | 949-950 | S46921D | 23 | 949-950 | S5011XD | 23 | 949-950 | ||
| S45209S | 05 | 299-301 | S46921S | 09 | 604-605 | S5011XS | 09 | 604-605 | ||
| S45211A | 21 | 913-914 | S46922A | 08 | 564-566 | S5012XA | 09 | 604-605 | ||
| S45211A | 24 | 963-965 | S46922A | 24 | 963-965 | S5012XA | 24 | 963-965 | ||
| S45211D | 23 | 949-950 | S46922D | 23 | 949-950 | S5012XD | 23 | 949-950 | ||
| S45211S | 05 | 299-301 | S46922S | 09 | 604-605 | S5012XS | 09 | 604-605 | ||
| S45212A | 21 | 913-914 | S46929A | 08 | 564-566 | S50311A | 09 | 604-605 | ||
| S45212A | 24 | 963-965 | S46929A | 24 | 963-965 | S50311A | 24 | 963-965 | ||
| S45212D | 23 | 949-950 | S46929D | 23 | 949-950 | S50311D | 23 | 949-950 | ||
| S45212S | 05 | 299-301 | S46929S | 09 | 604-605 | S50311S | 09 | 604-605 | ||
| S45219A | 21 | 913-914 | S46991A | 21 | 913-914 | S50312A | 09 | 604-605 | ||
| S45219A | 24 | 963-965 | S46991A | 24 | 963-965 | S50312A | 24 | 963-965 | ||
| S45219D | 23 | 949-950 | S46991D | 23 | 949-950 | S50312D | 23 | 949-950 | ||
| S45219S | 05 | 299-301 | S46991S | 21 | 913-914 | S50312S | 09 | 604-605 | ||
| S45291A | 21 | 913-914 | S46992A | 21 | 913-914 | S50319A | 09 | 604-605 | ||
| S45291A | 24 | 963-965 | S46992A | 24 | 963-965 | S50319A | 24 | 963-965 | ||
| S45291D | 23 | 949-950 | S46992D | 23 | 949-950 | S50319D | 23 | 949-950 | ||
| S45291S | 05 | 299-301 | S46992S | 21 | 913-914 | S50319S | 09 | 604-605 | ||
| S45292A | 21 | 913-914 | S46999A | 21 | 913-914 | S50321A | 09 | 606-607 | ||
| S45292A | 24 | 963-965 | S46999A | 24 | 963-965 | S50321A | 24 | 963-965 | ||
| S45292D | 23 | 949-950 | S46999D | 23 | 949-950 | S50321D | 23 | 949-950 | ||
| S45292S | 05 | 299-301 | S46999S | 21 | 913-914 | S50321S | 09 | 604-605 | ||
| S45299A | 21 | 913-914 | S471XXA | 21 | 913-914 | S50322A | 09 | 606-607 | ||
| S45299A | 24 | 963-965 | S471XXA | 24 | 963-965 | S50322A | 24 | 963-965 | ||
| S45299D | 23 | 949-950 | S471XXD | 23 | 949-950 | S50322D | 23 | 949-950 | ||
| S45299S | 05 | 299-301 | S471XXS | 09 | 604-605 | S50322S | 09 | 604-605 | ||
| S45301A | 21 | 913-914 | S472XXA | 21 | 913-914 | S50329A | 09 | 606-607 | ||
| S45301A | 24 | 963-965 | S472XXA | 24 | 963-965 | S50329A | 24 | 963-965 | ||
| S45301D | 23 | 949-950 | S472XXD | 23 | 949-950 | S50329D | 23 | 949-950 | ||
| S45301S | 05 | 299-301 | S472XXS | 09 | 604-605 | S50329S | 09 | 604-605 | ||
| S45302A | 21 | 913-914 | S479XXA | 21 | 913-914 | S50341A | 09 | 604-605 | ||
| S45302A | 24 | 963-965 | S479XXA | 24 | 963-965 | S50341A | 24 | 963-965 | ||
| S45302D | 23 | 949-950 | S479XXD | 23 | 949-950 | S50341D | 23 | 949-950 | ||
