ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v42.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 52 of 75 |
| A000 B2781 C5712 C8395 D107 E083542 E1301 F13259 G543 H16041 H4303 H8393 I63541 I97610 K4020 L0882 M00239 M19072 M314 M6519 M84311S M84759P M96830 N8501 O2990 O35GXX1 O4192X9 O99845 Q51818 R502 S02118D S06319D S1192XA S15399D S22082B S30823D S32309A S35221D S39002D S42261D S43202A S4991XA S52201Q S52345P S52699N S56909D S60929A S62136P S62390B S63208D S65500D S68619D S72043S S72133F S72355A S7291XC S80211S S82132R S82399Q S82854P S85801A S90821D S92153B S93103D S99032A T2161XA T23661D T3371XA T40903A T457X5D T50B15D T632X3D T8112XD T8454XD Z4801 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S68619D | 23 | 949-950 | S71139D | 23 | 949-950 | S72025B | 08 | 521-522 | ||
| S68619S | 08 | 559-561 | S71139S | 09 | 604-605 | S72025B | 08 | 535-536 | ||
| S68620A | 21 | 913-914 | S71141A | 21 | 913-914 | S72025B | 15 | 791 | ||
| S68620A | 24 | 963-965 | S71141A | 24 | 963-965 | S72025B | 15 | 793 | ||
| S68620D | 23 | 949-950 | S71141D | 23 | 949-950 | S72025B | 24 | 963-965 | ||
| S68620S | 08 | 559-561 | S71141S | 09 | 604-605 | S72025C | 08 | 521-522 | ||
| S68621A | 21 | 913-914 | S71142A | 21 | 913-914 | S72025C | 08 | 535-536 | ||
| S68621A | 24 | 963-965 | S71142A | 24 | 963-965 | S72025C | 15 | 791 | ||
| S68621D | 23 | 949-950 | S71142D | 23 | 949-950 | S72025C | 15 | 793 | ||
| S68621S | 08 | 559-561 | S71142S | 09 | 604-605 | S72025C | 24 | 963-965 | ||
| S68622A | 21 | 913-914 | S71149A | 21 | 913-914 | S72025D | 08 | 559-561 | ||
| S68622A | 24 | 963-965 | S71149A | 24 | 963-965 | S72025E | 08 | 559-561 | ||
| S68622D | 23 | 949-950 | S71149D | 23 | 949-950 | S72025F | 08 | 559-561 | ||
| S68622S | 08 | 559-561 | S71149S | 09 | 604-605 | S72025G | 08 | 521-522 | ||
| S68623A | 21 | 913-914 | S71151A | 09 | 604-605 | S72025G | 08 | 559-561 | ||
| S68623A | 24 | 963-965 | S71151A | 24 | 963-965 | S72025H | 08 | 521-522 | ||
| S68623D | 23 | 949-950 | S71151D | 23 | 949-950 | S72025H | 08 | 559-561 | ||
| S68623S | 08 | 559-561 | S71151S | 09 | 604-605 | S72025J | 08 | 521-522 | ||
| S68624A | 21 | 913-914 | S71152A | 09 | 604-605 | S72025J | 08 | 559-561 | ||
| S68624A | 24 | 963-965 | S71152A | 24 | 963-965 | S72025K | 08 | 521-522 | ||
| S68624D | 23 | 949-950 | S71152D | 23 | 949-950 | S72025K | 08 | 564-566 | ||
| S68624S | 08 | 559-561 | S71152S | 09 | 604-605 | S72025M | 08 | 521-522 | ||
| S68625A | 21 | 913-914 | S71159A | 09 | 604-605 | S72025M | 08 | 564-566 | ||
| S68625A | 24 | 963-965 | S71159A | 24 | 963-965 | S72025N | 08 | 521-522 | ||
| S68625D | 23 | 949-950 | S71159D | 23 | 949-950 | S72025N | 08 | 564-566 | ||
| S68625S | 08 | 559-561 | S71159S | 09 | 604-605 | S72025P | 08 | 521-522 | ||
| S68626A | 21 | 913-914 | S72001A | 08 | 521-522 | S72025P | 08 | 564-566 | ||
| S68626A | 24 | 963-965 | S72001A | 08 | 535-536 | S72025Q | 08 | 521-522 | ||
| S68626D | 23 | 949-950 | S72001A | 15 | 791 | S72025Q | 08 | 564-566 | ||
| S68626S | 08 | 559-561 | S72001A | 15 | 793 | S72025R | 08 | 521-522 | ||
| S68627A | 21 | 913-914 | S72001A | 24 | 963-965 | S72025R | 08 | 564-566 | ||
| S68627A | 24 | 963-965 | S72001B | 08 | 521-522 | S72025S | 08 | 559-561 | ||
| S68627D | 23 | 949-950 | S72001B | 08 | 535-536 | S72026A | 08 | 521-522 | ||
| S68627S | 08 | 559-561 | S72001B | 15 | 791 | S72026A | 08 | 535-536 | ||
| S68628A | 21 | 913-914 | S72001B | 15 | 793 | S72026A | 15 | 791 | ||
| S68628A | 24 | 963-965 | S72001B | 24 | 963-965 | S72026A | 15 | 793 | ||
| S68628D | 23 | 949-950 | S72001C | 08 | 521-522 | S72026A | 24 | 963-965 | ||
| S68628S | 08 | 559-561 | S72001C | 08 | 535-536 | S72026B | 08 | 521-522 | ||
| S68629A | 21 | 913-914 | S72001C | 15 | 791 | S72026B | 08 | 535-536 | ||
| S68629A | 24 | 963-965 | S72001C | 15 | 793 | S72026B | 15 | 791 | ||
| S68629D | 23 | 949-950 | S72001C | 24 | 963-965 | S72026B | 15 | 793 | ||
| S68629S | 08 | 559-561 | S72001D | 08 | 559-561 | S72026B | 24 | 963-965 | ||
