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 38 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S35221D | 23 | 949-950 | S36241A | 07 | 438-440 | S37092A | 11 | 698-700 | ||
| S35221S | 05 | 299-301 | S36241A | 24 | 963-965 | S37092A | 24 | 963-965 | ||
| S35222A | 21 | 913-914 | S36241D | 23 | 949-950 | S37092D | 23 | 949-950 | ||
| S35222A | 24 | 963-965 | S36241S | 06 | 393-395 | S37092S | 06 | 393-395 | ||
| S35222D | 23 | 949-950 | S36242A | 07 | 438-440 | S37099A | 11 | 698-700 | ||
| S35222S | 05 | 299-301 | S36242A | 24 | 963-965 | S37099A | 24 | 963-965 | ||
| S35228A | 21 | 913-914 | S36242D | 23 | 949-950 | S37099D | 23 | 949-950 | ||
| S35228A | 24 | 963-965 | S36242S | 06 | 393-395 | S37099S | 06 | 393-395 | ||
| S35228D | 23 | 949-950 | S36249A | 07 | 438-440 | S3710XA | 11 | 698-700 | ||
| S35228S | 05 | 299-301 | S36249A | 24 | 963-965 | S3710XA | 24 | 963-965 | ||
| S35229A | 21 | 913-914 | S36249D | 23 | 949-950 | S3710XD | 23 | 949-950 | ||
| S35229A | 24 | 963-965 | S36249S | 06 | 393-395 | S3710XS | 12 | 729-730 | ||
| S35229D | 23 | 949-950 | S36250A | 07 | 438-440 | S3710XS | 13 | 742-743 | ||
| S35229S | 05 | 299-301 | S36250A | 24 | 963-965 | S3710XS | 13 | 760-761 | ||
| S35231A | 21 | 913-914 | S36250D | 23 | 949-950 | S3712XA | 11 | 698-700 | ||
| S35231A | 24 | 963-965 | S36250S | 06 | 393-395 | S3712XA | 24 | 963-965 | ||
| S35231D | 23 | 949-950 | S36251A | 07 | 438-440 | S3712XD | 23 | 949-950 | ||
| S35231S | 05 | 299-301 | S36251A | 24 | 963-965 | S3712XS | 12 | 729-730 | ||
| S35232A | 21 | 913-914 | S36251D | 23 | 949-950 | S3712XS | 13 | 742-743 | ||
| S35232A | 24 | 963-965 | S36251S | 06 | 393-395 | S3712XS | 13 | 760-761 | ||
| S35232D | 23 | 949-950 | S36252A | 07 | 438-440 | S3713XA | 11 | 698-700 | ||
| S35232S | 05 | 299-301 | S36252A | 24 | 963-965 | S3713XA | 24 | 963-965 | ||
| S35238A | 21 | 913-914 | S36252D | 23 | 949-950 | S3713XD | 23 | 949-950 | ||
| S35238A | 24 | 963-965 | S36252S | 06 | 393-395 | S3713XS | 12 | 729-730 | ||
| S35238D | 23 | 949-950 | S36259A | 07 | 438-440 | S3713XS | 13 | 742-743 | ||
| S35238S | 05 | 299-301 | S36259A | 24 | 963-965 | S3713XS | 13 | 760-761 | ||
| S35239A | 21 | 913-914 | S36259D | 23 | 949-950 | S3719XA | 11 | 698-700 | ||
| S35239A | 24 | 963-965 | S36259S | 06 | 393-395 | S3719XA | 24 | 963-965 | ||
| S35239D | 23 | 949-950 | S36260A | 07 | 438-440 | S3719XD | 23 | 949-950 | ||
| S35239S | 05 | 299-301 | S36260A | 24 | 963-965 | S3719XS | 12 | 729-730 | ||
| S35291A | 21 | 913-914 | S36260D | 23 | 949-950 | S3719XS | 13 | 742-743 | ||
| S35291A | 24 | 963-965 | S36260S | 06 | 393-395 | S3719XS | 13 | 760-761 | ||
| S35291D | 23 | 949-950 | S36261A | 07 | 438-440 | S3720XA | 11 | 698-700 | ||
| S35291S | 05 | 299-301 | S36261A | 24 | 963-965 | S3720XA | 24 | 963-965 | ||
| S35292A | 21 | 913-914 | S36261D | 23 | 949-950 | S3720XD | 23 | 949-950 | ||
| S35292A | 24 | 963-965 | S36261S | 06 | 393-395 | S3720XS | 12 | 729-730 | ||
| S35292D | 23 | 949-950 | S36262A | 07 | 438-440 | S3720XS | 13 | 742-743 | ||
| S35292S | 05 | 299-301 | S36262A | 24 | 963-965 | S3720XS | 13 | 760-761 | ||
| S35298A | 21 | 913-914 | S36262D | 23 | 949-950 | S3722XA | 11 | 698-700 | ||
| S35298A | 24 | 963-965 | S36262S | 06 | 393-395 | S3722XA | 24 | 963-965 | ||
| S35298D | 23 | 949-950 | S36269A | 07 | 438-440 | S3722XD | 23 | 949-950 | ||
| S35298S | 05 | 299-301 | S36269A | 24 | 963-965 | S3722XS | 12 | 729-730 | ||
| S35299A | 21 | 913-914 | S36269D | 23 | 949-950 | S3722XS | 13 | 742-743 | ||
| S35299A | 24 | 963-965 | S36269S | 06 | 393-395 | S3722XS | 13 | 760-761 | ||
| S35299D | 23 | 949-950 | S36290A | 07 | 438-440 | S3723XA | 11 | 698-700 | ||
| S35299S | 05 | 299-301 | S36290A | 24 | 963-965 | S3723XA | 24 | 963-965 | ||
| S35311A | 21 | 913-914 | S36290D | 23 | 949-950 | S3723XD | 23 | 949-950 | ||
| S35311A | 24 | 963-965 | S36290S | 06 | 393-395 | S3723XS | 12 | 729-730 | ||
| S35311D | 23 | 949-950 | S36291A | 07 | 438-440 | S3723XS | 13 | 742-743 | ||
