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 56 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S7291XC | 08 | 533-534 | S75229D | 23 | 949-950 | S7720XD | 23 | 949-950 | ||
| S7291XC | 15 | 791 | S75229S | 05 | 299-301 | S7720XS | 09 | 604-605 | ||
| S7291XC | 15 | 793 | S75291A | 21 | 913-914 | S7721XA | 21 | 913-914 | ||
| S7291XC | 24 | 963-965 | S75291A | 24 | 963-965 | S7721XA | 24 | 963-965 | ||
| S7291XD | 08 | 559-561 | S75291D | 23 | 949-950 | S7721XD | 23 | 949-950 | ||
| S7291XE | 08 | 559-561 | S75291S | 05 | 299-301 | S7721XS | 09 | 604-605 | ||
| S7291XF | 08 | 559-561 | S75292A | 21 | 913-914 | S7722XA | 21 | 913-914 | ||
| S7291XG | 08 | 559-561 | S75292A | 24 | 963-965 | S7722XA | 24 | 963-965 | ||
| S7291XH | 08 | 559-561 | S75292D | 23 | 949-950 | S7722XD | 23 | 949-950 | ||
| S7291XJ | 08 | 559-561 | S75292S | 05 | 299-301 | S7722XS | 09 | 604-605 | ||
| S7291XK | 08 | 564-566 | S75299A | 21 | 913-914 | S78011A | 21 | 913-914 | ||
| S7291XM | 08 | 564-566 | S75299A | 24 | 963-965 | S78011A | 24 | 963-965 | ||
| S7291XN | 08 | 564-566 | S75299D | 23 | 949-950 | S78011D | 23 | 949-950 | ||
| S7291XP | 08 | 564-566 | S75299S | 05 | 299-301 | S78011S | 08 | 559-561 | ||
| S7291XQ | 08 | 564-566 | S75801A | 21 | 913-914 | S78012A | 21 | 913-914 | ||
| S7291XR | 08 | 564-566 | S75801A | 24 | 963-965 | S78012A | 24 | 963-965 | ||
| S7291XS | 08 | 559-561 | S75801D | 23 | 949-950 | S78012D | 23 | 949-950 | ||
| S7292XA | 08 | 533-534 | S75801S | 05 | 299-301 | S78012S | 08 | 559-561 | ||
| S7292XA | 15 | 791 | S75802A | 21 | 913-914 | S78019A | 21 | 913-914 | ||
| S7292XA | 15 | 793 | S75802A | 24 | 963-965 | S78019A | 24 | 963-965 | ||
| S7292XA | 24 | 963-965 | S75802D | 23 | 949-950 | S78019D | 23 | 949-950 | ||
| S7292XB | 08 | 533-534 | S75802S | 05 | 299-301 | S78019S | 08 | 559-561 | ||
| S7292XB | 15 | 791 | S75809A | 21 | 913-914 | S78021A | 21 | 913-914 | ||
| S7292XB | 15 | 793 | S75809A | 24 | 963-965 | S78021A | 24 | 963-965 | ||
| S7292XB | 24 | 963-965 | S75809D | 23 | 949-950 | S78021D | 23 | 949-950 | ||
| S7292XC | 08 | 533-534 | S75809S | 05 | 299-301 | S78021S | 08 | 559-561 | ||
| S7292XC | 15 | 791 | S75811A | 21 | 913-914 | S78022A | 21 | 913-914 | ||
| S7292XC | 15 | 793 | S75811A | 24 | 963-965 | S78022A | 24 | 963-965 | ||
| S7292XC | 24 | 963-965 | S75811D | 23 | 949-950 | S78022D | 23 | 949-950 | ||
| S7292XD | 08 | 559-561 | S75811S | 05 | 299-301 | S78022S | 08 | 559-561 | ||
| S7292XE | 08 | 559-561 | S75812A | 21 | 913-914 | S78029A | 21 | 913-914 | ||
| S7292XF | 08 | 559-561 | S75812A | 24 | 963-965 | S78029A | 24 | 963-965 | ||
| S7292XG | 08 | 559-561 | S75812D | 23 | 949-950 | S78029D | 23 | 949-950 | ||
| S7292XH | 08 | 559-561 | S75812S | 05 | 299-301 | S78029S | 08 | 559-561 | ||
| S7292XJ | 08 | 559-561 | S75819A | 21 | 913-914 | S78111A | 21 | 913-914 | ||
| S7292XK | 08 | 564-566 | S75819A | 24 | 963-965 | S78111A | 24 | 963-965 | ||
| S7292XM | 08 | 564-566 | S75819D | 23 | 949-950 | S78111D | 23 | 949-950 | ||
| S7292XN | 08 | 564-566 | S75819S | 05 | 299-301 | S78111S | 08 | 559-561 | ||
| S7292XP | 08 | 564-566 | S75891A | 21 | 913-914 | S78112A | 21 | 913-914 | ||
| S7292XQ | 08 | 564-566 | S75891A | 24 | 963-965 | S78112A | 24 | 963-965 | ||
| S7292XR | 08 | 564-566 | S75891D | 23 | 949-950 | S78112D | 23 | 949-950 | ||
| S7292XS | 08 | 559-561 | S75891S | 05 | 299-301 | S78112S | 08 | 559-561 | ||
| S73001A | 08 | 537-538 | S75892A | 21 | 913-914 | S78119A | 21 | 913-914 | ||
| S73001A | 24 | 963-965 | S75892A | 24 | 963-965 | S78119A | 24 | 963-965 | ||
| S73001D | 23 | 949-950 | S75892D | 23 | 949-950 | S78119D | 23 | 949-950 | ||
| S73001S | 08 | 562-563 | S75892S | 05 | 299-301 | S78119S | 08 | 559-561 | ||
| S73002A | 08 | 537-538 | S75899A | 21 | 913-914 | S78121A | 21 | 913-914 | ||
| S73002A | 24 | 963-965 | S75899A | 24 | 963-965 | S78121A | 24 | 963-965 | ||
| S73002D | 23 | 949-950 | S75899D | 23 | 949-950 | S78121D | 23 | 949-950 | ||