| S68711A | 21 | 913-914 | S72001E | 08 | 559-561 | S72026C | 08 | 521-522 | ||
| S68711A | 24 | 963-965 | S72001F | 08 | 559-561 | S72026C | 08 | 535-536 | ||
| S68711D | 23 | 949-950 | S72001G | 08 | 521-522 | S72026C | 15 | 791 | ||
| S68711S | 08 | 559-561 | S72001G | 08 | 559-561 | S72026C | 15 | 793 | ||
| S68712A | 21 | 913-914 | S72001H | 08 | 521-522 | S72026C | 24 | 963-965 | ||
| S68712A | 24 | 963-965 | S72001H | 08 | 559-561 | S72026D | 08 | 559-561 | ||
| S68712D | 23 | 949-950 | S72001J | 08 | 521-522 | S72026E | 08 | 559-561 | ||
| S68712S | 08 | 559-561 | S72001J | 08 | 559-561 | S72026F | 08 | 559-561 | ||
| S68719A | 21 | 913-914 | S72001K | 08 | 521-522 | S72026G | 08 | 521-522 | ||
| S68719A | 24 | 963-965 | S72001K | 08 | 564-566 | S72026G | 08 | 559-561 | ||
| S68719D | 23 | 949-950 | S72001M | 08 | 521-522 | S72026H | 08 | 521-522 | ||
| S68719S | 08 | 559-561 | S72001M | 08 | 564-566 | S72026H | 08 | 559-561 | ||
| S68721A | 21 | 913-914 | S72001N | 08 | 521-522 | S72026J | 08 | 521-522 | ||
| S68721A | 24 | 963-965 | S72001N | 08 | 564-566 | S72026J | 08 | 559-561 | ||
| S68721D | 23 | 949-950 | S72001P | 08 | 521-522 | S72026K | 08 | 521-522 | ||
| S68721S | 08 | 559-561 | S72001P | 08 | 564-566 | S72026K | 08 | 564-566 | ||
| S68722A | 21 | 913-914 | S72001Q | 08 | 521-522 | S72026M | 08 | 521-522 | ||
| S68722A | 24 | 963-965 | S72001Q | 08 | 564-566 | S72026M | 08 | 564-566 | ||
| S68722D | 23 | 949-950 | S72001R | 08 | 521-522 | S72026N | 08 | 521-522 | ||
| S68722S | 08 | 559-561 | S72001R | 08 | 564-566 | S72026N | 08 | 564-566 | ||
| S68729A | 21 | 913-914 | S72001S | 08 | 559-561 | S72026P | 08 | 521-522 | ||
| S68729A | 24 | 963-965 | S72002A | 08 | 521-522 | S72026P | 08 | 564-566 | ||
| S68729D | 23 | 949-950 | S72002A | 08 | 535-536 | S72026Q | 08 | 521-522 | ||
| S68729S | 08 | 559-561 | S72002A | 15 | 791 | S72026Q | 08 | 564-566 | ||
| S6980XA | 21 | 913-914 | S72002A | 15 | 793 | S72026R | 08 | 521-522 | ||
| S6980XA | 24 | 963-965 | S72002A | 24 | 963-965 | S72026R | 08 | 564-566 | ||
| S6980XD | 23 | 949-950 | S72002B | 08 | 521-522 | S72026S | 08 | 559-561 | ||
| S6980XS | 21 | 913-914 | S72002B | 08 | 535-536 | S72031A | 08 | 521-522 | ||
| S6981XA | 21 | 913-914 | S72002B | 15 | 791 | S72031A | 08 | 535-536 | ||
| S6981XA | 24 | 963-965 | S72002B | 15 | 793 | S72031A | 15 | 791 | ||
| S6981XD | 23 | 949-950 | S72002B | 24 | 963-965 | S72031A | 15 | 793 | ||
| S6981XS | 21 | 913-914 | S72002C | 08 | 521-522 | S72031A | 24 | 963-965 | ||
| S6982XA | 21 | 913-914 | S72002C | 08 | 535-536 | S72031B | 08 | 521-522 | ||
| S6982XA | 24 | 963-965 | S72002C | 15 | 791 | S72031B | 08 | 535-536 | ||
| S6982XD | 23 | 949-950 | S72002C | 15 | 793 | S72031B | 15 | 791 | ||
| S6982XS | 21 | 913-914 | S72002C | 24 | 963-965 | S72031B | 15 | 793 | ||
| S6990XA | 21 | 913-914 | S72002D | 08 | 559-561 | S72031B | 24 | 963-965 | ||
| S6990XA | 24 | 963-965 | S72002E | 08 | 559-561 | S72031C | 08 | 521-522 | ||
| S6990XD | 23 | 949-950 | S72002F | 08 | 559-561 | S72031C | 08 | 535-536 | ||
| S6990XS | 21 | 913-914 | S72002G | 08 | 521-522 | S72031C | 15 | 791 | ||
| S6991XA | 21 | 913-914 | S72002G | 08 | 559-561 | S72031C | 15 | 793 | ||
| S6991XA | 24 | 963-965 | S72002H | 08 | 521-522 | S72031C | 24 | 963-965 | ||
| S6991XD | 23 | 949-950 | S72002H | 08 | 559-561 | S72031D | 08 | 559-561 | ||
| S6991XS | 21 | 913-914 | S72002J | 08 | 521-522 | S72031E | 08 | 559-561 | ||
| S6992XA | 21 | 913-914 | S72002J | 08 | 559-561 | S72031F | 08 | 559-561 | ||
| S6992XA | 24 | 963-965 | S72002K | 08 | 521-522 | S72031G | 08 | 521-522 | ||
| S6992XD | 23 | 949-950 | S72002K | 08 | 564-566 | S72031G | 08 | 559-561 | ||
| S6992XS | 21 | 913-914 | S72002M | 08 | 521-522 | S72031H | 08 | 521-522 | ||
| S7000XA | 09 | 604-605 | S72002M | 08 | 564-566 | S72031H | 08 | 559-561 | ||
| S7000XA | 24 | 963-965 | S72002N | 08 | 521-522 | S72031J | 08 | 521-522 | ||
| S7000XD | 23 | 949-950 | S72002N | 08 | 564-566 | S72031J | 08 | 559-561 | ||