| S35311S | 05 | 299-301 | S36291A | 24 | 963-965 | S3723XS | 13 | 760-761 | ||
| S35318A | 21 | 913-914 | S36291D | 23 | 949-950 | S3729XA | 11 | 698-700 | ||
| S35318A | 24 | 963-965 | S36291S | 06 | 393-395 | S3729XA | 24 | 963-965 | ||
| S35318D | 23 | 949-950 | S36292A | 07 | 438-440 | S3729XD | 23 | 949-950 | ||
| S35318S | 05 | 299-301 | S36292A | 24 | 963-965 | S3729XS | 12 | 729-730 | ||
| S35319A | 21 | 913-914 | S36292D | 23 | 949-950 | S3729XS | 13 | 742-743 | ||
| S35319A | 24 | 963-965 | S36292S | 06 | 393-395 | S3729XS | 13 | 760-761 | ||
| S35319D | 23 | 949-950 | S36299A | 07 | 438-440 | S3730XA | 11 | 698-700 | ||
| S35319S | 05 | 299-301 | S36299A | 24 | 963-965 | S3730XA | 24 | 963-965 | ||
| S35321A | 21 | 913-914 | S36299D | 23 | 949-950 | S3730XD | 23 | 949-950 | ||
| S35321A | 24 | 963-965 | S36299S | 06 | 393-395 | S3730XS | 12 | 729-730 | ||
| S35321D | 23 | 949-950 | S3630XA | 06 | 393-395 | S3730XS | 13 | 742-743 | ||
| S35321S | 05 | 299-301 | S3630XA | 24 | 963-965 | S3730XS | 13 | 760-761 | ||
| S35328A | 21 | 913-914 | S3630XD | 23 | 949-950 | S3732XA | 11 | 698-700 | ||
| S35328A | 24 | 963-965 | S3630XS | 06 | 393-395 | S3732XA | 24 | 963-965 | ||
| S35328D | 23 | 949-950 | S3632XA | 06 | 393-395 | S3732XD | 23 | 949-950 | ||
| S35328S | 05 | 299-301 | S3632XA | 24 | 963-965 | S3732XS | 12 | 729-730 | ||
| S35329A | 21 | 913-914 | S3632XD | 23 | 949-950 | S3732XS | 13 | 742-743 | ||
| S35329A | 24 | 963-965 | S3632XS | 06 | 393-395 | S3732XS | 13 | 760-761 | ||
| S35329D | 23 | 949-950 | S3633XA | 06 | 393-395 | S3733XA | 11 | 698-700 | ||
| S35329S | 05 | 299-301 | S3633XA | 24 | 963-965 | S3733XA | 24 | 963-965 | ||
| S35331A | 21 | 913-914 | S3633XD | 23 | 949-950 | S3733XD | 23 | 949-950 | ||
| S35331A | 24 | 963-965 | S3633XS | 06 | 393-395 | S3733XS | 12 | 729-730 | ||
| S35331D | 23 | 949-950 | S3639XA | 06 | 393-395 | S3733XS | 13 | 742-743 | ||
| S35331S | 05 | 299-301 | S3639XA | 24 | 963-965 | S3733XS | 13 | 760-761 | ||
| S35338A | 21 | 913-914 | S3639XD | 23 | 949-950 | S3739XA | 11 | 698-700 | ||
| S35338A | 24 | 963-965 | S3639XS | 06 | 393-395 | S3739XA | 24 | 963-965 | ||
| S35338D | 23 | 949-950 | S36400A | 06 | 393-395 | S3739XD | 23 | 949-950 | ||
| S35338S | 05 | 299-301 | S36400A | 24 | 963-965 | S3739XS | 12 | 729-730 | ||
| S35339A | 21 | 913-914 | S36400D | 23 | 949-950 | S3739XS | 13 | 742-743 | ||
| S35339A | 24 | 963-965 | S36400S | 06 | 393-395 | S3739XS | 13 | 760-761 | ||
| S35339D | 23 | 949-950 | S36408A | 06 | 393-395 | S37401A | 13 | 742-743 | ||
| S35339S | 05 | 299-301 | S36408A | 24 | 963-965 | S37401A | 13 | 760-761 | ||
| S35341A | 21 | 913-914 | S36408D | 23 | 949-950 | S37401D | 23 | 949-950 | ||
| S35341A | 24 | 963-965 | S36408S | 06 | 393-395 | S37401S | 13 | 742-743 | ||
| S35341D | 23 | 949-950 | S36409A | 06 | 393-395 | S37401S | 13 | 760-761 | ||
| S35341S | 05 | 299-301 | S36409A | 24 | 963-965 | S37402A | 13 | 742-743 | ||
| S35348A | 21 | 913-914 | S36409D | 23 | 949-950 | S37402A | 13 | 760-761 | ||
| S35348A | 24 | 963-965 | S36409S | 06 | 393-395 | S37402D | 23 | 949-950 | ||
| S35348D | 23 | 949-950 | S36410A | 06 | 393-395 | S37402S | 13 | 742-743 | ||
| S35348S | 05 | 299-301 | S36410A | 24 | 963-965 | S37402S | 13 | 760-761 | ||
| S35349A | 21 | 913-914 | S36410D | 23 | 949-950 | S37409A | 13 | 742-743 | ||
| S35349A | 24 | 963-965 | S36410S | 06 | 393-395 | S37409A | 13 | 760-761 | ||
| S35349D | 23 | 949-950 | S36418A | 06 | 393-395 | S37409D | 23 | 949-950 | ||
| S35349S | 05 | 299-301 | S36418A | 24 | 963-965 | S37409S | 13 | 742-743 | ||
| S35401A | 21 | 913-914 | S36418D | 23 | 949-950 | S37409S | 13 | 760-761 | ||
| S35401A | 24 | 963-965 | S36418S | 06 | 393-395 | S37421A | 13 | 742-743 | ||
| S35401D | 23 | 949-950 | S36419A | 06 | 393-395 | S37421A | 13 | 760-761 | ||
| S35401S | 05 | 299-301 | S36419A | 24 | 963-965 | S37421D | 23 | 949-950 | ||
| S35402A | 21 | 913-914 | S36419D | 23 | 949-950 | S37421S | 13 | 742-743 | ||