| S45302S | 05 | 299-301 | S479XXS | 09 | 604-605 | S50341S | 09 | 604-605 | ||
| S45309A | 21 | 913-914 | S48011A | 21 | 913-914 | S50342A | 09 | 604-605 | ||
| S45309A | 24 | 963-965 | S48011A | 24 | 963-965 | S50342A | 24 | 963-965 | ||
| S45309D | 23 | 949-950 | S48011D | 23 | 949-950 | S50342D | 23 | 949-950 | ||
| S45309S | 05 | 299-301 | S48011S | 08 | 559-561 | S50342S | 09 | 604-605 | ||
| S45311A | 21 | 913-914 | S48012A | 21 | 913-914 | S50349A | 09 | 604-605 | ||
| S45311A | 24 | 963-965 | S48012A | 24 | 963-965 | S50349A | 24 | 963-965 | ||
| S45311D | 23 | 949-950 | S48012D | 23 | 949-950 | S50349D | 23 | 949-950 | ||
| S45311S | 05 | 299-301 | S48012S | 08 | 559-561 | S50349S | 09 | 604-605 | ||
| S45312A | 21 | 913-914 | S48019A | 21 | 913-914 | S50351A | 09 | 604-605 | ||
| S45312A | 24 | 963-965 | S48019A | 24 | 963-965 | S50351A | 24 | 963-965 | ||
| S45312D | 23 | 949-950 | S48019D | 23 | 949-950 | S50351D | 23 | 949-950 | ||
| S45312S | 05 | 299-301 | S48019S | 08 | 559-561 | S50351S | 09 | 604-605 | ||
| S45319A | 21 | 913-914 | S48021A | 21 | 913-914 | S50352A | 09 | 604-605 | ||
| S45319A | 24 | 963-965 | S48021A | 24 | 963-965 | S50352A | 24 | 963-965 | ||
| S45319D | 23 | 949-950 | S48021D | 23 | 949-950 | S50352D | 23 | 949-950 | ||
| S45319S | 05 | 299-301 | S48021S | 08 | 559-561 | S50352S | 09 | 604-605 | ||
| S45391A | 21 | 913-914 | S48022A | 21 | 913-914 | S50359A | 09 | 604-605 | ||
| S45391A | 24 | 963-965 | S48022A | 24 | 963-965 | S50359A | 24 | 963-965 | ||
| S45391D | 23 | 949-950 | S48022D | 23 | 949-950 | S50359D | 23 | 949-950 | ||
| S45391S | 05 | 299-301 | S48022S | 08 | 559-561 | S50359S | 09 | 604-605 | ||
| S45392A | 21 | 913-914 | S48029A | 21 | 913-914 | S50361A | 09 | 606-607 | ||
| S45392A | 24 | 963-965 | S48029A | 24 | 963-965 | S50361A | 24 | 963-965 | ||
| S45392D | 23 | 949-950 | S48029D | 23 | 949-950 | S50361D | 23 | 949-950 | ||
| S45392S | 05 | 299-301 | S48029S | 08 | 559-561 | S50361S | 09 | 604-605 | ||
| S45399A | 21 | 913-914 | S48111A | 21 | 913-914 | S50362A | 09 | 606-607 | ||
| S45399A | 24 | 963-965 | S48111A | 24 | 963-965 | S50362A | 24 | 963-965 | ||
| S45399D | 23 | 949-950 | S48111D | 23 | 949-950 | S50362D | 23 | 949-950 | ||
| S45399S | 05 | 299-301 | S48111S | 08 | 559-561 | S50362S | 09 | 604-605 | ||
| S45801A | 21 | 913-914 | S48112A | 21 | 913-914 | S50369A | 09 | 606-607 | ||
| S45801A | 24 | 963-965 | S48112A | 24 | 963-965 | S50369A | 24 | 963-965 | ||
| S45801D | 23 | 949-950 | S48112D | 23 | 949-950 | S50369D | 23 | 949-950 | ||
| S45801S | 05 | 299-301 | S48112S | 08 | 559-561 | S50369S | 09 | 604-605 | ||