| S7000XS | 09 | 604-605 | S72002P | 08 | 521-522 | S72031K | 08 | 521-522 | ||
| S7001XA | 09 | 604-605 | S72002P | 08 | 564-566 | S72031K | 08 | 564-566 | ||
| S7001XA | 24 | 963-965 | S72002Q | 08 | 521-522 | S72031M | 08 | 521-522 | ||
| S7001XD | 23 | 949-950 | S72002Q | 08 | 564-566 | S72031M | 08 | 564-566 | ||
| S7001XS | 09 | 604-605 | S72002R | 08 | 521-522 | S72031N | 08 | 521-522 | ||
| S7002XA | 09 | 604-605 | S72002R | 08 | 564-566 | S72031N | 08 | 564-566 | ||
| S7002XA | 24 | 963-965 | S72002S | 08 | 559-561 | S72031P | 08 | 521-522 | ||
| S7002XD | 23 | 949-950 | S72009A | 08 | 521-522 | S72031P | 08 | 564-566 | ||
| S7002XS | 09 | 604-605 | S72009A | 08 | 535-536 | S72031Q | 08 | 521-522 | ||
| S7010XA | 09 | 604-605 | S72009A | 15 | 791 | S72031Q | 08 | 564-566 | ||
| S7010XA | 24 | 963-965 | S72009A | 15 | 793 | S72031R | 08 | 521-522 | ||
| S7010XD | 23 | 949-950 | S72009A | 24 | 963-965 | S72031R | 08 | 564-566 | ||
| S7010XS | 09 | 604-605 | S72009B | 08 | 521-522 | S72031S | 08 | 559-561 | ||
| S7011XA | 09 | 604-605 | S72009B | 08 | 535-536 | S72032A | 08 | 521-522 | ||
| S7011XA | 24 | 963-965 | S72009B | 15 | 791 | S72032A | 08 | 535-536 | ||
| S7011XD | 23 | 949-950 | S72009B | 15 | 793 | S72032A | 15 | 791 | ||
| S7011XS | 09 | 604-605 | S72009B | 24 | 963-965 | S72032A | 15 | 793 | ||
| S7012XA | 09 | 604-605 | S72009C | 08 | 521-522 | S72032A | 24 | 963-965 | ||
| S7012XA | 24 | 963-965 | S72009C | 08 | 535-536 | S72032B | 08 | 521-522 | ||
| S7012XD | 23 | 949-950 | S72009C | 15 | 791 | S72032B | 08 | 535-536 | ||
| S7012XS | 09 | 604-605 | S72009C | 15 | 793 | S72032B | 15 | 791 | ||
| S70211A | 09 | 604-605 | S72009C | 24 | 963-965 | S72032B | 15 | 793 | ||
| S70211A | 24 | 963-965 | S72009D | 08 | 559-561 | S72032B | 24 | 963-965 | ||
| S70211D | 23 | 949-950 | S72009E | 08 | 559-561 | S72032C | 08 | 521-522 | ||
| S70211S | 09 | 604-605 | S72009F | 08 | 559-561 | S72032C | 08 | 535-536 | ||
| S70212A | 09 | 604-605 | S72009G | 08 | 521-522 | S72032C | 15 | 791 | ||
| S70212A | 24 | 963-965 | S72009G | 08 | 559-561 | S72032C | 15 | 793 | ||
| S70212D | 23 | 949-950 | S72009H | 08 | 521-522 | S72032C | 24 | 963-965 | ||
| S70212S | 09 | 604-605 | S72009H | 08 | 559-561 | S72032D | 08 | 559-561 | ||
| S70219A | 09 | 604-605 | S72009J | 08 | 521-522 | S72032E | 08 | 559-561 | ||
| S70219A | 24 | 963-965 | S72009J | 08 | 559-561 | S72032F | 08 | 559-561 | ||
| S70219D | 23 | 949-950 | S72009K | 08 | 521-522 | S72032G | 08 | 521-522 | ||
| S70219S | 09 | 604-605 | S72009K | 08 | 564-566 | S72032G | 08 | 559-561 | ||
| S70221A | 09 | 606-607 | S72009M | 08 | 521-522 | S72032H | 08 | 521-522 | ||
| S70221A | 24 | 963-965 | S72009M | 08 | 564-566 | S72032H | 08 | 559-561 | ||
| S70221D | 23 | 949-950 | S72009N | 08 | 521-522 | S72032J | 08 | 521-522 | ||
| S70221S | 09 | 604-605 | S72009N | 08 | 564-566 | S72032J | 08 | 559-561 | ||
| S70222A | 09 | 606-607 | S72009P | 08 | 521-522 | S72032K | 08 | 521-522 | ||
| S70222A | 24 | 963-965 | S72009P | 08 | 564-566 | S72032K | 08 | 564-566 | ||
| S70222D | 23 | 949-950 | S72009Q | 08 | 521-522 | S72032M | 08 | 521-522 | ||
| S70222S | 09 | 604-605 | S72009Q | 08 | 564-566 | S72032M | 08 | 564-566 | ||
| S70229A | 09 | 606-607 | S72009R | 08 | 521-522 | S72032N | 08 | 521-522 | ||
| S70229A | 24 | 963-965 | S72009R | 08 | 564-566 | S72032N | 08 | 564-566 | ||
| S70229D | 23 | 949-950 | S72009S | 08 | 559-561 | S72032P | 08 | 521-522 | ||
| S70229S | 09 | 604-605 | S72011A | 08 | 521-522 | S72032P | 08 | 564-566 | ||
| S70241A | 09 | 604-605 | S72011A | 08 | 535-536 | S72032Q | 08 | 521-522 | ||
| S70241A | 24 | 963-965 | S72011A | 15 | 791 | S72032Q | 08 | 564-566 | ||
| S70241D | 23 | 949-950 | S72011A | 15 | 793 | S72032R | 08 | 521-522 | ||
| S70241S | 09 | 604-605 | S72011A | 24 | 963-965 | S72032R | 08 | 564-566 | ||
| S70242A | 09 | 604-605 | S72011B | 08 | 521-522 | S72032S | 08 | 559-561 | ||
| S70242A | 24 | 963-965 | S72011B | 08 | 535-536 | S72033A | 08 | 521-522 | ||
| S70242D | 23 | 949-950 | S72011B | 15 | 791 | S72033A | 08 | 535-536 | ||