| S35402A | 24 | 963-965 | S36419S | 06 | 393-395 | S37421S | 13 | 760-761 | ||
| S35402D | 23 | 949-950 | S36420A | 06 | 393-395 | S37422A | 13 | 742-743 | ||
| S35402S | 05 | 299-301 | S36420A | 24 | 963-965 | S37422A | 13 | 760-761 | ||
| S35403A | 21 | 913-914 | S36420D | 23 | 949-950 | S37422D | 23 | 949-950 | ||
| S35403A | 24 | 963-965 | S36420S | 06 | 393-395 | S37422S | 13 | 742-743 | ||
| S35403D | 23 | 949-950 | S36428A | 06 | 393-395 | S37422S | 13 | 760-761 | ||
| S35403S | 05 | 299-301 | S36428A | 24 | 963-965 | S37429A | 13 | 742-743 | ||
| S35404A | 21 | 913-914 | S36428D | 23 | 949-950 | S37429A | 13 | 760-761 | ||
| S35404A | 24 | 963-965 | S36428S | 06 | 393-395 | S37429D | 23 | 949-950 | ||
| S35404D | 23 | 949-950 | S36429A | 06 | 393-395 | S37429S | 13 | 742-743 | ||
| S35404S | 05 | 299-301 | S36429A | 24 | 963-965 | S37429S | 13 | 760-761 | ||
| S35405A | 21 | 913-914 | S36429D | 23 | 949-950 | S37431A | 13 | 742-743 | ||
| S35405A | 24 | 963-965 | S36429S | 06 | 393-395 | S37431A | 13 | 760-761 | ||
| S35405D | 23 | 949-950 | S36430A | 06 | 393-395 | S37431D | 23 | 949-950 | ||
| S35405S | 05 | 299-301 | S36430A | 24 | 963-965 | S37431S | 13 | 742-743 | ||
| S35406A | 21 | 913-914 | S36430D | 23 | 949-950 | S37431S | 13 | 760-761 | ||
| S35406A | 24 | 963-965 | S36430S | 06 | 393-395 | S37432A | 13 | 742-743 | ||
| S35406D | 23 | 949-950 | S36438A | 06 | 393-395 | S37432A | 13 | 760-761 | ||
| S35406S | 05 | 299-301 | S36438A | 24 | 963-965 | S37432D | 23 | 949-950 | ||
| S35411A | 21 | 913-914 | S36438D | 23 | 949-950 | S37432S | 13 | 742-743 | ||
| S35411A | 24 | 963-965 | S36438S | 06 | 393-395 | S37432S | 13 | 760-761 | ||
| S35411D | 23 | 949-950 | S36439A | 06 | 393-395 | S37439A | 13 | 742-743 | ||
| S35411S | 05 | 299-301 | S36439A | 24 | 963-965 | S37439A | 13 | 760-761 | ||
| S35412A | 21 | 913-914 | S36439D | 23 | 949-950 | S37439D | 23 | 949-950 | ||
| S35412A | 24 | 963-965 | S36439S | 06 | 393-395 | S37439S | 13 | 742-743 | ||
| S35412D | 23 | 949-950 | S36490A | 06 | 393-395 | S37439S | 13 | 760-761 | ||
| S35412S | 05 | 299-301 | S36490A | 24 | 963-965 | S37491A | 13 | 742-743 | ||
| S35413A | 21 | 913-914 | S36490D | 23 | 949-950 | S37491A | 13 | 760-761 | ||
| S35413A | 24 | 963-965 | S36490S | 06 | 393-395 | S37491D | 23 | 949-950 | ||
| S35413D | 23 | 949-950 | S36498A | 06 | 393-395 | S37491S | 13 | 742-743 | ||
| S35413S | 05 | 299-301 | S36498A | 24 | 963-965 | S37491S | 13 | 760-761 | ||
| S35414A | 21 | 913-914 | S36498D | 23 | 949-950 | S37492A | 13 | 742-743 | ||
| S35414A | 24 | 963-965 | S36498S | 06 | 393-395 | S37492A | 13 | 760-761 | ||
| S35414D | 23 | 949-950 | S36499A | 06 | 393-395 | S37492D | 23 | 949-950 | ||
| S35414S | 05 | 299-301 | S36499A | 24 | 963-965 | S37492S | 13 | 742-743 | ||
| S35415A | 21 | 913-914 | S36499D | 23 | 949-950 | S37492S | 13 | 760-761 | ||
| S35415A | 24 | 963-965 | S36499S | 06 | 393-395 | S37499A | 13 | 742-743 | ||
| S35415D | 23 | 949-950 | S36500A | 06 | 393-395 | S37499A | 13 | 760-761 | ||
| S35415S | 05 | 299-301 | S36500A | 24 | 963-965 | S37499D | 23 | 949-950 | ||
| S35416A | 21 | 913-914 | S36500D | 23 | 949-950 | S37499S | 13 | 742-743 | ||
| S35416A | 24 | 963-965 | S36500S | 06 | 393-395 | S37499S | 13 | 760-761 | ||
| S35416D | 23 | 949-950 | S36501A | 06 | 393-395 | S37501A | 13 | 742-743 | ||
| S35416S | 05 | 299-301 | S36501A | 24 | 963-965 | S37501A | 13 | 760-761 | ||
| S35491A | 21 | 913-914 | S36501D | 23 | 949-950 | S37501D | 23 | 949-950 | ||
| S35491A | 24 | 963-965 | S36501S | 06 | 393-395 | S37501S | 13 | 742-743 | ||
| S35491D | 23 | 949-950 | S36502A | 06 | 393-395 | S37501S | 13 | 760-761 | ||
| S35491S | 05 | 299-301 | S36502A | 24 | 963-965 | S37502A | 13 | 742-743 | ||
| S35492A | 21 | 913-914 | S36502D | 23 | 949-950 | S37502A | 13 | 760-761 | ||
| S35492A | 24 | 963-965 | S36502S | 06 | 393-395 | S37502D | 23 | 949-950 | ||
| S35492D | 23 | 949-950 | S36503A | 06 | 393-395 | S37502S | 13 | 742-743 | ||
| S35492S | 05 | 299-301 | S36503A | 24 | 963-965 | S37502S | 13 | 760-761 | ||