| S73002S | 08 | 562-563 | S75899S | 05 | 299-301 | S78121S | 08 | 559-561 | ||
| S73003A | 08 | 537-538 | S75901A | 21 | 913-914 | S78122A | 21 | 913-914 | ||
| S73003A | 24 | 963-965 | S75901A | 24 | 963-965 | S78122A | 24 | 963-965 | ||
| S73003D | 23 | 949-950 | S75901D | 23 | 949-950 | S78122D | 23 | 949-950 | ||
| S73003S | 08 | 562-563 | S75901S | 05 | 299-301 | S78122S | 08 | 559-561 | ||
| S73004A | 08 | 537-538 | S75902A | 21 | 913-914 | S78129A | 21 | 913-914 | ||
| S73004A | 24 | 963-965 | S75902A | 24 | 963-965 | S78129A | 24 | 963-965 | ||
| S73004D | 23 | 949-950 | S75902D | 23 | 949-950 | S78129D | 23 | 949-950 | ||
| S73004S | 08 | 562-563 | S75902S | 05 | 299-301 | S78129S | 08 | 559-561 | ||
| S73005A | 08 | 537-538 | S75909A | 21 | 913-914 | S78911A | 21 | 913-914 | ||
| S73005A | 24 | 963-965 | S75909A | 24 | 963-965 | S78911A | 24 | 963-965 | ||
| S73005D | 23 | 949-950 | S75909D | 23 | 949-950 | S78911D | 23 | 949-950 | ||
| S73005S | 08 | 562-563 | S75909S | 05 | 299-301 | S78911S | 08 | 559-561 | ||
| S73006A | 08 | 537-538 | S75911A | 21 | 913-914 | S78912A | 21 | 913-914 | ||
| S73006A | 24 | 963-965 | S75911A | 24 | 963-965 | S78912A | 24 | 963-965 | ||
| S73006D | 23 | 949-950 | S75911D | 23 | 949-950 | S78912D | 23 | 949-950 | ||
| S73006S | 08 | 562-563 | S75911S | 05 | 299-301 | S78912S | 08 | 559-561 | ||
| S73011A | 08 | 537-538 | S75912A | 21 | 913-914 | S78919A | 21 | 913-914 | ||
| S73011A | 24 | 963-965 | S75912A | 24 | 963-965 | S78919A | 24 | 963-965 | ||
| S73011D | 23 | 949-950 | S75912D | 23 | 949-950 | S78919D | 23 | 949-950 | ||
| S73011S | 08 | 562-563 | S75912S | 05 | 299-301 | S78919S | 08 | 559-561 | ||
| S73012A | 08 | 537-538 | S75919A | 21 | 913-914 | S78921A | 21 | 913-914 | ||
| S73012A | 24 | 963-965 | S75919A | 24 | 963-965 | S78921A | 24 | 963-965 | ||
| S73012D | 23 | 949-950 | S75919D | 23 | 949-950 | S78921D | 23 | 949-950 | ||
| S73012S | 08 | 562-563 | S75919S | 05 | 299-301 | S78921S | 08 | 559-561 | ||
| S73013A | 08 | 537-538 | S75991A | 21 | 913-914 | S78922A | 21 | 913-914 | ||
| S73013A | 24 | 963-965 | S75991A | 24 | 963-965 | S78922A | 24 | 963-965 | ||
| S73013D | 23 | 949-950 | S75991D | 23 | 949-950 | S78922D | 23 | 949-950 | ||
| S73013S | 08 | 562-563 | S75991S | 05 | 299-301 | S78922S | 08 | 559-561 | ||
| S73014A | 08 | 537-538 | S75992A | 21 | 913-914 | S78929A | 21 | 913-914 | ||
| S73014A | 24 | 963-965 | S75992A | 24 | 963-965 | S78929A | 24 | 963-965 | ||
| S73014D | 23 | 949-950 | S75992D | 23 | 949-950 | S78929D | 23 | 949-950 | ||
| S73014S | 08 | 562-563 | S75992S | 05 | 299-301 | S78929S | 08 | 559-561 | ||
| S73015A | 08 | 537-538 | S75999A | 21 | 913-914 | S79001A | 08 | 521-522 | ||
| S73015A | 24 | 963-965 | S75999A | 24 | 963-965 | S79001A | 08 | 535-536 | ||
| S73015D | 23 | 949-950 | S75999D | 23 | 949-950 | S79001A | 15 | 791 | ||
| S73015S | 08 | 562-563 | S75999S | 05 | 299-301 | S79001A | 15 | 793 | ||
| S73016A | 08 | 537-538 | S76001A | 21 | 913-914 | S79001A | 24 | 963-965 | ||
| S73016A | 24 | 963-965 | S76001A | 24 | 963-965 | S79001D | 08 | 559-561 | ||
| S73016D | 23 | 949-950 | S76001D | 23 | 949-950 | S79001G | 08 | 521-522 | ||
| S73016S | 08 | 562-563 | S76001S | 21 | 913-914 | S79001G | 08 | 559-561 | ||
| S73021A | 08 | 537-538 | S76002A | 21 | 913-914 | S79001K | 08 | 521-522 | ||
| S73021A | 24 | 963-965 | S76002A | 24 | 963-965 | S79001K | 08 | 564-566 | ||
| S73021D | 23 | 949-950 | S76002D | 23 | 949-950 | S79001P | 08 | 521-522 | ||
| S73021S | 08 | 562-563 | S76002S | 21 | 913-914 | S79001P | 08 | 564-566 | ||
| S73022A | 08 | 537-538 | S76009A | 21 | 913-914 | S79001S | 08 | 559-561 | ||
| S73022A | 24 | 963-965 | S76009A | 24 | 963-965 | S79002A | 08 | 521-522 | ||
| S73022D | 23 | 949-950 | S76009D | 23 | 949-950 | S79002A | 08 | 535-536 | ||
| S73022S | 08 | 562-563 | S76009S | 21 | 913-914 | S79002A | 15 | 791 | ||
| S73023A | 08 | 537-538 | S76011A | 08 | 537-538 | S79002A | 15 | 793 | ||
| S73023A | 24 | 963-965 | S76011A | 24 | 963-965 | S79002A | 24 | 963-965 | ||