| S70242S | 09 | 604-605 | S72011B | 15 | 793 | S72033A | 15 | 791 | ||
| S70249A | 09 | 604-605 | S72011B | 24 | 963-965 | S72033A | 15 | 793 | ||
| S70249A | 24 | 963-965 | S72011C | 08 | 521-522 | S72033A | 24 | 963-965 | ||
| S70249D | 23 | 949-950 | S72011C | 08 | 535-536 | S72033B | 08 | 521-522 | ||
| S70249S | 09 | 604-605 | S72011C | 15 | 791 | S72033B | 08 | 535-536 | ||
| S70251A | 09 | 604-605 | S72011C | 15 | 793 | S72033B | 15 | 791 | ||
| S70251A | 24 | 963-965 | S72011C | 24 | 963-965 | S72033B | 15 | 793 | ||
| S70251D | 23 | 949-950 | S72011D | 08 | 559-561 | S72033B | 24 | 963-965 | ||
| S70251S | 09 | 604-605 | S72011E | 08 | 559-561 | S72033C | 08 | 521-522 | ||
| S70252A | 09 | 604-605 | S72011F | 08 | 559-561 | S72033C | 08 | 535-536 | ||
| S70252A | 24 | 963-965 | S72011G | 08 | 521-522 | S72033C | 15 | 791 | ||
| S70252D | 23 | 949-950 | S72011G | 08 | 559-561 | S72033C | 15 | 793 | ||
| S70252S | 09 | 604-605 | S72011H | 08 | 521-522 | S72033C | 24 | 963-965 | ||
| S70259A | 09 | 604-605 | S72011H | 08 | 559-561 | S72033D | 08 | 559-561 | ||
| S70259A | 24 | 963-965 | S72011J | 08 | 521-522 | S72033E | 08 | 559-561 | ||
| S70259D | 23 | 949-950 | S72011J | 08 | 559-561 | S72033F | 08 | 559-561 | ||
| S70259S | 09 | 604-605 | S72011K | 08 | 521-522 | S72033G | 08 | 521-522 | ||
| S70261A | 09 | 606-607 | S72011K | 08 | 564-566 | S72033G | 08 | 559-561 | ||
| S70261A | 24 | 963-965 | S72011M | 08 | 521-522 | S72033H | 08 | 521-522 | ||
| S70261D | 23 | 949-950 | S72011M | 08 | 564-566 | S72033H | 08 | 559-561 | ||
| S70261S | 09 | 604-605 | S72011N | 08 | 521-522 | S72033J | 08 | 521-522 | ||
| S70262A | 09 | 606-607 | S72011N | 08 | 564-566 | S72033J | 08 | 559-561 | ||
| S70262A | 24 | 963-965 | S72011P | 08 | 521-522 | S72033K | 08 | 521-522 | ||
| S70262D | 23 | 949-950 | S72011P | 08 | 564-566 | S72033K | 08 | 564-566 | ||
| S70262S | 09 | 604-605 | S72011Q | 08 | 521-522 | S72033M | 08 | 521-522 | ||
| S70269A | 09 | 606-607 | S72011Q | 08 | 564-566 | S72033M | 08 | 564-566 | ||
| S70269A | 24 | 963-965 | S72011R | 08 | 521-522 | S72033N | 08 | 521-522 | ||
| S70269D | 23 | 949-950 | S72011R | 08 | 564-566 | S72033N | 08 | 564-566 | ||
| S70269S | 09 | 604-605 | S72011S | 08 | 559-561 | S72033P | 08 | 521-522 | ||
| S70271A | 09 | 604-605 | S72012A | 08 | 521-522 | S72033P | 08 | 564-566 | ||
| S70271A | 24 | 963-965 | S72012A | 08 | 535-536 | S72033Q | 08 | 521-522 | ||
| S70271D | 23 | 949-950 | S72012A | 15 | 791 | S72033Q | 08 | 564-566 | ||
| S70271S | 09 | 604-605 | S72012A | 15 | 793 | S72033R | 08 | 521-522 | ||
| S70272A | 09 | 604-605 | S72012A | 24 | 963-965 | S72033R | 08 | 564-566 | ||
| S70272A | 24 | 963-965 | S72012B | 08 | 521-522 | S72033S | 08 | 559-561 | ||
| S70272D | 23 | 949-950 | S72012B | 08 | 535-536 | S72034A | 08 | 521-522 | ||
| S70272S | 09 | 604-605 | S72012B | 15 | 791 | S72034A | 08 | 535-536 | ||
| S70279A | 09 | 604-605 | S72012B | 15 | 793 | S72034A | 15 | 791 | ||
| S70279A | 24 | 963-965 | S72012B | 24 | 963-965 | S72034A | 15 | 793 | ||
| S70279D | 23 | 949-950 | S72012C | 08 | 521-522 | S72034A | 24 | 963-965 | ||
| S70279S | 09 | 604-605 | S72012C | 08 | 535-536 | S72034B | 08 | 521-522 | ||
| S70311A | 09 | 604-605 | S72012C | 15 | 791 | S72034B | 08 | 535-536 | ||
| S70311A | 24 | 963-965 | S72012C | 15 | 793 | S72034B | 15 | 791 | ||
| S70311D | 23 | 949-950 | S72012C | 24 | 963-965 | S72034B | 15 | 793 | ||
| S70311S | 09 | 604-605 | S72012D | 08 | 559-561 | S72034B | 24 | 963-965 | ||
| S70312A | 09 | 604-605 | S72012E | 08 | 559-561 | S72034C | 08 | 521-522 | ||
| S70312A | 24 | 963-965 | S72012F | 08 | 559-561 | S72034C | 08 | 535-536 | ||
| S70312D | 23 | 949-950 | S72012G | 08 | 521-522 | S72034C | 15 | 791 | ||
| S70312S | 09 | 604-605 | S72012G | 08 | 559-561 | S72034C | 15 | 793 | ||
| S70319A | 09 | 604-605 | S72012H | 08 | 521-522 | S72034C | 24 | 963-965 | ||
| S70319A | 24 | 963-965 | S72012H | 08 | 559-561 | S72034D | 08 | 559-561 | ||
