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This product contains material and information that is confidential and proprietary to Solventum and its licensors. The use of this product is governed by a license agreement. Except as explicitly permitted in the license agreement or permitted in writing by Solventum, no part of this product shall be: (i) reproduced, in whole or in part, by any electronic or mechanical means, (ii) disclosed or otherwise made available to, or accessible by, any third party (iii) sublicensed, leased, lent, or transferred to any third party, (iv) used for the benefit of any party other than the licensee, (v) disassembled, decrypted, decompiled, reverse-engineered, or (vi) used to create derivative works. This product includes commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which were developed exclusively at private expense by Solventum, its subsidiaries, affiliates and licensors. Applicable FAR/DFARS restrictions, and associated license terms, apply to US Government use. Solventum Health Information Systems can be contacted at 575 West Murray Boulevard, Murray, UT 84123. It is the policy of Solventum HIS to improve products as new technology and software become available. Because of this, Solventum HIS reserves the right to make changes in the specifications and materials contained herein without notice. Solventum complies with all applicable federal and state laws and regulations pertaining to patient privacy.

Solventum, the S logo and other trademarks are trademarks of Solventum or its affiliates. Other trademarks are the property of their respective owners.

Incorporating the International Statistical Classification of Diseases and Related Health Problems - Tenth Revision (ICD-10), Copyright World Health Organization, Geneva, Switzerland, 1992-2010.

If this product includes CPT® or CPT® Assistant, the following notices are applicable. CPT © 2024 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. This product includes CPT and/or CPT Assistant which is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 330 N. Wabash, Suite 39300, Chicago, IL 60611-5885. The responsibility for the content of any "National Correct Coding Policy" included in this product is with the Centers for Medicare & Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse or interpretation of information contained in this product. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.277014 (June 1987) and/or subject to the restricted rights provisions of FAR 52.22714 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

© ISO. All Rights Reserved.

If this product includes UB-04 information: Copyright 2025, American Hospital Association ("AHA"), Chicago, Illinois. Reproduced with permission. No portion of this publication may be reproduced, sorted in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior express, written consent of AHA.

The National Committee for Quality Assurance (NCQA) Copyright Notice and Disclaimer

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA. NCQA HEDIS Allowable Adjustments Measure Certification Program™ is a trademark of NCQA.

NCQA holds a copyright in these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than NCQA. Use of the Rules for Allowable Adjustments of HEDIS to make permitted adjustments of the materials does not constitute a modification. Any commercial use and/or internal or external reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA. Any use of the materials to identify records or calculate measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program. Reprinted with permission by NCQA. © 2025 NCQA, all rights reserved.

Limited proprietary coding is contained in the measure specifications for convenience. NCQA disclaims all liability for use or accuracy of any third-party code values contained in the specifications.

The American Medical Association holds a copyright to the CPT® codes contained in the measure specifications.

The American Hospital Association holds a copyright to the Uniform Billing Codes (“UB”) contained in the measure specifications. The UB Codes in the HEDIS specifications are included with the permission of the AHA. The UB Codes contained in the HEDIS specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting HEDIS measure results or using HEDIS measure results for their internal quality improvement purposes. All other uses of the UB Codes require a license from the AHA. Anyone desiring to use the UB Codes in a commercial product to generate HEDIS results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@aha.org.

Dental procedure codes © 2025 American Dental Association.