| S73023D | 23 | 949-950 | S76011D | 23 | 949-950 | S79002D | 08 | 559-561 | ||
| S73023S | 08 | 562-563 | S76011S | 08 | 562-563 | S79002G | 08 | 521-522 | ||
| S73024A | 08 | 537-538 | S76012A | 08 | 537-538 | S79002G | 08 | 559-561 | ||
| S73024A | 24 | 963-965 | S76012A | 24 | 963-965 | S79002K | 08 | 521-522 | ||
| S73024D | 23 | 949-950 | S76012D | 23 | 949-950 | S79002K | 08 | 564-566 | ||
| S73024S | 08 | 562-563 | S76012S | 08 | 562-563 | S79002P | 08 | 521-522 | ||
| S73025A | 08 | 537-538 | S76019A | 08 | 537-538 | S79002P | 08 | 564-566 | ||
| S73025A | 24 | 963-965 | S76019A | 24 | 963-965 | S79002S | 08 | 559-561 | ||
| S73025D | 23 | 949-950 | S76019D | 23 | 949-950 | S79009A | 08 | 521-522 | ||
| S73025S | 08 | 562-563 | S76019S | 08 | 562-563 | S79009A | 08 | 535-536 | ||
| S73026A | 08 | 537-538 | S76021A | 08 | 564-566 | S79009A | 15 | 791 | ||
| S73026A | 24 | 963-965 | S76021A | 24 | 963-965 | S79009A | 15 | 793 | ||
| S73026D | 23 | 949-950 | S76021D | 23 | 949-950 | S79009A | 24 | 963-965 | ||
| S73026S | 08 | 562-563 | S76021S | 09 | 604-605 | S79009D | 08 | 559-561 | ||
| S73031A | 08 | 537-538 | S76022A | 08 | 564-566 | S79009G | 08 | 521-522 | ||
| S73031A | 24 | 963-965 | S76022A | 24 | 963-965 | S79009G | 08 | 559-561 | ||
| S73031D | 23 | 949-950 | S76022D | 23 | 949-950 | S79009K | 08 | 521-522 | ||
| S73031S | 08 | 562-563 | S76022S | 09 | 604-605 | S79009K | 08 | 564-566 | ||
| S73032A | 08 | 537-538 | S76029A | 08 | 564-566 | S79009P | 08 | 521-522 | ||
| S73032A | 24 | 963-965 | S76029A | 24 | 963-965 | S79009P | 08 | 564-566 | ||
| S73032D | 23 | 949-950 | S76029D | 23 | 949-950 | S79009S | 08 | 559-561 | ||
| S73032S | 08 | 562-563 | S76029S | 09 | 604-605 | S79011A | 08 | 521-522 | ||
| S73033A | 08 | 537-538 | S76091A | 21 | 913-914 | S79011A | 08 | 535-536 | ||
| S73033A | 24 | 963-965 | S76091A | 24 | 963-965 | S79011A | 15 | 791 | ||
| S73033D | 23 | 949-950 | S76091D | 23 | 949-950 | S79011A | 15 | 793 | ||
| S73033S | 08 | 562-563 | S76091S | 21 | 913-914 | S79011A | 24 | 963-965 | ||
| S73034A | 08 | 537-538 | S76092A | 21 | 913-914 | S79011D | 08 | 559-561 | ||
| S73034A | 24 | 963-965 | S76092A | 24 | 963-965 | S79011G | 08 | 521-522 | ||
| S73034D | 23 | 949-950 | S76092D | 23 | 949-950 | S79011G | 08 | 559-561 | ||
| S73034S | 08 | 562-563 | S76092S | 21 | 913-914 | S79011K | 08 | 521-522 | ||
| S73035A | 08 | 537-538 | S76099A | 21 | 913-914 | S79011K | 08 | 564-566 | ||
| S73035A | 24 | 963-965 | S76099A | 24 | 963-965 | S79011P | 08 | 521-522 | ||
| S73035D | 23 | 949-950 | S76099D | 23 | 949-950 | S79011P | 08 | 564-566 | ||
| S73035S | 08 | 562-563 | S76099S | 21 | 913-914 | S79011S | 08 | 559-561 | ||
| S73036A | 08 | 537-538 | S76101A | 21 | 913-914 | S79012A | 08 | 521-522 | ||
| S73036A | 24 | 963-965 | S76101A | 24 | 963-965 | S79012A | 08 | 535-536 | ||
| S73036D | 23 | 949-950 | S76101D | 23 | 949-950 | S79012A | 15 | 791 | ||
| S73036S | 08 | 562-563 | S76101S | 21 | 913-914 | S79012A | 15 | 793 | ||
| S73041A | 08 | 537-538 | S76102A | 21 | 913-914 | S79012A | 24 | 963-965 | ||
| S73041A | 24 | 963-965 | S76102A | 24 | 963-965 | S79012D | 08 | 559-561 | ||
| S73041D | 23 | 949-950 | S76102D | 23 | 949-950 | S79012G | 08 | 521-522 | ||
| S73041S | 08 | 562-563 | S76102S | 21 | 913-914 | S79012G | 08 | 559-561 | ||
| S73042A | 08 | 537-538 | S76109A | 21 | 913-914 | S79012K | 08 | 521-522 | ||
| S73042A | 24 | 963-965 | S76109A | 24 | 963-965 | S79012K | 08 | 564-566 | ||
| S73042D | 23 | 949-950 | S76109D | 23 | 949-950 | S79012P | 08 | 521-522 | ||
| S73042S | 08 | 562-563 | S76109S | 21 | 913-914 | S79012P | 08 | 564-566 | ||
| S73043A | 08 | 537-538 | S76111A | 08 | 537-538 | S79012S | 08 | 559-561 | ||
| S73043A | 24 | 963-965 | S76111A | 24 | 963-965 | S79019A | 08 | 521-522 | ||
| S73043D | 23 | 949-950 | S76111D | 23 | 949-950 | S79019A | 08 | 535-536 | ||
| S73043S | 08 | 562-563 | S76111S | 08 | 562-563 | S79019A | 15 | 791 | ||