| S70319D | 23 | 949-950 | S72012J | 08 | 521-522 | S72034E | 08 | 559-561 | ||
| S70319S | 09 | 604-605 | S72012J | 08 | 559-561 | S72034F | 08 | 559-561 | ||
| S70321A | 09 | 606-607 | S72012K | 08 | 521-522 | S72034G | 08 | 521-522 | ||
| S70321A | 24 | 963-965 | S72012K | 08 | 564-566 | S72034G | 08 | 559-561 | ||
| S70321D | 23 | 949-950 | S72012M | 08 | 521-522 | S72034H | 08 | 521-522 | ||
| S70321S | 09 | 604-605 | S72012M | 08 | 564-566 | S72034H | 08 | 559-561 | ||
| S70322A | 09 | 606-607 | S72012N | 08 | 521-522 | S72034J | 08 | 521-522 | ||
| S70322A | 24 | 963-965 | S72012N | 08 | 564-566 | S72034J | 08 | 559-561 | ||
| S70322D | 23 | 949-950 | S72012P | 08 | 521-522 | S72034K | 08 | 521-522 | ||
| S70322S | 09 | 604-605 | S72012P | 08 | 564-566 | S72034K | 08 | 564-566 | ||
| S70329A | 09 | 606-607 | S72012Q | 08 | 521-522 | S72034M | 08 | 521-522 | ||
| S70329A | 24 | 963-965 | S72012Q | 08 | 564-566 | S72034M | 08 | 564-566 | ||
| S70329D | 23 | 949-950 | S72012R | 08 | 521-522 | S72034N | 08 | 521-522 | ||
| S70329S | 09 | 604-605 | S72012R | 08 | 564-566 | S72034N | 08 | 564-566 | ||
| S70341A | 09 | 604-605 | S72012S | 08 | 559-561 | S72034P | 08 | 521-522 | ||
| S70341A | 24 | 963-965 | S72019A | 08 | 521-522 | S72034P | 08 | 564-566 | ||
| S70341D | 23 | 949-950 | S72019A | 08 | 535-536 | S72034Q | 08 | 521-522 | ||
| S70341S | 09 | 604-605 | S72019A | 15 | 791 | S72034Q | 08 | 564-566 | ||
| S70342A | 09 | 604-605 | S72019A | 15 | 793 | S72034R | 08 | 521-522 | ||
| S70342A | 24 | 963-965 | S72019A | 24 | 963-965 | S72034R | 08 | 564-566 | ||
| S70342D | 23 | 949-950 | S72019B | 08 | 521-522 | S72034S | 08 | 559-561 | ||
| S70342S | 09 | 604-605 | S72019B | 08 | 535-536 | S72035A | 08 | 521-522 | ||
| S70349A | 09 | 604-605 | S72019B | 15 | 791 | S72035A | 08 | 535-536 | ||
| S70349A | 24 | 963-965 | S72019B | 15 | 793 | S72035A | 15 | 791 | ||
| S70349D | 23 | 949-950 | S72019B | 24 | 963-965 | S72035A | 15 | 793 | ||
| S70349S | 09 | 604-605 | S72019C | 08 | 521-522 | S72035A | 24 | 963-965 | ||
| S70351A | 09 | 604-605 | S72019C | 08 | 535-536 | S72035B | 08 | 521-522 | ||
| S70351A | 24 | 963-965 | S72019C | 15 | 791 | S72035B | 08 | 535-536 | ||
| S70351D | 23 | 949-950 | S72019C | 15 | 793 | S72035B | 15 | 791 | ||
| S70351S | 09 | 604-605 | S72019C | 24 | 963-965 | S72035B | 15 | 793 | ||
| S70352A | 09 | 604-605 | S72019D | 08 | 559-561 | S72035B | 24 | 963-965 | ||
| S70352A | 24 | 963-965 | S72019E | 08 | 559-561 | S72035C | 08 | 521-522 | ||
| S70352D | 23 | 949-950 | S72019F | 08 | 559-561 | S72035C | 08 | 535-536 | ||
| S70352S | 09 | 604-605 | S72019G | 08 | 521-522 | S72035C | 15 | 791 | ||
| S70359A | 09 | 604-605 | S72019G | 08 | 559-561 | S72035C | 15 | 793 | ||
| S70359A | 24 | 963-965 | S72019H | 08 | 521-522 | S72035C | 24 | 963-965 | ||
| S70359D | 23 | 949-950 | S72019H | 08 | 559-561 | S72035D | 08 | 559-561 | ||
| S70359S | 09 | 604-605 | S72019J | 08 | 521-522 | S72035E | 08 | 559-561 | ||
| S70361A | 09 | 606-607 | S72019J | 08 | 559-561 | S72035F | 08 | 559-561 | ||
| S70361A | 24 | 963-965 | S72019K | 08 | 521-522 | S72035G | 08 | 521-522 | ||
| S70361D | 23 | 949-950 | S72019K | 08 | 564-566 | S72035G | 08 | 559-561 | ||
| S70361S | 09 | 604-605 | S72019M | 08 | 521-522 | S72035H | 08 | 521-522 | ||
| S70362A | 09 | 606-607 | S72019M | 08 | 564-566 | S72035H | 08 | 559-561 | ||
| S70362A | 24 | 963-965 | S72019N | 08 | 521-522 | S72035J | 08 | 521-522 | ||
| S70362D | 23 | 949-950 | S72019N | 08 | 564-566 | S72035J | 08 | 559-561 | ||
| S70362S | 09 | 604-605 | S72019P | 08 | 521-522 | S72035K | 08 | 521-522 | ||
| S70369A | 09 | 606-607 | S72019P | 08 | 564-566 | S72035K | 08 | 564-566 | ||
| S70369A | 24 | 963-965 | S72019Q | 08 | 521-522 | S72035M | 08 | 521-522 | ||
| S70369D | 23 | 949-950 | S72019Q | 08 | 564-566 | S72035M | 08 | 564-566 | ||
| S70369S | 09 | 604-605 | S72019R | 08 | 521-522 | S72035N | 08 | 521-522 | ||
| S70371A | 09 | 604-605 | S72019R | 08 | 564-566 | S72035N | 08 | 564-566 | ||