| S45802A | 21 | 913-914 | S48119A | 21 | 913-914 | S50371A | 09 | 604-605 | ||
| S45802A | 24 | 963-965 | S48119A | 24 | 963-965 | S50371A | 24 | 963-965 | ||
| S45802D | 23 | 949-950 | S48119D | 23 | 949-950 | S50371D | 23 | 949-950 | ||
| S45802S | 05 | 299-301 | S48119S | 08 | 559-561 | S50371S | 09 | 604-605 | ||
| S45809A | 21 | 913-914 | S48121A | 21 | 913-914 | S50372A | 09 | 604-605 | ||
| S45809A | 24 | 963-965 | S48121A | 24 | 963-965 | S50372A | 24 | 963-965 | ||
| S45809D | 23 | 949-950 | S48121D | 23 | 949-950 | S50372D | 23 | 949-950 | ||
| S45809S | 05 | 299-301 | S48121S | 08 | 559-561 | S50372S | 09 | 604-605 | ||
| S45811A | 21 | 913-914 | S48122A | 21 | 913-914 | S50379A | 09 | 604-605 | ||
| S45811A | 24 | 963-965 | S48122A | 24 | 963-965 | S50379A | 24 | 963-965 | ||
| S45811D | 23 | 949-950 | S48122D | 23 | 949-950 | S50379D | 23 | 949-950 | ||
| S45811S | 05 | 299-301 | S48122S | 08 | 559-561 | S50379S | 09 | 604-605 | ||
| S45812A | 21 | 913-914 | S48129A | 21 | 913-914 | S50811A | 09 | 604-605 | ||
| S45812A | 24 | 963-965 | S48129A | 24 | 963-965 | S50811A | 24 | 963-965 | ||
| S45812D | 23 | 949-950 | S48129D | 23 | 949-950 | S50811D | 23 | 949-950 | ||
| S45812S | 05 | 299-301 | S48129S | 08 | 559-561 | S50811S | 09 | 604-605 | ||
| S45819A | 21 | 913-914 | S48911A | 21 | 913-914 | S50812A | 09 | 604-605 | ||
| S45819A | 24 | 963-965 | S48911A | 24 | 963-965 | S50812A | 24 | 963-965 | ||
| S45819D | 23 | 949-950 | S48911D | 23 | 949-950 | S50812D | 23 | 949-950 | ||
| S45819S | 05 | 299-301 | S48911S | 08 | 559-561 | S50812S | 09 | 604-605 | ||
| S45891A | 21 | 913-914 | S48912A | 21 | 913-914 | S50819A | 09 | 604-605 | ||
| S45891A | 24 | 963-965 | S48912A | 24 | 963-965 | S50819A | 24 | 963-965 | ||
| S45891D | 23 | 949-950 | S48912D | 23 | 949-950 | S50819D | 23 | 949-950 | ||
| S45891S | 05 | 299-301 | S48912S | 08 | 559-561 | S50819S | 09 | 604-605 | ||
| S45892A | 21 | 913-914 | S48919A | 21 | 913-914 | S50821A | 09 | 606-607 | ||
| S45892A | 24 | 963-965 | S48919A | 24 | 963-965 | S50821A | 24 | 963-965 | ||
| S45892D | 23 | 949-950 | S48919D | 23 | 949-950 | S50821D | 23 | 949-950 | ||
| S45892S | 05 | 299-301 | S48919S | 08 | 559-561 | S50821S | 09 | 604-605 | ||
| S45899A | 21 | 913-914 | S48921A | 21 | 913-914 | S50822A | 09 | 606-607 | ||
| S45899A | 24 | 963-965 | S48921A | 24 | 963-965 | S50822A | 24 | 963-965 | ||
| S45899D | 23 | 949-950 | S48921D | 23 | 949-950 | S50822D | 23 | 949-950 | ||
| S45899S | 05 | 299-301 | S48921S | 08 | 559-561 | S50822S | 09 | 604-605 | ||
| S45901A | 21 | 913-914 | S48922A | 21 | 913-914 | S50829A | 09 | 606-607 | ||