| S73044A | 08 | 537-538 | S76112A | 08 | 537-538 | S79019A | 15 | 793 | ||
| S73044A | 24 | 963-965 | S76112A | 24 | 963-965 | S79019A | 24 | 963-965 | ||
| S73044D | 23 | 949-950 | S76112D | 23 | 949-950 | S79019D | 08 | 559-561 | ||
| S73044S | 08 | 562-563 | S76112S | 08 | 562-563 | S79019G | 08 | 521-522 | ||
| S73045A | 08 | 537-538 | S76119A | 08 | 537-538 | S79019G | 08 | 559-561 | ||
| S73045A | 24 | 963-965 | S76119A | 24 | 963-965 | S79019K | 08 | 521-522 | ||
| S73045D | 23 | 949-950 | S76119D | 23 | 949-950 | S79019K | 08 | 564-566 | ||
| S73045S | 08 | 562-563 | S76119S | 08 | 562-563 | S79019P | 08 | 521-522 | ||
| S73046A | 08 | 537-538 | S76121A | 08 | 564-566 | S79019P | 08 | 564-566 | ||
| S73046A | 24 | 963-965 | S76121A | 24 | 963-965 | S79019S | 08 | 559-561 | ||
| S73046D | 23 | 949-950 | S76121D | 23 | 949-950 | S79091A | 08 | 521-522 | ||
| S73046S | 08 | 562-563 | S76121S | 09 | 604-605 | S79091A | 08 | 535-536 | ||
| S73101A | 08 | 537-538 | S76122A | 08 | 564-566 | S79091A | 15 | 791 | ||
| S73101A | 24 | 963-965 | S76122A | 24 | 963-965 | S79091A | 15 | 793 | ||
| S73101D | 23 | 949-950 | S76122D | 23 | 949-950 | S79091A | 24 | 963-965 | ||
| S73101S | 08 | 562-563 | S76122S | 09 | 604-605 | S79091D | 08 | 559-561 | ||
| S73102A | 08 | 537-538 | S76129A | 08 | 564-566 | S79091G | 08 | 521-522 | ||
| S73102A | 24 | 963-965 | S76129A | 24 | 963-965 | S79091G | 08 | 559-561 | ||
| S73102D | 23 | 949-950 | S76129D | 23 | 949-950 | S79091K | 08 | 521-522 | ||
| S73102S | 08 | 562-563 | S76129S | 09 | 604-605 | S79091K | 08 | 564-566 | ||
| S73109A | 08 | 537-538 | S76191A | 21 | 913-914 | S79091P | 08 | 521-522 | ||
| S73109A | 24 | 963-965 | S76191A | 24 | 963-965 | S79091P | 08 | 564-566 | ||
| S73109D | 23 | 949-950 | S76191D | 23 | 949-950 | S79091S | 08 | 559-561 | ||
| S73109S | 08 | 562-563 | S76191S | 21 | 913-914 | S79092A | 08 | 521-522 | ||
| S73111A | 08 | 537-538 | S76192A | 21 | 913-914 | S79092A | 08 | 535-536 | ||
| S73111A | 24 | 963-965 | S76192A | 24 | 963-965 | S79092A | 15 | 791 | ||
| S73111D | 23 | 949-950 | S76192D | 23 | 949-950 | S79092A | 15 | 793 | ||
| S73111S | 08 | 562-563 | S76192S | 21 | 913-914 | S79092A | 24 | 963-965 | ||
| S73112A | 08 | 537-538 | S76199A | 21 | 913-914 | S79092D | 08 | 559-561 | ||
| S73112A | 24 | 963-965 | S76199A | 24 | 963-965 | S79092G | 08 | 521-522 | ||
| S73112D | 23 | 949-950 | S76199D | 23 | 949-950 | S79092G | 08 | 559-561 | ||
| S73112S | 08 | 562-563 | S76199S | 21 | 913-914 | S79092K | 08 | 521-522 | ||
| S73119A | 08 | 537-538 | S76201A | 21 | 913-914 | S79092K | 08 | 564-566 | ||
| S73119A | 24 | 963-965 | S76201A | 24 | 963-965 | S79092P | 08 | 521-522 | ||
| S73119D | 23 | 949-950 | S76201D | 23 | 949-950 | S79092P | 08 | 564-566 | ||
| S73119S | 08 | 562-563 | S76201S | 21 | 913-914 | S79092S | 08 | 559-561 | ||
| S73121A | 08 | 537-538 | S76202A | 21 | 913-914 | S79099A | 08 | 521-522 | ||
| S73121A | 24 | 963-965 | S76202A | 24 | 963-965 | S79099A | 08 | 535-536 | ||
| S73121D | 23 | 949-950 | S76202D | 23 | 949-950 | S79099A | 15 | 791 | ||
| S73121S | 08 | 562-563 | S76202S | 21 | 913-914 | S79099A | 15 | 793 | ||
| S73122A | 08 | 537-538 | S76209A | 21 | 913-914 | S79099A | 24 | 963-965 | ||
| S73122A | 24 | 963-965 | S76209A | 24 | 963-965 | S79099D | 08 | 559-561 | ||
| S73122D | 23 | 949-950 | S76209D | 23 | 949-950 | S79099G | 08 | 521-522 | ||
| S73122S | 08 | 562-563 | S76209S | 21 | 913-914 | S79099G | 08 | 559-561 | ||
| S73129A | 08 | 537-538 | S76211A | 08 | 537-538 | S79099K | 08 | 521-522 | ||
| S73129A | 24 | 963-965 | S76211A | 24 | 963-965 | S79099K | 08 | 564-566 | ||
| S73129D | 23 | 949-950 | S76211D | 23 | 949-950 | S79099P | 08 | 521-522 | ||
| S73129S | 08 | 562-563 | S76211S | 08 | 562-563 | S79099P | 08 | 564-566 | ||
| S73191A | 08 | 537-538 | S76212A | 08 | 537-538 | S79099S | 08 | 559-561 | ||
| S73191A | 24 | 963-965 | S76212A | 24 | 963-965 | S79101A | 08 | 533-534 | ||
| S73191D | 23 | 949-950 | S76212D | 23 | 949-950 | S79101A | 24 | 963-965 | ||