| S35493A | 21 | 913-914 | S36503D | 23 | 949-950 | S37509A | 13 | 742-743 | ||
| S35493A | 24 | 963-965 | S36503S | 06 | 393-395 | S37509A | 13 | 760-761 | ||
| S35493D | 23 | 949-950 | S36508A | 06 | 393-395 | S37509D | 23 | 949-950 | ||
| S35493S | 05 | 299-301 | S36508A | 24 | 963-965 | S37509S | 13 | 742-743 | ||
| S35494A | 21 | 913-914 | S36508D | 23 | 949-950 | S37509S | 13 | 760-761 | ||
| S35494A | 24 | 963-965 | S36508S | 06 | 393-395 | S37511A | 13 | 742-743 | ||
| S35494D | 23 | 949-950 | S36509A | 06 | 393-395 | S37511A | 13 | 760-761 | ||
| S35494S | 05 | 299-301 | S36509A | 24 | 963-965 | S37511D | 23 | 949-950 | ||
| S35495A | 21 | 913-914 | S36509D | 23 | 949-950 | S37511S | 13 | 742-743 | ||
| S35495A | 24 | 963-965 | S36509S | 06 | 393-395 | S37511S | 13 | 760-761 | ||
| S35495D | 23 | 949-950 | S36510A | 06 | 393-395 | S37512A | 13 | 742-743 | ||
| S35495S | 05 | 299-301 | S36510A | 24 | 963-965 | S37512A | 13 | 760-761 | ||
| S35496A | 21 | 913-914 | S36510D | 23 | 949-950 | S37512D | 23 | 949-950 | ||
| S35496A | 24 | 963-965 | S36510S | 06 | 393-395 | S37512S | 13 | 742-743 | ||
| S35496D | 23 | 949-950 | S36511A | 06 | 393-395 | S37512S | 13 | 760-761 | ||
| S35496S | 05 | 299-301 | S36511A | 24 | 963-965 | S37519A | 13 | 742-743 | ||
| S3550XA | 21 | 913-914 | S36511D | 23 | 949-950 | S37519A | 13 | 760-761 | ||
| S3550XA | 24 | 963-965 | S36511S | 06 | 393-395 | S37519D | 23 | 949-950 | ||
| S3550XD | 23 | 949-950 | S36512A | 06 | 393-395 | S37519S | 13 | 742-743 | ||
| S3550XS | 05 | 299-301 | S36512A | 24 | 963-965 | S37519S | 13 | 760-761 | ||
| S35511A | 21 | 913-914 | S36512D | 23 | 949-950 | S37521A | 13 | 742-743 | ||
| S35511A | 24 | 963-965 | S36512S | 06 | 393-395 | S37521A | 13 | 760-761 | ||
| S35511D | 23 | 949-950 | S36513A | 06 | 393-395 | S37521D | 23 | 949-950 | ||
| S35511S | 05 | 299-301 | S36513A | 24 | 963-965 | S37521S | 13 | 742-743 | ||
| S35512A | 21 | 913-914 | S36513D | 23 | 949-950 | S37521S | 13 | 760-761 | ||
| S35512A | 24 | 963-965 | S36513S | 06 | 393-395 | S37522A | 13 | 742-743 | ||
| S35512D | 23 | 949-950 | S36518A | 06 | 393-395 | S37522A | 13 | 760-761 | ||
| S35512S | 05 | 299-301 | S36518A | 24 | 963-965 | S37522D | 23 | 949-950 | ||
| S35513A | 21 | 913-914 | S36518D | 23 | 949-950 | S37522S | 13 | 742-743 | ||
| S35513A | 24 | 963-965 | S36518S | 06 | 393-395 | S37522S | 13 | 760-761 | ||
| S35513D | 23 | 949-950 | S36519A | 06 | 393-395 | S37529A | 13 | 742-743 | ||
| S35513S | 05 | 299-301 | S36519A | 24 | 963-965 | S37529A | 13 | 760-761 | ||
| S35514A | 21 | 913-914 | S36519D | 23 | 949-950 | S37529D | 23 | 949-950 | ||
| S35514A | 24 | 963-965 | S36519S | 06 | 393-395 | S37529S | 13 | 742-743 | ||
| S35514D | 23 | 949-950 | S36520A | 06 | 393-395 | S37529S | 13 | 760-761 | ||
| S35514S | 05 | 299-301 | S36520A | 24 | 963-965 | S37531A | 13 | 742-743 | ||
| S35515A | 21 | 913-914 | S36520D | 23 | 949-950 | S37531A | 13 | 760-761 | ||
| S35515A | 24 | 963-965 | S36520S | 06 | 393-395 | S37531D | 23 | 949-950 | ||
| S35515D | 23 | 949-950 | S36521A | 06 | 393-395 | S37531S | 13 | 742-743 | ||
| S35515S | 05 | 299-301 | S36521A | 24 | 963-965 | S37531S | 13 | 760-761 | ||
| S35516A | 21 | 913-914 | S36521D | 23 | 949-950 | S37532A | 13 | 742-743 | ||
| S35516A | 24 | 963-965 | S36521S | 06 | 393-395 | S37532A | 13 | 760-761 | ||
| S35516D | 23 | 949-950 | S36522A | 06 | 393-395 | S37532D | 23 | 949-950 | ||
| S35516S | 05 | 299-301 | S36522A | 24 | 963-965 | S37532S | 13 | 742-743 | ||
| S35531A | 21 | 913-914 | S36522D | 23 | 949-950 | S37532S | 13 | 760-761 | ||
| S35531A | 24 | 963-965 | S36522S | 06 | 393-395 | S37539A | 13 | 742-743 | ||
| S35531D | 23 | 949-950 | S36523A | 06 | 393-395 | S37539A | 13 | 760-761 | ||
| S35531S | 05 | 299-301 | S36523A | 24 | 963-965 | S37539D | 23 | 949-950 | ||
| S35532A | 21 | 913-914 | S36523D | 23 | 949-950 | S37539S | 13 | 742-743 | ||
| S35532A | 24 | 963-965 | S36523S | 06 | 393-395 | S37539S | 13 | 760-761 | ||