| S45901A | 24 | 963-965 | S48922A | 24 | 963-965 | S50829A | 24 | 963-965 | ||
| S45901D | 23 | 949-950 | S48922D | 23 | 949-950 | S50829D | 23 | 949-950 | ||
| S45901S | 05 | 299-301 | S48922S | 08 | 559-561 | S50829S | 09 | 604-605 | ||
| S45902A | 21 | 913-914 | S48929A | 21 | 913-914 | S50841A | 09 | 604-605 | ||
| S45902A | 24 | 963-965 | S48929A | 24 | 963-965 | S50841A | 24 | 963-965 | ||
| S45902D | 23 | 949-950 | S48929D | 23 | 949-950 | S50841D | 23 | 949-950 | ||
| S45902S | 05 | 299-301 | S48929S | 08 | 559-561 | S50841S | 09 | 604-605 | ||
| S45909A | 21 | 913-914 | S49001A | 08 | 562-563 | S50842A | 09 | 604-605 | ||
| S45909A | 24 | 963-965 | S49001A | 24 | 963-965 | S50842A | 24 | 963-965 | ||
| S45909D | 23 | 949-950 | S49001D | 08 | 559-561 | S50842D | 23 | 949-950 | ||
| S45909S | 05 | 299-301 | S49001G | 08 | 559-561 | S50842S | 09 | 604-605 | ||
| S45911A | 21 | 913-914 | S49001K | 08 | 564-566 | S50849A | 09 | 604-605 | ||
| S45911A | 24 | 963-965 | S49001P | 08 | 564-566 | S50849A | 24 | 963-965 | ||
| S45911D | 23 | 949-950 | S49001S | 08 | 559-561 | S50849D | 23 | 949-950 | ||
| S45911S | 05 | 299-301 | S49002A | 08 | 562-563 | S50849S | 09 | 604-605 | ||
| S45912A | 21 | 913-914 | S49002A | 24 | 963-965 | S50851A | 09 | 604-605 | ||
| S45912A | 24 | 963-965 | S49002D | 08 | 559-561 | S50851A | 24 | 963-965 | ||
| S45912D | 23 | 949-950 | S49002G | 08 | 559-561 | S50851D | 23 | 949-950 | ||
| S45912S | 05 | 299-301 | S49002K | 08 | 564-566 | S50851S | 09 | 604-605 | ||
| S45919A | 21 | 913-914 | S49002P | 08 | 564-566 | S50852A | 09 | 604-605 | ||
| S45919A | 24 | 963-965 | S49002S | 08 | 559-561 | S50852A | 24 | 963-965 | ||
| S45919D | 23 | 949-950 | S49009A | 08 | 562-563 | S50852D | 23 | 949-950 | ||
| S45919S | 05 | 299-301 | S49009A | 24 | 963-965 | S50852S | 09 | 604-605 | ||
| S45991A | 21 | 913-914 | S49009D | 08 | 559-561 | S50859A | 09 | 604-605 | ||
| S45991A | 24 | 963-965 | S49009G | 08 | 559-561 | S50859A | 24 | 963-965 | ||
| S45991D | 23 | 949-950 | S49009K | 08 | 564-566 | S50859D | 23 | 949-950 | ||
| S45991S | 05 | 299-301 | S49009P | 08 | 564-566 | S50859S | 09 | 604-605 | ||
| S45992A | 21 | 913-914 | S49009S | 08 | 559-561 | S50861A | 09 | 606-607 | ||
| S45992A | 24 | 963-965 | S49011A | 08 | 562-563 | S50861A | 24 | 963-965 | ||
| S45992D | 23 | 949-950 | S49011A | 24 | 963-965 | S50861D | 23 | 949-950 | ||
| S45992S | 05 | 299-301 | S49011D | 08 | 559-561 | S50861S | 09 | 604-605 | ||
| S45999A | 21 | 913-914 | S49011G | 08 | 559-561 | S50862A | 09 | 606-607 | ||
| S45999A | 24 | 963-965 | S49011K | 08 | 564-566 | S50862A | 24 | 963-965 | ||