| S73191S | 08 | 562-563 | S76212S | 08 | 562-563 | S79101D | 08 | 559-561 | ||
| S73192A | 08 | 537-538 | S76219A | 08 | 537-538 | S79101G | 08 | 559-561 | ||
| S73192A | 24 | 963-965 | S76219A | 24 | 963-965 | S79101K | 08 | 564-566 | ||
| S73192D | 23 | 949-950 | S76219D | 23 | 949-950 | S79101P | 08 | 564-566 | ||
| S73192S | 08 | 562-563 | S76219S | 08 | 562-563 | S79101S | 08 | 559-561 | ||
| S73199A | 08 | 537-538 | S76221A | 08 | 564-566 | S79102A | 08 | 533-534 | ||
| S73199A | 24 | 963-965 | S76221A | 24 | 963-965 | S79102A | 24 | 963-965 | ||
| S73199D | 23 | 949-950 | S76221D | 23 | 949-950 | S79102D | 08 | 559-561 | ||
| S73199S | 08 | 562-563 | S76221S | 09 | 604-605 | S79102G | 08 | 559-561 | ||
| S7400XA | 01 | 073-074 | S76222A | 08 | 564-566 | S79102K | 08 | 564-566 | ||
| S7400XA | 24 | 963-965 | S76222A | 24 | 963-965 | S79102P | 08 | 564-566 | ||
| S7400XD | 23 | 949-950 | S76222D | 23 | 949-950 | S79102S | 08 | 559-561 | ||
| S7400XS | 01 | 091-093 | S76222S | 09 | 604-605 | S79109A | 08 | 533-534 | ||
| S7401XA | 01 | 073-074 | S76229A | 08 | 564-566 | S79109A | 24 | 963-965 | ||
| S7401XA | 24 | 963-965 | S76229A | 24 | 963-965 | S79109D | 08 | 559-561 | ||
| S7401XD | 23 | 949-950 | S76229D | 23 | 949-950 | S79109G | 08 | 559-561 | ||
| S7401XS | 01 | 091-093 | S76229S | 09 | 604-605 | S79109K | 08 | 564-566 | ||
| S7402XA | 01 | 073-074 | S76291A | 21 | 913-914 | S79109P | 08 | 564-566 | ||
| S7402XA | 24 | 963-965 | S76291A | 24 | 963-965 | S79109S | 08 | 559-561 | ||
| S7402XD | 23 | 949-950 | S76291D | 23 | 949-950 | S79111A | 08 | 533-534 | ||
| S7402XS | 01 | 091-093 | S76291S | 21 | 913-914 | S79111A | 24 | 963-965 | ||
| S7410XA | 01 | 073-074 | S76292A | 21 | 913-914 | S79111D | 08 | 559-561 | ||
| S7410XA | 24 | 963-965 | S76292A | 24 | 963-965 | S79111G | 08 | 559-561 | ||
| S7410XD | 23 | 949-950 | S76292D | 23 | 949-950 | S79111K | 08 | 564-566 | ||
| S7410XS | 01 | 091-093 | S76292S | 21 | 913-914 | S79111P | 08 | 564-566 | ||
| S7411XA | 01 | 073-074 | S76299A | 21 | 913-914 | S79111S | 08 | 559-561 | ||
| S7411XA | 24 | 963-965 | S76299A | 24 | 963-965 | S79112A | 08 | 533-534 | ||
| S7411XD | 23 | 949-950 | S76299D | 23 | 949-950 | S79112A | 24 | 963-965 | ||
| S7411XS | 01 | 091-093 | S76299S | 21 | 913-914 | S79112D | 08 | 559-561 | ||
| S7412XA | 01 | 073-074 | S76301A | 21 | 913-914 | S79112G | 08 | 559-561 | ||
| S7412XA | 24 | 963-965 | S76301A | 24 | 963-965 | S79112K | 08 | 564-566 | ||
| S7412XD | 23 | 949-950 | S76301D | 23 | 949-950 | S79112P | 08 | 564-566 | ||
| S7412XS | 01 | 091-093 | S76301S | 21 | 913-914 | S79112S | 08 | 559-561 | ||
| S7420XA | 01 | 073-074 | S76302A | 21 | 913-914 | S79119A | 08 | 533-534 | ||
| S7420XA | 24 | 963-965 | S76302A | 24 | 963-965 | S79119A | 24 | 963-965 | ||
| S7420XD | 23 | 949-950 | S76302D | 23 | 949-950 | S79119D | 08 | 559-561 | ||
| S7420XS | 01 | 091-093 | S76302S | 21 | 913-914 | S79119G | 08 | 559-561 | ||
| S7421XA | 01 | 073-074 | S76309A | 21 | 913-914 | S79119K | 08 | 564-566 | ||
| S7421XA | 24 | 963-965 | S76309A | 24 | 963-965 | S79119P | 08 | 564-566 | ||
| S7421XD | 23 | 949-950 | S76309D | 23 | 949-950 | S79119S | 08 | 559-561 | ||
| S7421XS | 01 | 091-093 | S76309S | 21 | 913-914 | S79121A | 08 | 533-534 | ||
| S7422XA | 01 | 073-074 | S76311A | 08 | 537-538 | S79121A | 24 | 963-965 | ||
| S7422XA | 24 | 963-965 | S76311A | 24 | 963-965 | S79121D | 08 | 559-561 | ||
| S7422XD | 23 | 949-950 | S76311D | 23 | 949-950 | S79121G | 08 | 559-561 | ||
| S7422XS | 01 | 091-093 | S76311S | 08 | 562-563 | S79121K | 08 | 564-566 | ||
| S748X1A | 01 | 073-074 | S76312A | 08 | 537-538 | S79121P | 08 | 564-566 | ||
| S748X1A | 24 | 963-965 | S76312A | 24 | 963-965 | S79121S | 08 | 559-561 | ||
| S748X1D | 23 | 949-950 | S76312D | 23 | 949-950 | S79122A | 08 | 533-534 | ||
| S748X1S | 01 | 091-093 | S76312S | 08 | 562-563 | S79122A | 24 | 963-965 | ||
| S748X2A | 01 | 073-074 | S76319A | 08 | 537-538 | S79122D | 08 | 559-561 | ||