| S35532D | 23 | 949-950 | S36528A | 06 | 393-395 | S37591A | 13 | 742-743 | ||
| S35532S | 05 | 299-301 | S36528A | 24 | 963-965 | S37591A | 13 | 760-761 | ||
| S35533A | 21 | 913-914 | S36528D | 23 | 949-950 | S37591D | 23 | 949-950 | ||
| S35533A | 24 | 963-965 | S36528S | 06 | 393-395 | S37591S | 13 | 742-743 | ||
| S35533D | 23 | 949-950 | S36529A | 06 | 393-395 | S37591S | 13 | 760-761 | ||
| S35533S | 05 | 299-301 | S36529A | 24 | 963-965 | S37592A | 13 | 742-743 | ||
| S35534A | 21 | 913-914 | S36529D | 23 | 949-950 | S37592A | 13 | 760-761 | ||
| S35534A | 24 | 963-965 | S36529S | 06 | 393-395 | S37592D | 23 | 949-950 | ||
| S35534D | 23 | 949-950 | S36530A | 06 | 393-395 | S37592S | 13 | 742-743 | ||
| S35534S | 05 | 299-301 | S36530A | 24 | 963-965 | S37592S | 13 | 760-761 | ||
| S35535A | 21 | 913-914 | S36530D | 23 | 949-950 | S37599A | 13 | 742-743 | ||
| S35535A | 24 | 963-965 | S36530S | 06 | 393-395 | S37599A | 13 | 760-761 | ||
| S35535D | 23 | 949-950 | S36531A | 06 | 393-395 | S37599D | 23 | 949-950 | ||
| S35535S | 05 | 299-301 | S36531A | 24 | 963-965 | S37599S | 13 | 742-743 | ||
| S35536A | 21 | 913-914 | S36531D | 23 | 949-950 | S37599S | 13 | 760-761 | ||
| S35536A | 24 | 963-965 | S36531S | 06 | 393-395 | S3760XA | 13 | 742-743 | ||
| S35536D | 23 | 949-950 | S36532A | 06 | 393-395 | S3760XA | 13 | 760-761 | ||
| S35536S | 05 | 299-301 | S36532A | 24 | 963-965 | S3760XA | 24 | 963-965 | ||
| S3559XA | 21 | 913-914 | S36532D | 23 | 949-950 | S3760XD | 23 | 949-950 | ||
| S3559XA | 24 | 963-965 | S36532S | 06 | 393-395 | S3760XS | 13 | 742-743 | ||
| S3559XD | 23 | 949-950 | S36533A | 06 | 393-395 | S3760XS | 13 | 760-761 | ||
| S3559XS | 05 | 299-301 | S36533A | 24 | 963-965 | S3762XA | 13 | 742-743 | ||
| S358X1A | 21 | 913-914 | S36533D | 23 | 949-950 | S3762XA | 13 | 760-761 | ||
| S358X1A | 24 | 963-965 | S36533S | 06 | 393-395 | S3762XA | 24 | 963-965 | ||
| S358X1D | 23 | 949-950 | S36538A | 06 | 393-395 | S3762XD | 23 | 949-950 | ||
| S358X1S | 05 | 299-301 | S36538A | 24 | 963-965 | S3762XS | 13 | 742-743 | ||
| S358X8A | 21 | 913-914 | S36538D | 23 | 949-950 | S3762XS | 13 | 760-761 | ||
| S358X8A | 24 | 963-965 | S36538S | 06 | 393-395 | S3763XA | 13 | 742-743 | ||
| S358X8D | 23 | 949-950 | S36539A | 06 | 393-395 | S3763XA | 13 | 760-761 | ||
| S358X8S | 05 | 299-301 | S36539A | 24 | 963-965 | S3763XA | 24 | 963-965 | ||
| S358X9A | 21 | 913-914 | S36539D | 23 | 949-950 | S3763XD | 23 | 949-950 | ||
| S358X9A | 24 | 963-965 | S36539S | 06 | 393-395 | S3763XS | 13 | 742-743 | ||
| S358X9D | 23 | 949-950 | S36590A | 06 | 393-395 | S3763XS | 13 | 760-761 | ||
| S358X9S | 05 | 299-301 | S36590A | 24 | 963-965 | S3769XA | 13 | 742-743 | ||
| S3590XA | 21 | 913-914 | S36590D | 23 | 949-950 | S3769XA | 13 | 760-761 | ||
| S3590XA | 24 | 963-965 | S36590S | 06 | 393-395 | S3769XA | 24 | 963-965 | ||
| S3590XD | 23 | 949-950 | S36591A | 06 | 393-395 | S3769XD | 23 | 949-950 | ||
| S3590XS | 05 | 299-301 | S36591A | 24 | 963-965 | S3769XS | 13 | 742-743 | ||
| S3591XA | 21 | 913-914 | S36591D | 23 | 949-950 | S3769XS | 13 | 760-761 | ||
| S3591XA | 24 | 963-965 | S36591S | 06 | 393-395 | S37812A | 10 | 643-645 | ||
| S3591XD | 23 | 949-950 | S36592A | 06 | 393-395 | S37812A | 24 | 963-965 | ||
| S3591XS | 05 | 299-301 | S36592A | 24 | 963-965 | S37812D | 23 | 949-950 | ||
| S3599XA | 21 | 913-914 | S36592D | 23 | 949-950 | S37812S | 12 | 729-730 | ||
| S3599XA | 24 | 963-965 | S36592S | 06 | 393-395 | S37812S | 13 | 742-743 | ||
| S3599XD | 23 | 949-950 | S36593A | 06 | 393-395 | S37812S | 13 | 760-761 | ||
| S3599XS | 05 | 299-301 | S36593A | 24 | 963-965 | S37813A | 10 | 643-645 | ||
| S3600XA | 15 | 791 | S36593D | 23 | 949-950 | S37813A | 24 | 963-965 | ||
| S3600XA | 15 | 793 | S36593S | 06 | 393-395 | S37813D | 23 | 949-950 | ||
| S3600XA | 16 | 814-816 | S36598A | 06 | 393-395 | S37813S | 12 | 729-730 | ||
| S3600XA | 24 | 963-965 | S36598A | 24 | 963-965 | S37813S | 13 | 742-743 | ||