| S45999D | 23 | 949-950 | S49011P | 08 | 564-566 | S50862D | 23 | 949-950 | ||
| S45999S | 05 | 299-301 | S49011S | 08 | 559-561 | S50862S | 09 | 604-605 | ||
| S46001A | 21 | 913-914 | S49012A | 08 | 562-563 | S50869A | 09 | 606-607 | ||
| S46001A | 24 | 963-965 | S49012A | 24 | 963-965 | S50869A | 24 | 963-965 | ||
| S46001D | 23 | 949-950 | S49012D | 08 | 559-561 | S50869D | 23 | 949-950 | ||
| S46001S | 21 | 913-914 | S49012G | 08 | 559-561 | S50869S | 09 | 604-605 | ||
| S46002A | 21 | 913-914 | S49012K | 08 | 564-566 | S50871A | 09 | 604-605 | ||
| S46002A | 24 | 963-965 | S49012P | 08 | 564-566 | S50871A | 24 | 963-965 | ||
| S46002D | 23 | 949-950 | S49012S | 08 | 559-561 | S50871D | 23 | 949-950 | ||
| S46002S | 21 | 913-914 | S49019A | 08 | 562-563 | S50871S | 09 | 604-605 | ||
| S46009A | 21 | 913-914 | S49019A | 24 | 963-965 | S50872A | 09 | 604-605 | ||
| S46009A | 24 | 963-965 | S49019D | 08 | 559-561 | S50872A | 24 | 963-965 | ||
| S46009D | 23 | 949-950 | S49019G | 08 | 559-561 | S50872D | 23 | 949-950 | ||
| S46009S | 21 | 913-914 | S49019K | 08 | 564-566 | S50872S | 09 | 604-605 | ||
| S46011A | 08 | 562-563 | S49019P | 08 | 564-566 | S50879A | 09 | 604-605 | ||
| S46011A | 24 | 963-965 | S49019S | 08 | 559-561 | S50879A | 24 | 963-965 | ||
| S46011D | 23 | 949-950 | S49021A | 08 | 562-563 | S50879D | 23 | 949-950 | ||
| S46011S | 08 | 562-563 | S49021A | 24 | 963-965 | S50879S | 09 | 604-605 | ||
| S46012A | 08 | 562-563 | S49021D | 08 | 559-561 | S50901A | 09 | 604-605 | ||
| S46012A | 24 | 963-965 | S49021G | 08 | 559-561 | S50901A | 24 | 963-965 | ||
| S46012D | 23 | 949-950 | S49021K | 08 | 564-566 | S50901D | 23 | 949-950 | ||
| S46012S | 08 | 562-563 | S49021P | 08 | 564-566 | S50901S | 09 | 604-605 | ||
| S46019A | 08 | 562-563 | S49021S | 08 | 559-561 | S50902A | 09 | 604-605 | ||
| S46019A | 24 | 963-965 | S49022A | 08 | 562-563 | S50902A | 24 | 963-965 | ||
| S46019D | 23 | 949-950 | S49022A | 24 | 963-965 | S50902D | 23 | 949-950 | ||
| S46019S | 08 | 562-563 | S49022D | 08 | 559-561 | S50902S | 09 | 604-605 | ||
| S46021A | 08 | 564-566 | S49022G | 08 | 559-561 | S50909A | 09 | 604-605 | ||
| S46021A | 24 | 963-965 | S49022K | 08 | 564-566 | S50909A | 24 | 963-965 | ||
| S46021D | 23 | 949-950 | S49022P | 08 | 564-566 | S50909D | 23 | 949-950 | ||
| S46021S | 09 | 604-605 | S49022S | 08 | 559-561 | S50909S | 09 | 604-605 | ||
| S46022A | 08 | 564-566 | S49029A | 08 | 562-563 | S50911A | 09 | 604-605 | ||
| S46022A | 24 | 963-965 | S49029A | 24 | 963-965 | S50911A | 24 | 963-965 |
| | |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Mar 2026 13:16:25 CMS, code-revision=381, description-revision=1473 |