| S748X2A | 24 | 963-965 | S76319A | 24 | 963-965 | S79122G | 08 | 559-561 | ||
| S748X2D | 23 | 949-950 | S76319D | 23 | 949-950 | S79122K | 08 | 564-566 | ||
| S748X2S | 01 | 091-093 | S76319S | 08 | 562-563 | S79122P | 08 | 564-566 | ||
| S748X9A | 01 | 073-074 | S76321A | 08 | 564-566 | S79122S | 08 | 559-561 | ||
| S748X9A | 24 | 963-965 | S76321A | 24 | 963-965 | S79129A | 08 | 533-534 | ||
| S748X9D | 23 | 949-950 | S76321D | 23 | 949-950 | S79129A | 24 | 963-965 | ||
| S748X9S | 01 | 091-093 | S76321S | 09 | 604-605 | S79129D | 08 | 559-561 | ||
| S7490XA | 01 | 073-074 | S76322A | 08 | 564-566 | S79129G | 08 | 559-561 | ||
| S7490XA | 24 | 963-965 | S76322A | 24 | 963-965 | S79129K | 08 | 564-566 | ||
| S7490XD | 23 | 949-950 | S76322D | 23 | 949-950 | S79129P | 08 | 564-566 | ||
| S7490XS | 01 | 091-093 | S76322S | 09 | 604-605 | S79129S | 08 | 559-561 | ||
| S7491XA | 01 | 073-074 | S76329A | 08 | 564-566 | S79131A | 08 | 533-534 | ||
| S7491XA | 24 | 963-965 | S76329A | 24 | 963-965 | S79131A | 24 | 963-965 | ||
| S7491XD | 23 | 949-950 | S76329D | 23 | 949-950 | S79131D | 08 | 559-561 | ||
| S7491XS | 01 | 091-093 | S76329S | 09 | 604-605 | S79131G | 08 | 559-561 | ||
| S7492XA | 01 | 073-074 | S76391A | 21 | 913-914 | S79131K | 08 | 564-566 | ||
| S7492XA | 24 | 963-965 | S76391A | 24 | 963-965 | S79131P | 08 | 564-566 | ||
| S7492XD | 23 | 949-950 | S76391D | 23 | 949-950 | S79131S | 08 | 559-561 | ||
| S7492XS | 01 | 091-093 | S76391S | 21 | 913-914 | S79132A | 08 | 533-534 | ||
| S75001A | 21 | 913-914 | S76392A | 21 | 913-914 | S79132A | 24 | 963-965 | ||
| S75001A | 24 | 963-965 | S76392A | 24 | 963-965 | S79132D | 08 | 559-561 | ||
| S75001D | 23 | 949-950 | S76392D | 23 | 949-950 | S79132G | 08 | 559-561 | ||
| S75001S | 05 | 299-301 | S76392S | 21 | 913-914 | S79132K | 08 | 564-566 | ||
| S75002A | 21 | 913-914 | S76399A | 21 | 913-914 | S79132P | 08 | 564-566 | ||
| S75002A | 24 | 963-965 | S76399A | 24 | 963-965 | S79132S | 08 | 559-561 | ||
| S75002D | 23 | 949-950 | S76399D | 23 | 949-950 | S79139A | 08 | 533-534 | ||
| S75002S | 05 | 299-301 | S76399S | 21 | 913-914 | S79139A | 24 | 963-965 | ||
| S75009A | 21 | 913-914 | S76801A | 21 | 913-914 | S79139D | 08 | 559-561 | ||
| S75009A | 24 | 963-965 | S76801A | 24 | 963-965 | S79139G | 08 | 559-561 | ||
| S75009D | 23 | 949-950 | S76801D | 23 | 949-950 | S79139K | 08 | 564-566 | ||
| S75009S | 05 | 299-301 | S76801S | 21 | 913-914 | S79139P | 08 | 564-566 | ||
| S75011A | 21 | 913-914 | S76802A | 21 | 913-914 | S79139S | 08 | 559-561 | ||
| S75011A | 24 | 963-965 | S76802A | 24 | 963-965 | S79141A | 08 | 533-534 | ||
| S75011D | 23 | 949-950 | S76802D | 23 | 949-950 | S79141A | 24 | 963-965 | ||
| S75011S | 05 | 299-301 | S76802S | 21 | 913-914 | S79141D | 08 | 559-561 | ||
| S75012A | 21 | 913-914 | S76809A | 21 | 913-914 | S79141G | 08 | 559-561 | ||
| S75012A | 24 | 963-965 | S76809A | 24 | 963-965 | S79141K | 08 | 564-566 | ||
| S75012D | 23 | 949-950 | S76809D | 23 | 949-950 | S79141P | 08 | 564-566 | ||
| S75012S | 05 | 299-301 | S76809S | 21 | 913-914 | S79141S | 08 | 559-561 | ||
| S75019A | 21 | 913-914 | S76811A | 08 | 537-538 | S79142A | 08 | 533-534 | ||
| S75019A | 24 | 963-965 | S76811A | 24 | 963-965 | S79142A | 24 | 963-965 | ||
| S75019D | 23 | 949-950 | S76811D | 23 | 949-950 | S79142D | 08 | 559-561 | ||
| S75019S | 05 | 299-301 | S76811S | 08 | 562-563 | S79142G | 08 | 559-561 | ||
| S75021A | 21 | 913-914 | S76812A | 08 | 537-538 | S79142K | 08 | 564-566 | ||
| S75021A | 24 | 963-965 | S76812A | 24 | 963-965 | S79142P | 08 | 564-566 | ||
| S75021D | 23 | 949-950 | S76812D | 23 | 949-950 | S79142S | 08 | 559-561 | ||
| S75021S | 05 | 299-301 | S76812S | 08 | 562-563 | S79149A | 08 | 533-534 | ||
| S75022A | 21 | 913-914 | S76819A | 08 | 537-538 | S79149A | 24 | 963-965 | ||
| S75022A | 24 | 963-965 | S76819A | 24 | 963-965 | S79149D | 08 | 559-561 | ||
| S75022D | 23 | 949-950 | S76819D | 23 | 949-950 | S79149G | 08 | 559-561 | ||