| S3600XD | 23 | 949-950 | S36598D | 23 | 949-950 | S37813S | 13 | 760-761 | ||
| S3600XS | 06 | 393-395 | S36598S | 06 | 393-395 | S37818A | 10 | 643-645 | ||
| S36020A | 15 | 791 | S36599A | 06 | 393-395 | S37818A | 24 | 963-965 | ||
| S36020A | 15 | 793 | S36599A | 24 | 963-965 | S37818D | 23 | 949-950 | ||
| S36020A | 16 | 814-816 | S36599D | 23 | 949-950 | S37818S | 12 | 729-730 | ||
| S36020A | 24 | 963-965 | S36599S | 06 | 393-395 | S37818S | 13 | 742-743 | ||
| S36020D | 23 | 949-950 | S3660XA | 06 | 393-395 | S37818S | 13 | 760-761 | ||
| S36020S | 06 | 393-395 | S3660XA | 24 | 963-965 | S37819A | 10 | 643-645 | ||
| S36021A | 15 | 791 | S3660XD | 23 | 949-950 | S37819A | 24 | 963-965 | ||
| S36021A | 15 | 793 | S3660XS | 06 | 393-395 | S37819D | 23 | 949-950 | ||
| S36021A | 16 | 814-816 | S3661XA | 06 | 393-395 | S37819S | 12 | 729-730 | ||
| S36021A | 24 | 963-965 | S3661XA | 24 | 963-965 | S37819S | 13 | 742-743 | ||
| S36021D | 23 | 949-950 | S3661XD | 23 | 949-950 | S37819S | 13 | 760-761 | ||
| S36021S | 06 | 393-395 | S3661XS | 06 | 393-395 | S37822A | 12 | 729-730 | ||
| S36029A | 15 | 791 | S3662XA | 06 | 393-395 | S37822D | 23 | 949-950 | ||
| S36029A | 15 | 793 | S3662XA | 24 | 963-965 | S37822S | 12 | 729-730 | ||
| S36029A | 16 | 814-816 | S3662XD | 23 | 949-950 | S37823A | 12 | 729-730 | ||
| S36029A | 24 | 963-965 | S3662XS | 06 | 393-395 | S37823D | 23 | 949-950 | ||
| S36029D | 23 | 949-950 | S3663XA | 06 | 393-395 | S37823S | 12 | 729-730 | ||
| S36029S | 06 | 393-395 | S3663XA | 24 | 963-965 | S37828A | 12 | 729-730 | ||
| S36030A | 15 | 791 | S3663XD | 23 | 949-950 | S37828D | 23 | 949-950 | ||
| S36030A | 15 | 793 | S3663XS | 06 | 393-395 | S37828S | 12 | 729-730 | ||
| S36030A | 16 | 814-816 | S3669XA | 06 | 393-395 | S37829A | 12 | 729-730 | ||
| S36030A | 24 | 963-965 | S3669XA | 24 | 963-965 | S37829D | 23 | 949-950 | ||
| S36030D | 23 | 949-950 | S3669XD | 23 | 949-950 | S37829S | 12 | 729-730 | ||
| S36030S | 06 | 393-395 | S3669XS | 06 | 393-395 | S37892A | 12 | 729-730 | ||
| S36031A | 15 | 791 | S3681XA | 06 | 393-395 | S37892A | 13 | 742-743 | ||
| S36031A | 15 | 793 | S3681XA | 24 | 963-965 | S37892A | 13 | 760-761 | ||
| S36031A | 16 | 814-816 | S3681XD | 23 | 949-950 | S37892A | 24 | 963-965 | ||
| S36031A | 24 | 963-965 | S3681XS | 06 | 393-395 | S37892D | 23 | 949-950 | ||
| S36031D | 23 | 949-950 | S36892A | 21 | 913-914 | S37892S | 12 | 729-730 | ||
| S36031S | 06 | 393-395 | S36892A | 24 | 963-965 | S37892S | 13 | 742-743 | ||
| S36032A | 15 | 791 | S36892D | 23 | 949-950 | S37892S | 13 | 760-761 | ||
| S36032A | 15 | 793 | S36892S | 06 | 393-395 | S37893A | 12 | 729-730 | ||
| S36032A | 16 | 814-816 | S36893A | 21 | 913-914 | S37893A | 13 | 742-743 | ||
| S36032A | 24 | 963-965 | S36893A | 24 | 963-965 | S37893A | 13 | 760-761 | ||
| S36032D | 23 | 949-950 | S36893D | 23 | 949-950 | S37893A | 24 | 963-965 | ||
| S36032S | 06 | 393-395 | S36893S | 06 | 393-395 | S37893D | 23 | 949-950 | ||
| S36039A | 15 | 791 | S36898A | 21 | 913-914 | S37893S | 12 | 729-730 | ||
| S36039A | 15 | 793 | S36898A | 24 | 963-965 | S37893S | 13 | 742-743 | ||
| S36039A | 16 | 814-816 | S36898D | 23 | 949-950 | S37893S | 13 | 760-761 | ||
| S36039A | 24 | 963-965 | S36898S | 06 | 393-395 | S37898A | 12 | 729-730 | ||
| S36039D | 23 | 949-950 | S36899A | 21 | 913-914 | S37898A | 13 | 742-743 | ||
| S36039S | 06 | 393-395 | S36899A | 24 | 963-965 | S37898A | 13 | 760-761 | ||
| S3609XA | 15 | 791 | S36899D | 23 | 949-950 | S37898A | 24 | 963-965 | ||
| S3609XA | 15 | 793 | S36899S | 06 | 393-395 | S37898D | 23 | 949-950 | ||
| S3609XA | 16 | 814-816 | S3690XA | 06 | 393-395 | S37898S | 12 | 729-730 | ||
| S3609XA | 24 | 963-965 | S3690XA | 24 | 963-965 | S37898S | 13 | 742-743 | ||
| S3609XD | 23 | 949-950 | S3690XD | 23 | 949-950 | S37898S | 13 | 760-761 | ||
| S3609XS | 06 | 393-395 | S3690XS | 06 | 393-395 | S37899A | 12 | 729-730 | ||
| S36112A | 07 | 441-443 | S3692XA | 06 | 393-395 | S37899A | 13 | 742-743 | ||