| S70371A | 24 | 963-965 | S72019S | 08 | 559-561 | S72035P | 08 | 521-522 | ||
| S70371D | 23 | 949-950 | S72021A | 08 | 521-522 | S72035P | 08 | 564-566 | ||
| S70371S | 09 | 604-605 | S72021A | 08 | 535-536 | S72035Q | 08 | 521-522 | ||
| S70372A | 09 | 604-605 | S72021A | 15 | 791 | S72035Q | 08 | 564-566 | ||
| S70372A | 24 | 963-965 | S72021A | 15 | 793 | S72035R | 08 | 521-522 | ||
| S70372D | 23 | 949-950 | S72021A | 24 | 963-965 | S72035R | 08 | 564-566 | ||
| S70372S | 09 | 604-605 | S72021B | 08 | 521-522 | S72035S | 08 | 559-561 | ||
| S70379A | 09 | 604-605 | S72021B | 08 | 535-536 | S72036A | 08 | 521-522 | ||
| S70379A | 24 | 963-965 | S72021B | 15 | 791 | S72036A | 08 | 535-536 | ||
| S70379D | 23 | 949-950 | S72021B | 15 | 793 | S72036A | 15 | 791 | ||
| S70379S | 09 | 604-605 | S72021B | 24 | 963-965 | S72036A | 15 | 793 | ||
| S70911A | 09 | 604-605 | S72021C | 08 | 521-522 | S72036A | 24 | 963-965 | ||
| S70911A | 24 | 963-965 | S72021C | 08 | 535-536 | S72036B | 08 | 521-522 | ||
| S70911D | 23 | 949-950 | S72021C | 15 | 791 | S72036B | 08 | 535-536 | ||
| S70911S | 09 | 604-605 | S72021C | 15 | 793 | S72036B | 15 | 791 | ||
| S70912A | 09 | 604-605 | S72021C | 24 | 963-965 | S72036B | 15 | 793 | ||
| S70912A | 24 | 963-965 | S72021D | 08 | 559-561 | S72036B | 24 | 963-965 | ||
| S70912D | 23 | 949-950 | S72021E | 08 | 559-561 | S72036C | 08 | 521-522 | ||
| S70912S | 09 | 604-605 | S72021F | 08 | 559-561 | S72036C | 08 | 535-536 | ||
| S70919A | 09 | 604-605 | S72021G | 08 | 521-522 | S72036C | 15 | 791 | ||
| S70919A | 24 | 963-965 | S72021G | 08 | 559-561 | S72036C | 15 | 793 | ||
| S70919D | 23 | 949-950 | S72021H | 08 | 521-522 | S72036C | 24 | 963-965 | ||
| S70919S | 09 | 604-605 | S72021H | 08 | 559-561 | S72036D | 08 | 559-561 | ||
| S70921A | 09 | 604-605 | S72021J | 08 | 521-522 | S72036E | 08 | 559-561 | ||
| S70921A | 24 | 963-965 | S72021J | 08 | 559-561 | S72036F | 08 | 559-561 | ||
| S70921D | 23 | 949-950 | S72021K | 08 | 521-522 | S72036G | 08 | 521-522 | ||
| S70921S | 09 | 604-605 | S72021K | 08 | 564-566 | S72036G | 08 | 559-561 | ||
| S70922A | 09 | 604-605 | S72021M | 08 | 521-522 | S72036H | 08 | 521-522 | ||
| S70922A | 24 | 963-965 | S72021M | 08 | 564-566 | S72036H | 08 | 559-561 | ||
| S70922D | 23 | 949-950 | S72021N | 08 | 521-522 | S72036J | 08 | 521-522 | ||
| S70922S | 09 | 604-605 | S72021N | 08 | 564-566 | S72036J | 08 | 559-561 | ||
| S70929A | 09 | 604-605 | S72021P | 08 | 521-522 | S72036K | 08 | 521-522 | ||
| S70929A | 24 | 963-965 | S72021P | 08 | 564-566 | S72036K | 08 | 564-566 | ||
| S70929D | 23 | 949-950 | S72021Q | 08 | 521-522 | S72036M | 08 | 521-522 | ||
| S70929S | 09 | 604-605 | S72021Q | 08 | 564-566 | S72036M | 08 | 564-566 | ||
| S71001A | 09 | 604-605 | S72021R | 08 | 521-522 | S72036N | 08 | 521-522 | ||
| S71001A | 24 | 963-965 | S72021R | 08 | 564-566 | S72036N | 08 | 564-566 | ||
| S71001D | 23 | 949-950 | S72021S | 08 | 559-561 | S72036P | 08 | 521-522 | ||
| S71001S | 09 | 604-605 | S72022A | 08 | 521-522 | S72036P | 08 | 564-566 | ||
| S71002A | 09 | 604-605 | S72022A | 08 | 535-536 | S72036Q | 08 | 521-522 | ||
| S71002A | 24 | 963-965 | S72022A | 15 | 791 | S72036Q | 08 | 564-566 | ||
| S71002D | 23 | 949-950 | S72022A | 15 | 793 | S72036R | 08 | 521-522 | ||
| S71002S | 09 | 604-605 | S72022A | 24 | 963-965 | S72036R | 08 | 564-566 | ||
| S71009A | 09 | 604-605 | S72022B | 08 | 521-522 | S72036S | 08 | 559-561 | ||
| S71009A | 24 | 963-965 | S72022B | 08 | 535-536 | S72041A | 08 | 521-522 | ||
| S71009D | 23 | 949-950 | S72022B | 15 | 791 | S72041A | 08 | 535-536 | ||
| S71009S | 09 | 604-605 | S72022B | 15 | 793 | S72041A | 15 | 791 | ||
| S71011A | 09 | 604-605 | S72022B | 24 | 963-965 | S72041A | 15 | 793 | ||
| S71011A | 24 | 963-965 | S72022C | 08 | 521-522 | S72041A | 24 | 963-965 | ||
| S71011D | 23 | 949-950 | S72022C | 08 | 535-536 | S72041B | 08 | 521-522 | ||
| S71011S | 09 | 604-605 | S72022C | 15 | 791 | S72041B | 08 | 535-536 | ||
| S71012A | 09 | 604-605 | S72022C | 15 | 793 | S72041B | 15 | 791 | ||