| S75022S | 05 | 299-301 | S76819S | 08 | 562-563 | S79149K | 08 | 564-566 | ||
| S75029A | 21 | 913-914 | S76821A | 08 | 564-566 | S79149P | 08 | 564-566 | ||
| S75029A | 24 | 963-965 | S76821A | 24 | 963-965 | S79149S | 08 | 559-561 | ||
| S75029D | 23 | 949-950 | S76821D | 23 | 949-950 | S79191A | 08 | 533-534 | ||
| S75029S | 05 | 299-301 | S76821S | 09 | 604-605 | S79191A | 24 | 963-965 | ||
| S75091A | 21 | 913-914 | S76822A | 08 | 564-566 | S79191D | 08 | 559-561 | ||
| S75091A | 24 | 963-965 | S76822A | 24 | 963-965 | S79191G | 08 | 559-561 | ||
| S75091D | 23 | 949-950 | S76822D | 23 | 949-950 | S79191K | 08 | 564-566 | ||
| S75091S | 05 | 299-301 | S76822S | 09 | 604-605 | S79191P | 08 | 564-566 | ||
| S75092A | 21 | 913-914 | S76829A | 08 | 564-566 | S79191S | 08 | 559-561 | ||
| S75092A | 24 | 963-965 | S76829A | 24 | 963-965 | S79192A | 08 | 533-534 | ||
| S75092D | 23 | 949-950 | S76829D | 23 | 949-950 | S79192A | 24 | 963-965 | ||
| S75092S | 05 | 299-301 | S76829S | 09 | 604-605 | S79192D | 08 | 559-561 | ||
| S75099A | 21 | 913-914 | S76891A | 21 | 913-914 | S79192G | 08 | 559-561 | ||
| S75099A | 24 | 963-965 | S76891A | 24 | 963-965 | S79192K | 08 | 564-566 | ||
| S75099D | 23 | 949-950 | S76891D | 23 | 949-950 | S79192P | 08 | 564-566 | ||
| S75099S | 05 | 299-301 | S76891S | 21 | 913-914 | S79192S | 08 | 559-561 | ||
| S75101A | 21 | 913-914 | S76892A | 21 | 913-914 | S79199A | 08 | 533-534 | ||
| S75101A | 24 | 963-965 | S76892A | 24 | 963-965 | S79199A | 24 | 963-965 | ||
| S75101D | 23 | 949-950 | S76892D | 23 | 949-950 | S79199D | 08 | 559-561 | ||
| S75101S | 05 | 299-301 | S76892S | 21 | 913-914 | S79199G | 08 | 559-561 | ||
| S75102A | 21 | 913-914 | S76899A | 21 | 913-914 | S79199K | 08 | 564-566 | ||
| S75102A | 24 | 963-965 | S76899A | 24 | 963-965 | S79199P | 08 | 564-566 | ||
| S75102D | 23 | 949-950 | S76899D | 23 | 949-950 | S79199S | 08 | 559-561 | ||
| S75102S | 05 | 299-301 | S76899S | 21 | 913-914 | S79811A | 21 | 913-914 | ||
| S75109A | 21 | 913-914 | S76901A | 21 | 913-914 | S79811A | 24 | 963-965 | ||
| S75109A | 24 | 963-965 | S76901A | 24 | 963-965 | S79811D | 23 | 949-950 | ||
| S75109D | 23 | 949-950 | S76901D | 23 | 949-950 | S79811S | 21 | 913-914 | ||
| S75109S | 05 | 299-301 | S76901S | 21 | 913-914 | S79812A | 21 | 913-914 | ||
| S75111A | 21 | 913-914 | S76902A | 21 | 913-914 | S79812A | 24 | 963-965 | ||
| S75111A | 24 | 963-965 | S76902A | 24 | 963-965 | S79812D | 23 | 949-950 | ||
| S75111D | 23 | 949-950 | S76902D | 23 | 949-950 | S79812S | 21 | 913-914 | ||
| S75111S | 05 | 299-301 | S76902S | 21 | 913-914 | S79819A | 21 | 913-914 | ||
| S75112A | 21 | 913-914 | S76909A | 21 | 913-914 | S79819A | 24 | 963-965 | ||
| S75112A | 24 | 963-965 | S76909A | 24 | 963-965 | S79819D | 23 | 949-950 | ||
| S75112D | 23 | 949-950 | S76909D | 23 | 949-950 | S79819S | 21 | 913-914 | ||
| S75112S | 05 | 299-301 | S76909S | 21 | 913-914 | S79821A | 21 | 913-914 | ||
| S75119A | 21 | 913-914 | S76911A | 08 | 537-538 | S79821A | 24 | 963-965 | ||
| S75119A | 24 | 963-965 | S76911A | 24 | 963-965 | S79821D | 23 | 949-950 | ||
| S75119D | 23 | 949-950 | S76911D | 23 | 949-950 | S79821S | 21 | 913-914 | ||
| S75119S | 05 | 299-301 | S76911S | 08 | 562-563 | S79822A | 21 | 913-914 | ||
| S75121A | 21 | 913-914 | S76912A | 08 | 537-538 | S79822A | 24 | 963-965 | ||
| S75121A | 24 | 963-965 | S76912A | 24 | 963-965 | S79822D | 23 | 949-950 | ||
| S75121D | 23 | 949-950 | S76912D | 23 | 949-950 | S79822S | 21 | 913-914 | ||
| S75121S | 05 | 299-301 | S76912S | 08 | 562-563 | S79829A | 21 | 913-914 | ||
| S75122A | 21 | 913-914 | S76919A | 08 | 537-538 | S79829A | 24 | 963-965 | ||
| S75122A | 24 | 963-965 | S76919A | 24 | 963-965 | S79829D | 23 | 949-950 | ||
| S75122D | 23 | 949-950 | S76919D | 23 | 949-950 | S79829S | 21 | 913-914 | ||
| S75122S | 05 | 299-301 | S76919S | 08 | 562-563 | S79911A | 21 | 913-914 | ||
| S75129A | 21 | 913-914 | S76921A | 08 | 564-566 | S79911A | 24 | 963-965 | ||