| S36112A | 24 | 963-965 | S3692XA | 24 | 963-965 | S37899A | 13 | 760-761 | ||
| S36112D | 23 | 949-950 | S3692XD | 23 | 949-950 | S37899A | 24 | 963-965 | ||
| S36112S | 06 | 393-395 | S3692XS | 06 | 393-395 | S37899D | 23 | 949-950 | ||
| S36113A | 07 | 441-443 | S3693XA | 06 | 393-395 | S37899S | 12 | 729-730 | ||
| S36113A | 24 | 963-965 | S3693XA | 24 | 963-965 | S37899S | 13 | 742-743 | ||
| S36113D | 23 | 949-950 | S3693XD | 23 | 949-950 | S37899S | 13 | 760-761 | ||
| S36113S | 06 | 393-395 | S3693XS | 06 | 393-395 | S3790XA | 12 | 729-730 | ||
| S36114A | 07 | 441-443 | S3699XA | 06 | 393-395 | S3790XA | 13 | 742-743 | ||
| S36114A | 24 | 963-965 | S3699XA | 24 | 963-965 | S3790XA | 13 | 760-761 | ||
| S36114D | 23 | 949-950 | S3699XD | 23 | 949-950 | S3790XA | 24 | 963-965 | ||
| S36114S | 06 | 393-395 | S3699XS | 06 | 393-395 | S3790XD | 23 | 949-950 | ||
| S36115A | 07 | 441-443 | S37001A | 11 | 698-700 | S3790XS | 12 | 729-730 | ||
| S36115A | 24 | 963-965 | S37001A | 24 | 963-965 | S3790XS | 13 | 742-743 | ||
| S36115D | 23 | 949-950 | S37001D | 23 | 949-950 | S3790XS | 13 | 760-761 | ||
| S36115S | 06 | 393-395 | S37001S | 06 | 393-395 | S3792XA | 12 | 729-730 | ||
| S36116A | 07 | 441-443 | S37002A | 11 | 698-700 | S3792XA | 13 | 742-743 | ||
| S36116A | 24 | 963-965 | S37002A | 24 | 963-965 | S3792XA | 13 | 760-761 | ||
| S36116D | 23 | 949-950 | S37002D | 23 | 949-950 | S3792XA | 24 | 963-965 | ||
| S36116S | 06 | 393-395 | S37002S | 06 | 393-395 | S3792XD | 23 | 949-950 | ||
| S36118A | 07 | 441-443 | S37009A | 11 | 698-700 | S3792XS | 12 | 729-730 | ||
| S36118A | 24 | 963-965 | S37009A | 24 | 963-965 | S3792XS | 13 | 742-743 | ||
| S36118D | 23 | 949-950 | S37009D | 23 | 949-950 | S3792XS | 13 | 760-761 | ||
| S36118S | 06 | 393-395 | S37009S | 06 | 393-395 | S3793XA | 12 | 729-730 | ||
| S36119A | 07 | 441-443 | S37011A | 11 | 698-700 | S3793XA | 13 | 742-743 | ||
| S36119A | 24 | 963-965 | S37011A | 24 | 963-965 | S3793XA | 13 | 760-761 | ||
| S36119D | 23 | 949-950 | S37011D | 23 | 949-950 | S3793XA | 24 | 963-965 | ||
| S36119S | 06 | 393-395 | S37011S | 06 | 393-395 | S3793XD | 23 | 949-950 | ||
| S36122A | 07 | 444-446 | S37012A | 11 | 698-700 | S3793XS | 12 | 729-730 | ||
| S36122A | 24 | 963-965 | S37012A | 24 | 963-965 | S3793XS | 13 | 742-743 | ||
| S36122D | 23 | 949-950 | S37012D | 23 | 949-950 | S3793XS | 13 | 760-761 | ||
| S36122S | 06 | 393-395 | S37012S | 06 | 393-395 | S3799XA | 12 | 729-730 | ||
| S36123A | 07 | 444-446 | S37019A | 11 | 698-700 | S3799XA | 13 | 742-743 | ||
| S36123A | 24 | 963-965 | S37019A | 24 | 963-965 | S3799XA | 13 | 760-761 | ||
| S36123D | 23 | 949-950 | S37019D | 23 | 949-950 | S3799XA | 24 | 963-965 | ||
| S36123S | 06 | 393-395 | S37019S | 06 | 393-395 | S3799XD | 23 | 949-950 | ||
| S36128A | 07 | 444-446 | S37021A | 11 | 698-700 | S3799XS | 12 | 729-730 | ||
| S36128A | 24 | 963-965 | S37021A | 24 | 963-965 | S3799XS | 13 | 742-743 | ||
| S36128D | 23 | 949-950 | S37021D | 23 | 949-950 | S3799XS | 13 | 760-761 | ||
| S36128S | 06 | 393-395 | S37021S | 06 | 393-395 | S38001A | 12 | 729-730 | ||
| S36129A | 07 | 444-446 | S37022A | 11 | 698-700 | S38001A | 24 | 963-965 | ||
| S36129A | 24 | 963-965 | S37022A | 24 | 963-965 | S38001D | 23 | 949-950 | ||
| S36129D | 23 | 949-950 | S37022D | 23 | 949-950 | S38001S | 09 | 604-605 | ||
| S36129S | 06 | 393-395 | S37022S | 06 | 393-395 | S38002A | 13 | 742-743 | ||
| S3613XA | 07 | 444-446 | S37029A | 11 | 698-700 | S38002A | 13 | 760-761 | ||
| S3613XA | 24 | 963-965 | S37029A | 24 | 963-965 | S38002A | 24 | 963-965 | ||
| S3613XD | 23 | 949-950 | S37029D | 23 | 949-950 | S38002D | 23 | 949-950 | ||
| S3613XS | 06 | 393-395 | S37029S | 06 | 393-395 | S38002S | 09 | 604-605 | ||
| S36200A | 07 | 438-440 | S37031A | 11 | 698-700 | S3801XA | 12 | 729-730 | ||
| S36200A | 24 | 963-965 | S37031A | 24 | 963-965 | S3801XA | 24 | 963-965 | ||
| S36200D | 23 | 949-950 | S37031D | 23 | 949-950 | S3801XD | 23 | 949-950 | ||
| S36200S | 06 | 393-395 | S37031S | 06 | 393-395 | S3801XS | 09 | 604-605 | ||