| S71012A | 24 | 963-965 | S72022C | 24 | 963-965 | S72041B | 15 | 793 | ||
| S71012D | 23 | 949-950 | S72022D | 08 | 559-561 | S72041B | 24 | 963-965 | ||
| S71012S | 09 | 604-605 | S72022E | 08 | 559-561 | S72041C | 08 | 521-522 | ||
| S71019A | 09 | 604-605 | S72022F | 08 | 559-561 | S72041C | 08 | 535-536 | ||
| S71019A | 24 | 963-965 | S72022G | 08 | 521-522 | S72041C | 15 | 791 | ||
| S71019D | 23 | 949-950 | S72022G | 08 | 559-561 | S72041C | 15 | 793 | ||
| S71019S | 09 | 604-605 | S72022H | 08 | 521-522 | S72041C | 24 | 963-965 | ||
| S71021A | 21 | 913-914 | S72022H | 08 | 559-561 | S72041D | 08 | 559-561 | ||
| S71021A | 24 | 963-965 | S72022J | 08 | 521-522 | S72041E | 08 | 559-561 | ||
| S71021D | 23 | 949-950 | S72022J | 08 | 559-561 | S72041F | 08 | 559-561 | ||
| S71021S | 09 | 604-605 | S72022K | 08 | 521-522 | S72041G | 08 | 521-522 | ||
| S71022A | 21 | 913-914 | S72022K | 08 | 564-566 | S72041G | 08 | 559-561 | ||
| S71022A | 24 | 963-965 | S72022M | 08 | 521-522 | S72041H | 08 | 521-522 | ||
| S71022D | 23 | 949-950 | S72022M | 08 | 564-566 | S72041H | 08 | 559-561 | ||
| S71022S | 09 | 604-605 | S72022N | 08 | 521-522 | S72041J | 08 | 521-522 | ||
| S71029A | 21 | 913-914 | S72022N | 08 | 564-566 | S72041J | 08 | 559-561 | ||
| S71029A | 24 | 963-965 | S72022P | 08 | 521-522 | S72041K | 08 | 521-522 | ||
| S71029D | 23 | 949-950 | S72022P | 08 | 564-566 | S72041K | 08 | 564-566 | ||
| S71029S | 09 | 604-605 | S72022Q | 08 | 521-522 | S72041M | 08 | 521-522 | ||
| S71031A | 09 | 604-605 | S72022Q | 08 | 564-566 | S72041M | 08 | 564-566 | ||
| S71031A | 24 | 963-965 | S72022R | 08 | 521-522 | S72041N | 08 | 521-522 | ||
| S71031D | 23 | 949-950 | S72022R | 08 | 564-566 | S72041N | 08 | 564-566 | ||
| S71031S | 09 | 604-605 | S72022S | 08 | 559-561 | S72041P | 08 | 521-522 | ||
| S71032A | 09 | 604-605 | S72023A | 08 | 521-522 | S72041P | 08 | 564-566 | ||
| S71032A | 24 | 963-965 | S72023A | 08 | 535-536 | S72041Q | 08 | 521-522 | ||
| S71032D | 23 | 949-950 | S72023A | 15 | 791 | S72041Q | 08 | 564-566 | ||
| S71032S | 09 | 604-605 | S72023A | 15 | 793 | S72041R | 08 | 521-522 | ||
| S71039A | 09 | 604-605 | S72023A | 24 | 963-965 | S72041R | 08 | 564-566 | ||
| S71039A | 24 | 963-965 | S72023B | 08 | 521-522 | S72041S | 08 | 559-561 | ||
| S71039D | 23 | 949-950 | S72023B | 08 | 535-536 | S72042A | 08 | 521-522 | ||
| S71039S | 09 | 604-605 | S72023B | 15 | 791 | S72042A | 08 | 535-536 | ||
| S71041A | 21 | 913-914 | S72023B | 15 | 793 | S72042A | 15 | 791 | ||
| S71041A | 24 | 963-965 | S72023B | 24 | 963-965 | S72042A | 15 | 793 | ||
| S71041D | 23 | 949-950 | S72023C | 08 | 521-522 | S72042A | 24 | 963-965 | ||
| S71041S | 09 | 604-605 | S72023C | 08 | 535-536 | S72042B | 08 | 521-522 | ||
| S71042A | 21 | 913-914 | S72023C | 15 | 791 | S72042B | 08 | 535-536 | ||
| S71042A | 24 | 963-965 | S72023C | 15 | 793 | S72042B | 15 | 791 | ||
| S71042D | 23 | 949-950 | S72023C | 24 | 963-965 | S72042B | 15 | 793 | ||
| S71042S | 09 | 604-605 | S72023D | 08 | 559-561 | S72042B | 24 | 963-965 | ||
| S71049A | 21 | 913-914 | S72023E | 08 | 559-561 | S72042C | 08 | 521-522 | ||
| S71049A | 24 | 963-965 | S72023F | 08 | 559-561 | S72042C | 08 | 535-536 | ||
| S71049D | 23 | 949-950 | S72023G | 08 | 521-522 | S72042C | 15 | 791 | ||
| S71049S | 09 | 604-605 | S72023G | 08 | 559-561 | S72042C | 15 | 793 | ||
| S71051A | 09 | 604-605 | S72023H | 08 | 521-522 | S72042C | 24 | 963-965 | ||
| S71051A | 24 | 963-965 | S72023H | 08 | 559-561 | S72042D | 08 | 559-561 | ||
| S71051D | 23 | 949-950 | S72023J | 08 | 521-522 | S72042E | 08 | 559-561 | ||
| S71051S | 09 | 604-605 | S72023J | 08 | 559-561 | S72042F | 08 | 559-561 | ||
| S71052A | 09 | 604-605 | S72023K | 08 | 521-522 | S72042G | 08 | 521-522 | ||
| S71052A | 24 | 963-965 | S72023K | 08 | 564-566 | S72042G | 08 | 559-561 | ||
| S71052D | 23 | 949-950 | S72023M | 08 | 521-522 | S72042H | 08 | 521-522 | ||
| S71052S | 09 | 604-605 | S72023M | 08 | 564-566 | S72042H | 08 | 559-561 | ||