| S75129A | 24 | 963-965 | S76921A | 24 | 963-965 | S79911D | 23 | 949-950 | ||
| S75129D | 23 | 949-950 | S76921D | 23 | 949-950 | S79911S | 21 | 913-914 | ||
| S75129S | 05 | 299-301 | S76921S | 09 | 604-605 | S79912A | 21 | 913-914 | ||
| S75191A | 21 | 913-914 | S76922A | 08 | 564-566 | S79912A | 24 | 963-965 | ||
| S75191A | 24 | 963-965 | S76922A | 24 | 963-965 | S79912D | 23 | 949-950 | ||
| S75191D | 23 | 949-950 | S76922D | 23 | 949-950 | S79912S | 21 | 913-914 | ||
| S75191S | 05 | 299-301 | S76922S | 09 | 604-605 | S79919A | 21 | 913-914 | ||
| S75192A | 21 | 913-914 | S76929A | 08 | 564-566 | S79919A | 24 | 963-965 | ||
| S75192A | 24 | 963-965 | S76929A | 24 | 963-965 | S79919D | 23 | 949-950 | ||
| S75192D | 23 | 949-950 | S76929D | 23 | 949-950 | S79919S | 21 | 913-914 | ||
| S75192S | 05 | 299-301 | S76929S | 09 | 604-605 | S79921A | 21 | 913-914 | ||
| S75199A | 21 | 913-914 | S76991A | 21 | 913-914 | S79921A | 24 | 963-965 | ||
| S75199A | 24 | 963-965 | S76991A | 24 | 963-965 | S79921D | 23 | 949-950 | ||
| S75199D | 23 | 949-950 | S76991D | 23 | 949-950 | S79921S | 21 | 913-914 | ||
| S75199S | 05 | 299-301 | S76991S | 21 | 913-914 | S79922A | 21 | 913-914 | ||
| S75201A | 21 | 913-914 | S76992A | 21 | 913-914 | S79922A | 24 | 963-965 | ||
| S75201A | 24 | 963-965 | S76992A | 24 | 963-965 | S79922D | 23 | 949-950 | ||
| S75201D | 23 | 949-950 | S76992D | 23 | 949-950 | S79922S | 21 | 913-914 | ||
| S75201S | 05 | 299-301 | S76992S | 21 | 913-914 | S79929A | 21 | 913-914 | ||
| S75202A | 21 | 913-914 | S76999A | 21 | 913-914 | S79929A | 24 | 963-965 | ||
| S75202A | 24 | 963-965 | S76999A | 24 | 963-965 | S79929D | 23 | 949-950 | ||
| S75202D | 23 | 949-950 | S76999D | 23 | 949-950 | S79929S | 21 | 913-914 | ||
| S75202S | 05 | 299-301 | S76999S | 21 | 913-914 | S8000XA | 09 | 604-605 | ||
| S75209A | 21 | 913-914 | S7700XA | 21 | 913-914 | S8000XA | 24 | 963-965 | ||
| S75209A | 24 | 963-965 | S7700XA | 24 | 963-965 | S8000XD | 23 | 949-950 | ||
| S75209D | 23 | 949-950 | S7700XD | 23 | 949-950 | S8000XS | 09 | 604-605 | ||
| S75209S | 05 | 299-301 | S7700XS | 09 | 604-605 | S8001XA | 09 | 604-605 | ||
| S75211A | 21 | 913-914 | S7701XA | 21 | 913-914 | S8001XA | 24 | 963-965 | ||
| S75211A | 24 | 963-965 | S7701XA | 24 | 963-965 | S8001XD | 23 | 949-950 | ||
| S75211D | 23 | 949-950 | S7701XD | 23 | 949-950 | S8001XS | 09 | 604-605 | ||
| S75211S | 05 | 299-301 | S7701XS | 09 | 604-605 | S8002XA | 09 | 604-605 | ||
| S75212A | 21 | 913-914 | S7702XA | 21 | 913-914 | S8002XA | 24 | 963-965 | ||
| S75212A | 24 | 963-965 | S7702XA | 24 | 963-965 | S8002XD | 23 | 949-950 | ||
| S75212D | 23 | 949-950 | S7702XD | 23 | 949-950 | S8002XS | 09 | 604-605 | ||
| S75212S | 05 | 299-301 | S7702XS | 09 | 604-605 | S8010XA | 09 | 604-605 | ||
| S75219A | 21 | 913-914 | S7710XA | 21 | 913-914 | S8010XA | 24 | 963-965 | ||
| S75219A | 24 | 963-965 | S7710XA | 24 | 963-965 | S8010XD | 23 | 949-950 | ||
| S75219D | 23 | 949-950 | S7710XD | 23 | 949-950 | S8010XS | 09 | 604-605 | ||
| S75219S | 05 | 299-301 | S7710XS | 09 | 604-605 | S8011XA | 09 | 604-605 | ||
| S75221A | 21 | 913-914 | S7711XA | 21 | 913-914 | S8011XA | 24 | 963-965 | ||
| S75221A | 24 | 963-965 | S7711XA | 24 | 963-965 | S8011XD | 23 | 949-950 | ||
| S75221D | 23 | 949-950 | S7711XD | 23 | 949-950 | S8011XS | 09 | 604-605 | ||
| S75221S | 05 | 299-301 | S7711XS | 09 | 604-605 | S8012XA | 09 | 604-605 | ||
| S75222A | 21 | 913-914 | S7712XA | 21 | 913-914 | S8012XA | 24 | 963-965 | ||
| S75222A | 24 | 963-965 | S7712XA | 24 | 963-965 | S8012XD | 23 | 949-950 | ||
| S75222D | 23 | 949-950 | S7712XD | 23 | 949-950 | S8012XS | 09 | 604-605 | ||
| S75222S | 05 | 299-301 | S7712XS | 09 | 604-605 | S80211A | 09 | 604-605 | ||
| S75229A | 21 | 913-914 | S7720XA | 21 | 913-914 | S80211A | 24 | 963-965 | ||
| S75229A | 24 | 963-965 | S7720XA | 24 | 963-965 | S80211D | 23 | 949-950 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 29 Mar 2024 17:03:46 CMS, code-revision=361, description-revision=1397 |