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 E04 Surgical Procedures, Operative D013514 +
  E04.950 Urogenital Surgical Procedures D013519 +
   E04.950.599 Sterilization, Reproductive D013245 +
    E04.950.599.900 Vasectomy D014659 
 E04 Surgical Procedures, Operative D013514 +
  E04.950 Urogenital Surgical Procedures D013519 +
   E04.950.774 Urologic Surgical Procedures D013520 +
    E04.950.774.860 Urologic Surgical Procedures, Male D013521 +
     E04.950.774.860.856 Vasectomy D014659