| S36201A | 07 | 438-440 | S37032A | 11 | 698-700 | S3802XA | 12 | 729-730 | ||
| S36201A | 24 | 963-965 | S37032A | 24 | 963-965 | S3802XA | 24 | 963-965 | ||
| S36201D | 23 | 949-950 | S37032D | 23 | 949-950 | S3802XD | 23 | 949-950 | ||
| S36201S | 06 | 393-395 | S37032S | 06 | 393-395 | S3802XS | 09 | 604-605 | ||
| S36202A | 07 | 438-440 | S37039A | 11 | 698-700 | S3803XA | 13 | 742-743 | ||
| S36202A | 24 | 963-965 | S37039A | 24 | 963-965 | S3803XA | 13 | 760-761 | ||
| S36202D | 23 | 949-950 | S37039D | 23 | 949-950 | S3803XA | 24 | 963-965 | ||
| S36202S | 06 | 393-395 | S37039S | 06 | 393-395 | S3803XD | 23 | 949-950 | ||
| S36209A | 07 | 438-440 | S37041A | 11 | 698-700 | S3803XS | 09 | 604-605 | ||
| S36209A | 24 | 963-965 | S37041A | 24 | 963-965 | S381XXA | 21 | 913-914 | ||
| S36209D | 23 | 949-950 | S37041D | 23 | 949-950 | S381XXA | 24 | 963-965 | ||
| S36209S | 06 | 393-395 | S37041S | 06 | 393-395 | S381XXD | 23 | 949-950 | ||
| S36220A | 07 | 438-440 | S37042A | 11 | 698-700 | S381XXS | 09 | 604-605 | ||
| S36220A | 24 | 963-965 | S37042A | 24 | 963-965 | S38211A | 13 | 742-743 | ||
| S36220D | 23 | 949-950 | S37042D | 23 | 949-950 | S38211A | 13 | 760-761 | ||
| S36220S | 06 | 393-395 | S37042S | 06 | 393-395 | S38211A | 24 | 963-965 | ||
| S36221A | 07 | 438-440 | S37049A | 11 | 698-700 | S38211D | 23 | 949-950 | ||
| S36221A | 24 | 963-965 | S37049A | 24 | 963-965 | S38211S | 09 | 604-605 | ||
| S36221D | 23 | 949-950 | S37049D | 23 | 949-950 | S38212A | 13 | 742-743 | ||
| S36221S | 06 | 393-395 | S37049S | 06 | 393-395 | S38212A | 13 | 760-761 | ||
| S36222A | 07 | 438-440 | S37051A | 11 | 698-700 | S38212A | 24 | 963-965 | ||
| S36222A | 24 | 963-965 | S37051A | 24 | 963-965 | S38212D | 23 | 949-950 | ||
| S36222D | 23 | 949-950 | S37051D | 23 | 949-950 | S38212S | 09 | 604-605 | ||
| S36222S | 06 | 393-395 | S37051S | 06 | 393-395 | S38221A | 12 | 729-730 | ||
| S36229A | 07 | 438-440 | S37052A | 11 | 698-700 | S38221A | 24 | 963-965 | ||
| S36229A | 24 | 963-965 | S37052A | 24 | 963-965 | S38221D | 23 | 949-950 | ||
| S36229D | 23 | 949-950 | S37052D | 23 | 949-950 | S38221S | 09 | 604-605 | ||
| S36229S | 06 | 393-395 | S37052S | 06 | 393-395 | S38222A | 12 | 729-730 | ||
| S36230A | 07 | 438-440 | S37059A | 11 | 698-700 | S38222A | 24 | 963-965 | ||
| S36230A | 24 | 963-965 | S37059A | 24 | 963-965 | S38222D | 23 | 949-950 | ||
| S36230D | 23 | 949-950 | S37059D | 23 | 949-950 | S38222S | 09 | 604-605 | ||
| S36230S | 06 | 393-395 | S37059S | 06 | 393-395 | S38231A | 12 | 729-730 | ||
| S36231A | 07 | 438-440 | S37061A | 11 | 698-700 | S38231A | 24 | 963-965 | ||
| S36231A | 24 | 963-965 | S37061A | 24 | 963-965 | S38231D | 23 | 949-950 | ||
| S36231D | 23 | 949-950 | S37061D | 23 | 949-950 | S38231S | 09 | 604-605 | ||
| S36231S | 06 | 393-395 | S37061S | 06 | 393-395 | S38232A | 12 | 729-730 | ||
| S36232A | 07 | 438-440 | S37062A | 11 | 698-700 | S38232A | 24 | 963-965 | ||
| S36232A | 24 | 963-965 | S37062A | 24 | 963-965 | S38232D | 23 | 949-950 | ||
| S36232D | 23 | 949-950 | S37062D | 23 | 949-950 | S38232S | 09 | 604-605 | ||
| S36232S | 06 | 393-395 | S37062S | 06 | 393-395 | S383XXA | 09 | 604-605 | ||
| S36239A | 07 | 438-440 | S37069A | 11 | 698-700 | S383XXA | 24 | 963-965 | ||
| S36239A | 24 | 963-965 | S37069A | 24 | 963-965 | S383XXD | 23 | 949-950 | ||
| S36239D | 23 | 949-950 | S37069D | 23 | 949-950 | S383XXS | 09 | 604-605 | ||
| S36239S | 06 | 393-395 | S37069S | 06 | 393-395 | S39001A | 21 | 913-914 | ||
| S36240A | 07 | 438-440 | S37091A | 11 | 698-700 | S39001A | 24 | 963-965 | ||
| S36240A | 24 | 963-965 | S37091A | 24 | 963-965 | S39001D | 23 | 949-950 | ||
| S36240D | 23 | 949-950 | S37091D | 23 | 949-950 | S39001S | 21 | 913-914 | ||
| S36240S | 06 | 393-395 | S37091S | 06 | 393-395 | S39002A | 21 | 913-914 | ||
| S39002A | 24 | 963-965 |
| | |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 06 Sep 2024 16:41:54 CMS, code-revision=366, description-revision=1405 |