| S71059A | 09 | 604-605 | S72023N | 08 | 521-522 | S72042J | 08 | 521-522 | ||
| S71059A | 24 | 963-965 | S72023N | 08 | 564-566 | S72042J | 08 | 559-561 | ||
| S71059D | 23 | 949-950 | S72023P | 08 | 521-522 | S72042K | 08 | 521-522 | ||
| S71059S | 09 | 604-605 | S72023P | 08 | 564-566 | S72042K | 08 | 564-566 | ||
| S71101A | 09 | 604-605 | S72023Q | 08 | 521-522 | S72042M | 08 | 521-522 | ||
| S71101A | 24 | 963-965 | S72023Q | 08 | 564-566 | S72042M | 08 | 564-566 | ||
| S71101D | 23 | 949-950 | S72023R | 08 | 521-522 | S72042N | 08 | 521-522 | ||
| S71101S | 09 | 604-605 | S72023R | 08 | 564-566 | S72042N | 08 | 564-566 | ||
| S71102A | 09 | 604-605 | S72023S | 08 | 559-561 | S72042P | 08 | 521-522 | ||
| S71102A | 24 | 963-965 | S72024A | 08 | 521-522 | S72042P | 08 | 564-566 | ||
| S71102D | 23 | 949-950 | S72024A | 08 | 535-536 | S72042Q | 08 | 521-522 | ||
| S71102S | 09 | 604-605 | S72024A | 15 | 791 | S72042Q | 08 | 564-566 | ||
| S71109A | 09 | 604-605 | S72024A | 15 | 793 | S72042R | 08 | 521-522 | ||
| S71109A | 24 | 963-965 | S72024A | 24 | 963-965 | S72042R | 08 | 564-566 | ||
| S71109D | 23 | 949-950 | S72024B | 08 | 521-522 | S72042S | 08 | 559-561 | ||
| S71109S | 09 | 604-605 | S72024B | 08 | 535-536 | S72043A | 08 | 521-522 | ||
| S71111A | 09 | 604-605 | S72024B | 15 | 791 | S72043A | 08 | 535-536 | ||
| S71111A | 24 | 963-965 | S72024B | 15 | 793 | S72043A | 15 | 791 | ||
| S71111D | 23 | 949-950 | S72024B | 24 | 963-965 | S72043A | 15 | 793 | ||
| S71111S | 09 | 604-605 | S72024C | 08 | 521-522 | S72043A | 24 | 963-965 | ||
| S71112A | 09 | 604-605 | S72024C | 08 | 535-536 | S72043B | 08 | 521-522 | ||
| S71112A | 24 | 963-965 | S72024C | 15 | 791 | S72043B | 08 | 535-536 | ||
| S71112D | 23 | 949-950 | S72024C | 15 | 793 | S72043B | 15 | 791 | ||
| S71112S | 09 | 604-605 | S72024C | 24 | 963-965 | S72043B | 15 | 793 | ||
| S71119A | 09 | 604-605 | S72024D | 08 | 559-561 | S72043B | 24 | 963-965 | ||
| S71119A | 24 | 963-965 | S72024E | 08 | 559-561 | S72043C | 08 | 521-522 | ||
| S71119D | 23 | 949-950 | S72024F | 08 | 559-561 | S72043C | 08 | 535-536 | ||
| S71119S | 09 | 604-605 | S72024G | 08 | 521-522 | S72043C | 15 | 791 | ||
| S71121A | 21 | 913-914 | S72024G | 08 | 559-561 | S72043C | 15 | 793 | ||
| S71121A | 24 | 963-965 | S72024H | 08 | 521-522 | S72043C | 24 | 963-965 | ||
| S71121D | 23 | 949-950 | S72024H | 08 | 559-561 | S72043D | 08 | 559-561 | ||
| S71121S | 09 | 604-605 | S72024J | 08 | 521-522 | S72043E | 08 | 559-561 | ||
| S71122A | 21 | 913-914 | S72024J | 08 | 559-561 | S72043F | 08 | 559-561 | ||
| S71122A | 24 | 963-965 | S72024K | 08 | 521-522 | S72043G | 08 | 521-522 | ||
| S71122D | 23 | 949-950 | S72024K | 08 | 564-566 | S72043G | 08 | 559-561 | ||
| S71122S | 09 | 604-605 | S72024M | 08 | 521-522 | S72043H | 08 | 521-522 | ||
| S71129A | 21 | 913-914 | S72024M | 08 | 564-566 | S72043H | 08 | 559-561 | ||
| S71129A | 24 | 963-965 | S72024N | 08 | 521-522 | S72043J | 08 | 521-522 | ||
| S71129D | 23 | 949-950 | S72024N | 08 | 564-566 | S72043J | 08 | 559-561 | ||
| S71129S | 09 | 604-605 | S72024P | 08 | 521-522 | S72043K | 08 | 521-522 | ||
| S71131A | 09 | 604-605 | S72024P | 08 | 564-566 | S72043K | 08 | 564-566 | ||
| S71131A | 24 | 963-965 | S72024Q | 08 | 521-522 | S72043M | 08 | 521-522 | ||
| S71131D | 23 | 949-950 | S72024Q | 08 | 564-566 | S72043M | 08 | 564-566 | ||
| S71131S | 09 | 604-605 | S72024R | 08 | 521-522 | S72043N | 08 | 521-522 | ||
| S71132A | 09 | 604-605 | S72024R | 08 | 564-566 | S72043N | 08 | 564-566 | ||
| S71132A | 24 | 963-965 | S72024S | 08 | 559-561 | S72043P | 08 | 521-522 | ||
| S71132D | 23 | 949-950 | S72025A | 08 | 521-522 | S72043P | 08 | 564-566 | ||
| S71132S | 09 | 604-605 | S72025A | 08 | 535-536 | S72043Q | 08 | 521-522 | ||
| S71139A | 09 | 604-605 | S72025A | 15 | 791 | S72043Q | 08 | 564-566 | ||
| S71139A | 24 | 963-965 | S72025A | 15 | 793 | S72043R | 08 | 521-522 | ||
| S72025A | 24 | 963-965 | S72043R | 08 | 564-566 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |