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 54 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S72133F | 08 | 559-561 | S7222XC | 08 | 521-522 | S72331A | 08 | 533-534 | ||
| S72133G | 08 | 521-522 | S7222XC | 08 | 535-536 | S72331A | 15 | 791 | ||
| S72133G | 08 | 559-561 | S7222XC | 15 | 791 | S72331A | 15 | 793 | ||
| S72133H | 08 | 521-522 | S7222XC | 15 | 793 | S72331A | 24 | 963-965 | ||
| S72133H | 08 | 559-561 | S7222XC | 24 | 963-965 | S72331B | 08 | 533-534 | ||
| S72133J | 08 | 521-522 | S7222XD | 08 | 559-561 | S72331B | 15 | 791 | ||
| S72133J | 08 | 559-561 | S7222XE | 08 | 559-561 | S72331B | 15 | 793 | ||
| S72133K | 08 | 521-522 | S7222XF | 08 | 559-561 | S72331B | 24 | 963-965 | ||
| S72133K | 08 | 564-566 | S7222XG | 08 | 521-522 | S72331C | 08 | 533-534 | ||
| S72133M | 08 | 521-522 | S7222XG | 08 | 559-561 | S72331C | 15 | 791 | ||
| S72133M | 08 | 564-566 | S7222XH | 08 | 521-522 | S72331C | 15 | 793 | ||
| S72133N | 08 | 521-522 | S7222XH | 08 | 559-561 | S72331C | 24 | 963-965 | ||
| S72133N | 08 | 564-566 | S7222XJ | 08 | 521-522 | S72331D | 08 | 559-561 | ||
| S72133P | 08 | 521-522 | S7222XJ | 08 | 559-561 | S72331E | 08 | 559-561 | ||
| S72133P | 08 | 564-566 | S7222XK | 08 | 521-522 | S72331F | 08 | 559-561 | ||
| S72133Q | 08 | 521-522 | S7222XK | 08 | 564-566 | S72331G | 08 | 559-561 | ||
| S72133Q | 08 | 564-566 | S7222XM | 08 | 521-522 | S72331H | 08 | 559-561 | ||
| S72133R | 08 | 521-522 | S7222XM | 08 | 564-566 | S72331J | 08 | 559-561 | ||
| S72133R | 08 | 564-566 | S7222XN | 08 | 521-522 | S72331K | 08 | 564-566 | ||
| S72133S | 08 | 559-561 | S7222XN | 08 | 564-566 | S72331M | 08 | 564-566 | ||
| S72134A | 08 | 521-522 | S7222XP | 08 | 521-522 | S72331N | 08 | 564-566 | ||
| S72134A | 08 | 535-536 | S7222XP | 08 | 564-566 | S72331P | 08 | 564-566 | ||
| S72134A | 15 | 791 | S7222XQ | 08 | 521-522 | S72331Q | 08 | 564-566 | ||
| S72134A | 15 | 793 | S7222XQ | 08 | 564-566 | S72331R | 08 | 564-566 | ||
| S72134A | 24 | 963-965 | S7222XR | 08 | 521-522 | S72331S | 08 | 559-561 | ||
| S72134B | 08 | 521-522 | S7222XR | 08 | 564-566 | S72332A | 08 | 533-534 | ||
| S72134B | 08 | 535-536 | S7222XS | 08 | 559-561 | S72332A | 15 | 791 | ||
| S72134B | 15 | 791 | S7223XA | 08 | 521-522 | S72332A | 15 | 793 | ||
| S72134B | 15 | 793 | S7223XA | 08 | 535-536 | S72332A | 24 | 963-965 | ||
| S72134B | 24 | 963-965 | S7223XA | 15 | 791 | S72332B | 08 | 533-534 | ||
| S72134C | 08 | 521-522 | S7223XA | 15 | 793 | S72332B | 15 | 791 | ||
| S72134C | 08 | 535-536 | S7223XA | 24 | 963-965 | S72332B | 15 | 793 | ||
| S72134C | 15 | 791 | S7223XB | 08 | 521-522 | S72332B | 24 | 963-965 | ||
| S72134C | 15 | 793 | S7223XB | 08 | 535-536 | S72332C | 08 | 533-534 | ||
| S72134C | 24 | 963-965 | S7223XB | 15 | 791 | S72332C | 15 | 791 | ||
| S72134D | 08 | 559-561 | S7223XB | 15 | 793 | S72332C | 15 | 793 | ||
| S72134E | 08 | 559-561 | S7223XB | 24 | 963-965 | S72332C | 24 | 963-965 | ||
| S72134F | 08 | 559-561 | S7223XC | 08 | 521-522 | S72332D | 08 | 559-561 | ||
| S72134G | 08 | 521-522 | S7223XC | 08 | 535-536 | S72332E | 08 | 559-561 | ||
| S72134G | 08 | 559-561 | S7223XC | 15 | 791 | S72332F | 08 | 559-561 | ||
| S72134H | 08 | 521-522 | S7223XC | 15 | 793 | S72332G | 08 | 559-561 | ||
| S72134H | 08 | 559-561 | S7223XC | 24 | 963-965 | S72332H | 08 | 559-561 | ||
| S72134J | 08 | 521-522 | S7223XD | 08 | 559-561 | S72332J | 08 | 559-561 | ||
| S72134J | 08 | 559-561 | S7223XE | 08 | 559-561 | S72332K | 08 | 564-566 | ||
| S72134K | 08 | 521-522 | S7223XF | 08 | 559-561 | S72332M | 08 | 564-566 | ||
| S72134K | 08 | 564-566 | S7223XG | 08 | 521-522 | S72332N | 08 | 564-566 | ||
| S72134M | 08 | 521-522 | S7223XG | 08 | 559-561 | S72332P | 08 | 564-566 | ||
| S72134M | 08 | 564-566 | S7223XH | 08 | 521-522 | S72332Q | 08 | 564-566 | ||
| S72134N | 08 | 521-522 | S7223XH | 08 | 559-561 | S72332R | 08 | 564-566 | ||
| S72134N | 08 | 564-566 | S7223XJ | 08 | 521-522 | S72332S | 08 | 559-561 | ||
| S72134P | 08 | 521-522 | S7223XJ | 08 | 559-561 | S72333A | 08 | 533-534 | ||
| S72134P | 08 | 564-566 | S7223XK | 08 | 521-522 | S72333A | 15 | 791 | ||
| S72134Q | 08 | 521-522 | S7223XK | 08 | 564-566 | S72333A | 15 | 793 | ||
| S72134Q | 08 | 564-566 | S7223XM | 08 | 521-522 | S72333A | 24 | 963-965 | ||
| S72134R | 08 | 521-522 | S7223XM | 08 | 564-566 | S72333B | 08 | 533-534 | ||
| S72134R | 08 | 564-566 | S7223XN | 08 | 521-522 | S72333B | 15 | 791 | ||
| S72134S | 08 | 559-561 | S7223XN | 08 | 564-566 | S72333B | 15 | 793 | ||
| S72135A | 08 | 521-522 | S7223XP | 08 | 521-522 | S72333B | 24 | 963-965 | ||
| S72135A | 08 | 535-536 | S7223XP | 08 | 564-566 | S72333C | 08 | 533-534 | ||
| S72135A | 15 | 791 | S7223XQ | 08 | 521-522 | S72333C | 15 | 791 | ||
| S72135A | 15 | 793 | S7223XQ | 08 | 564-566 | S72333C | 15 | 793 | ||
| S72135A | 24 | 963-965 | S7223XR | 08 | 521-522 | S72333C | 24 | 963-965 | ||
| S72135B | 08 | 521-522 | S7223XR | 08 | 564-566 | S72333D | 08 | 559-561 | ||
| S72135B | 08 | 535-536 | S7223XS | 08 | 559-561 | S72333E | 08 | 559-561 | ||
| S72135B | 15 | 791 | S7224XA | 08 | 521-522 | S72333F | 08 | 559-561 | ||
| S72135B | 15 | 793 | S7224XA | 08 | 535-536 | S72333G | 08 | 559-561 | ||
| S72135B | 24 | 963-965 | S7224XA | 15 | 791 | S72333H | 08 | 559-561 | ||
| S72135C | 08 | 521-522 | S7224XA | 15 | 793 | S72333J | 08 | 559-561 | ||
| S72135C | 08 | 535-536 | S7224XA | 24 | 963-965 | S72333K | 08 | 564-566 | ||
| S72135C | 15 | 791 | S7224XB | 08 | 521-522 | S72333M | 08 | 564-566 | ||
| S72135C | 15 | 793 | S7224XB | 08 | 535-536 | S72333N | 08 | 564-566 | ||
| S72135C | 24 | 963-965 | S7224XB | 15 | 791 | S72333P | 08 | 564-566 | ||
| S72135D | 08 | 559-561 | S7224XB | 15 | 793 | S72333Q | 08 | 564-566 | ||
| S72135E | 08 | 559-561 | S7224XB | 24 | 963-965 | S72333R | 08 | 564-566 | ||
| S72135F | 08 | 559-561 | S7224XC | 08 | 521-522 | S72333S | 08 | 559-561 | ||
| S72135G | 08 | 521-522 | S7224XC | 08 | 535-536 | S72334A | 08 | 533-534 | ||
| S72135G | 08 | 559-561 | S7224XC | 15 | 791 | S72334A | 15 | 791 | ||
| S72135H | 08 | 521-522 | S7224XC | 15 | 793 | S72334A | 15 | 793 | ||
| S72135H | 08 | 559-561 | S7224XC | 24 | 963-965 | S72334A | 24 | 963-965 | ||
| S72135J | 08 | 521-522 | S7224XD | 08 | 559-561 | S72334B | 08 | 533-534 | ||
| S72135J | 08 | 559-561 | S7224XE | 08 | 559-561 | S72334B | 15 | 791 | ||
| S72135K | 08 | 521-522 | S7224XF | 08 | 559-561 | S72334B | 15 | 793 | ||
| S72135K | 08 | 564-566 | S7224XG | 08 | 521-522 | S72334B | 24 | 963-965 | ||
| S72135M | 08 | 521-522 | S7224XG | 08 | 559-561 | S72334C | 08 | 533-534 | ||
| S72135M | 08 | 564-566 | S7224XH | 08 | 521-522 | S72334C | 15 | 791 | ||
| S72135N | 08 | 521-522 | S7224XH | 08 | 559-561 | S72334C | 15 | 793 | ||
| S72135N | 08 | 564-566 | S7224XJ | 08 | 521-522 | S72334C | 24 | 963-965 | ||
| S72135P | 08 | 521-522 | S7224XJ | 08 | 559-561 | S72334D | 08 | 559-561 | ||
| S72135P | 08 | 564-566 | S7224XK | 08 | 521-522 | S72334E | 08 | 559-561 | ||
| S72135Q | 08 | 521-522 | S7224XK | 08 | 564-566 | S72334F | 08 | 559-561 | ||
| S72135Q | 08 | 564-566 | S7224XM | 08 | 521-522 | S72334G | 08 | 559-561 | ||
| S72135R | 08 | 521-522 | S7224XM | 08 | 564-566 | S72334H | 08 | 559-561 | ||
| S72135R | 08 | 564-566 | S7224XN | 08 | 521-522 | S72334J | 08 | 559-561 | ||
| S72135S | 08 | 559-561 | S7224XN | 08 | 564-566 | S72334K | 08 | 564-566 | ||
| S72136A | 08 | 521-522 | S7224XP | 08 | 521-522 | S72334M | 08 | 564-566 | ||
| S72136A | 08 | 535-536 | S7224XP | 08 | 564-566 | S72334N | 08 | 564-566 | ||
| S72136A | 15 | 791 | S7224XQ | 08 | 521-522 | S72334P | 08 | 564-566 | ||
| S72136A | 15 | 793 | S7224XQ | 08 | 564-566 | S72334Q | 08 | 564-566 | ||
| S72136A | 24 | 963-965 | S7224XR | 08 | 521-522 | S72334R | 08 | 564-566 | ||
| S72136B | 08 | 521-522 | S7224XR | 08 | 564-566 | S72334S | 08 | 559-561 | ||
| S72136B | 08 | 535-536 | S7224XS | 08 | 559-561 | S72335A | 08 | 533-534 | ||
| S72136B | 15 | 791 | S7225XA | 08 | 521-522 | S72335A | 15 | 791 | ||
| S72136B | 15 | 793 | S7225XA | 08 | 535-536 | S72335A | 15 | 793 | ||
| S72136B | 24 | 963-965 | S7225XA | 15 | 791 | S72335A | 24 | 963-965 | ||
| S72136C | 08 | 521-522 | S7225XA | 15 | 793 | S72335B | 08 | 533-534 | ||
| S72136C | 08 | 535-536 | S7225XA | 24 | 963-965 | S72335B | 15 | 791 | ||
| S72136C | 15 | 791 | S7225XB | 08 | 521-522 | S72335B | 15 | 793 | ||
| S72136C | 15 | 793 | S7225XB | 08 | 535-536 | S72335B | 24 | 963-965 | ||
| S72136C | 24 | 963-965 | S7225XB | 15 | 791 | S72335C | 08 | 533-534 | ||
| S72136D | 08 | 559-561 | S7225XB | 15 | 793 | S72335C | 15 | 791 | ||
| S72136E | 08 | 559-561 | S7225XB | 24 | 963-965 | S72335C | 15 | 793 | ||
| S72136F | 08 | 559-561 | S7225XC | 08 | 521-522 | S72335C | 24 | 963-965 | ||
| S72136G | 08 | 521-522 | S7225XC | 08 | 535-536 | S72335D | 08 | 559-561 | ||
| S72136G | 08 | 559-561 | S7225XC | 15 | 791 | S72335E | 08 | 559-561 | ||
| S72136H | 08 | 521-522 | S7225XC | 15 | 793 | S72335F | 08 | 559-561 | ||
| S72136H | 08 | 559-561 | S7225XC | 24 | 963-965 | S72335G | 08 | 559-561 | ||
| S72136J | 08 | 521-522 | S7225XD | 08 | 559-561 | S72335H | 08 | 559-561 | ||
| S72136J | 08 | 559-561 | S7225XE | 08 | 559-561 | S72335J | 08 | 559-561 | ||
| S72136K | 08 | 521-522 | S7225XF | 08 | 559-561 | S72335K | 08 | 564-566 | ||
| S72136K | 08 | 564-566 | S7225XG | 08 | 521-522 | S72335M | 08 | 564-566 | ||
| S72136M | 08 | 521-522 | S7225XG | 08 | 559-561 | S72335N | 08 | 564-566 | ||
| S72136M | 08 | 564-566 | S7225XH | 08 | 521-522 | S72335P | 08 | 564-566 | ||
| S72136N | 08 | 521-522 | S7225XH | 08 | 559-561 | S72335Q | 08 | 564-566 | ||
| S72136N | 08 | 564-566 | S7225XJ | 08 | 521-522 | S72335R | 08 | 564-566 | ||
| S72136P | 08 | 521-522 | S7225XJ | 08 | 559-561 | S72335S | 08 | 559-561 | ||
| S72136P | 08 | 564-566 | S7225XK | 08 | 521-522 | S72336A | 08 | 533-534 | ||
| S72136Q | 08 | 521-522 | S7225XK | 08 | 564-566 | S72336A | 15 | 791 | ||
| S72136Q | 08 | 564-566 | S7225XM | 08 | 521-522 | S72336A | 15 | 793 | ||
| S72136R | 08 | 521-522 | S7225XM | 08 | 564-566 | S72336A | 24 | 963-965 | ||
| S72136R | 08 | 564-566 | S7225XN | 08 | 521-522 | S72336B | 08 | 533-534 | ||
| S72136S | 08 | 559-561 | S7225XN | 08 | 564-566 | S72336B | 15 | 791 | ||
| S72141A | 08 | 521-522 | S7225XP | 08 | 521-522 | S72336B | 15 | 793 | ||
| S72141A | 08 | 535-536 | S7225XP | 08 | 564-566 | S72336B | 24 | 963-965 | ||
| S72141A | 15 | 791 | S7225XQ | 08 | 521-522 | S72336C | 08 | 533-534 | ||
| S72141A | 15 | 793 | S7225XQ | 08 | 564-566 | S72336C | 15 | 791 | ||
| S72141A | 24 | 963-965 | S7225XR | 08 | 521-522 | S72336C | 15 | 793 | ||
| S72141B | 08 | 521-522 | S7225XR | 08 | 564-566 | S72336C | 24 | 963-965 | ||
| S72141B | 08 | 535-536 | S7225XS | 08 | 559-561 | S72336D | 08 | 559-561 | ||
| S72141B | 15 | 791 | S7226XA | 08 | 521-522 | S72336E | 08 | 559-561 | ||
| S72141B | 15 | 793 | S7226XA | 08 | 535-536 | S72336F | 08 | 559-561 | ||
| S72141B | 24 | 963-965 | S7226XA | 15 | 791 | S72336G | 08 | 559-561 | ||
| S72141C | 08 | 521-522 | S7226XA | 15 | 793 | S72336H | 08 | 559-561 | ||
| S72141C | 08 | 535-536 | S7226XA | 24 | 963-965 | S72336J | 08 | 559-561 | ||
| S72141C | 15 | 791 | S7226XB | 08 | 521-522 | S72336K | 08 | 564-566 | ||
| S72141C | 15 | 793 | S7226XB | 08 | 535-536 | S72336M | 08 | 564-566 | ||
| S72141C | 24 | 963-965 | S7226XB | 15 | 791 | S72336N | 08 | 564-566 | ||
| S72141D | 08 | 559-561 | S7226XB | 15 | 793 | S72336P | 08 | 564-566 | ||
| S72141E | 08 | 559-561 | S7226XB | 24 | 963-965 | S72336Q | 08 | 564-566 | ||
| S72141F | 08 | 559-561 | S7226XC | 08 | 521-522 | S72336R | 08 | 564-566 | ||
| S72141G | 08 | 521-522 | S7226XC | 08 | 535-536 | S72336S | 08 | 559-561 | ||
| S72141G | 08 | 559-561 | S7226XC | 15 | 791 | S72341A | 08 | 533-534 | ||
| S72141H | 08 | 521-522 | S7226XC | 15 | 793 | S72341A | 15 | 791 | ||
| S72141H | 08 | 559-561 | S7226XC | 24 | 963-965 | S72341A | 15 | 793 | ||
| S72141J | 08 | 521-522 | S7226XD | 08 | 559-561 | S72341A | 24 | 963-965 | ||
| S72141J | 08 | 559-561 | S7226XE | 08 | 559-561 | S72341B | 08 | 533-534 | ||
| S72141K | 08 | 521-522 | S7226XF | 08 | 559-561 | S72341B | 15 | 791 | ||
| S72141K | 08 | 564-566 | S7226XG | 08 | 521-522 | S72341B | 15 | 793 | ||
| S72141M | 08 | 521-522 | S7226XG | 08 | 559-561 | S72341B | 24 | 963-965 | ||
| S72141M | 08 | 564-566 | S7226XH | 08 | 521-522 | S72341C | 08 | 533-534 | ||
| S72141N | 08 | 521-522 | S7226XH | 08 | 559-561 | S72341C | 15 | 791 | ||
| S72141N | 08 | 564-566 | S7226XJ | 08 | 521-522 | S72341C | 15 | 793 | ||
| S72141P | 08 | 521-522 | S7226XJ | 08 | 559-561 | S72341C | 24 | 963-965 | ||
| S72141P | 08 | 564-566 | S7226XK | 08 | 521-522 | S72341D | 08 | 559-561 | ||
| S72141Q | 08 | 521-522 | S7226XK | 08 | 564-566 | S72341E | 08 | 559-561 | ||
| S72141Q | 08 | 564-566 | S7226XM | 08 | 521-522 | S72341F | 08 | 559-561 | ||
| S72141R | 08 | 521-522 | S7226XM | 08 | 564-566 | S72341G | 08 | 559-561 | ||
| S72141R | 08 | 564-566 | S7226XN | 08 | 521-522 | S72341H | 08 | 559-561 | ||
| S72141S | 08 | 559-561 | S7226XN | 08 | 564-566 | S72341J | 08 | 559-561 | ||
| S72142A | 08 | 521-522 | S7226XP | 08 | 521-522 | S72341K | 08 | 564-566 | ||
| S72142A | 08 | 535-536 | S7226XP | 08 | 564-566 | S72341M | 08 | 564-566 | ||
| S72142A | 15 | 791 | S7226XQ | 08 | 521-522 | S72341N | 08 | 564-566 | ||
| S72142A | 15 | 793 | S7226XQ | 08 | 564-566 | S72341P | 08 | 564-566 | ||
| S72142A | 24 | 963-965 | S7226XR | 08 | 521-522 | S72341Q | 08 | 564-566 | ||
| S72142B | 08 | 521-522 | S7226XR | 08 | 564-566 | S72341R | 08 | 564-566 | ||
| S72142B | 08 | 535-536 | S7226XS | 08 | 559-561 | S72341S | 08 | 559-561 | ||
| S72142B | 15 | 791 | S72301A | 08 | 533-534 | S72342A | 08 | 533-534 | ||
| S72142B | 15 | 793 | S72301A | 15 | 791 | S72342A | 15 | 791 | ||
| S72142B | 24 | 963-965 | S72301A | 15 | 793 | S72342A | 15 | 793 | ||
| S72142C | 08 | 521-522 | S72301A | 24 | 963-965 | S72342A | 24 | 963-965 | ||
| S72142C | 08 | 535-536 | S72301B | 08 | 533-534 | S72342B | 08 | 533-534 | ||
| S72142C | 15 | 791 | S72301B | 15 | 791 | S72342B | 15 | 791 | ||
| S72142C | 15 | 793 | S72301B | 15 | 793 | S72342B | 15 | 793 | ||
| S72142C | 24 | 963-965 | S72301B | 24 | 963-965 | S72342B | 24 | 963-965 | ||
| S72142D | 08 | 559-561 | S72301C | 08 | 533-534 | S72342C | 08 | 533-534 | ||
| S72142E | 08 | 559-561 | S72301C | 15 | 791 | S72342C | 15 | 791 | ||
| S72142F | 08 | 559-561 | S72301C | 15 | 793 | S72342C | 15 | 793 | ||
| S72142G | 08 | 521-522 | S72301C | 24 | 963-965 | S72342C | 24 | 963-965 | ||
| S72142G | 08 | 559-561 | S72301D | 08 | 559-561 | S72342D | 08 | 559-561 | ||
| S72142H | 08 | 521-522 | S72301E | 08 | 559-561 | S72342E | 08 | 559-561 | ||
| S72142H | 08 | 559-561 | S72301F | 08 | 559-561 | S72342F | 08 | 559-561 | ||
| S72142J | 08 | 521-522 | S72301G | 08 | 559-561 | S72342G | 08 | 559-561 | ||
| S72142J | 08 | 559-561 | S72301H | 08 | 559-561 | S72342H | 08 | 559-561 | ||
| S72142K | 08 | 521-522 | S72301J | 08 | 559-561 | S72342J | 08 | 559-561 | ||
| S72142K | 08 | 564-566 | S72301K | 08 | 564-566 | S72342K | 08 | 564-566 | ||
| S72142M | 08 | 521-522 | S72301M | 08 | 564-566 | S72342M | 08 | 564-566 | ||
| S72142M | 08 | 564-566 | S72301N | 08 | 564-566 | S72342N | 08 | 564-566 | ||
| S72142N | 08 | 521-522 | S72301P | 08 | 564-566 | S72342P | 08 | 564-566 | ||
| S72142N | 08 | 564-566 | S72301Q | 08 | 564-566 | S72342Q | 08 | 564-566 | ||
| S72142P | 08 | 521-522 | S72301R | 08 | 564-566 | S72342R | 08 | 564-566 | ||
| S72142P | 08 | 564-566 | S72301S | 08 | 559-561 | S72342S | 08 | 559-561 | ||
| S72142Q | 08 | 521-522 | S72302A | 08 | 533-534 | S72343A | 08 | 533-534 | ||
| S72142Q | 08 | 564-566 | S72302A | 15 | 791 | S72343A | 15 | 791 | ||
| S72142R | 08 | 521-522 | S72302A | 15 | 793 | S72343A | 15 | 793 | ||
| S72142R | 08 | 564-566 | S72302A | 24 | 963-965 | S72343A | 24 | 963-965 | ||
| S72142S | 08 | 559-561 | S72302B | 08 | 533-534 | S72343B | 08 | 533-534 | ||
| S72143A | 08 | 521-522 | S72302B | 15 | 791 | S72343B | 15 | 791 | ||
| S72143A | 08 | 535-536 | S72302B | 15 | 793 | S72343B | 15 | 793 | ||
| S72143A | 15 | 791 | S72302B | 24 | 963-965 | S72343B | 24 | 963-965 | ||
| S72143A | 15 | 793 | S72302C | 08 | 533-534 | S72343C | 08 | 533-534 | ||
| S72143A | 24 | 963-965 | S72302C | 15 | 791 | S72343C | 15 | 791 | ||
| S72143B | 08 | 521-522 | S72302C | 15 | 793 | S72343C | 15 | 793 | ||
| S72143B | 08 | 535-536 | S72302C | 24 | 963-965 | S72343C | 24 | 963-965 | ||
| S72143B | 15 | 791 | S72302D | 08 | 559-561 | S72343D | 08 | 559-561 | ||
| S72143B | 15 | 793 | S72302E | 08 | 559-561 | S72343E | 08 | 559-561 | ||
| S72143B | 24 | 963-965 | S72302F | 08 | 559-561 | S72343F | 08 | 559-561 | ||
| S72143C | 08 | 521-522 | S72302G | 08 | 559-561 | S72343G | 08 | 559-561 | ||
| S72143C | 08 | 535-536 | S72302H | 08 | 559-561 | S72343H | 08 | 559-561 | ||
| S72143C | 15 | 791 | S72302J | 08 | 559-561 | S72343J | 08 | 559-561 | ||
| S72143C | 15 | 793 | S72302K | 08 | 564-566 | S72343K | 08 | 564-566 | ||
| S72143C | 24 | 963-965 | S72302M | 08 | 564-566 | S72343M | 08 | 564-566 | ||
| S72143D | 08 | 559-561 | S72302N | 08 | 564-566 | S72343N | 08 | 564-566 | ||
| S72143E | 08 | 559-561 | S72302P | 08 | 564-566 | S72343P | 08 | 564-566 | ||
| S72143F | 08 | 559-561 | S72302Q | 08 | 564-566 | S72343Q | 08 | 564-566 | ||
| S72143G | 08 | 521-522 | S72302R | 08 | 564-566 | S72343R | 08 | 564-566 | ||
| S72143G | 08 | 559-561 | S72302S | 08 | 559-561 | S72343S | 08 | 559-561 | ||
| S72143H | 08 | 521-522 | S72309A | 08 | 533-534 | S72344A | 08 | 533-534 | ||
| S72143H | 08 | 559-561 | S72309A | 15 | 791 | S72344A | 15 | 791 | ||
| S72143J | 08 | 521-522 | S72309A | 15 | 793 | S72344A | 15 | 793 | ||
| S72143J | 08 | 559-561 | S72309A | 24 | 963-965 | S72344A | 24 | 963-965 | ||
| S72143K | 08 | 521-522 | S72309B | 08 | 533-534 | S72344B | 08 | 533-534 | ||
| S72143K | 08 | 564-566 | S72309B | 15 | 791 | S72344B | 15 | 791 | ||
| S72143M | 08 | 521-522 | S72309B | 15 | 793 | S72344B | 15 | 793 | ||
| S72143M | 08 | 564-566 | S72309B | 24 | 963-965 | S72344B | 24 | 963-965 | ||
| S72143N | 08 | 521-522 | S72309C | 08 | 533-534 | S72344C | 08 | 533-534 | ||
| S72143N | 08 | 564-566 | S72309C | 15 | 791 | S72344C | 15 | 791 | ||
| S72143P | 08 | 521-522 | S72309C | 15 | 793 | S72344C | 15 | 793 | ||
| S72143P | 08 | 564-566 | S72309C | 24 | 963-965 | S72344C | 24 | 963-965 | ||
| S72143Q | 08 | 521-522 | S72309D | 08 | 559-561 | S72344D | 08 | 559-561 | ||
| S72143Q | 08 | 564-566 | S72309E | 08 | 559-561 | S72344E | 08 | 559-561 | ||
| S72143R | 08 | 521-522 | S72309F | 08 | 559-561 | S72344F | 08 | 559-561 | ||
| S72143R | 08 | 564-566 | S72309G | 08 | 559-561 | S72344G | 08 | 559-561 | ||
| S72143S | 08 | 559-561 | S72309H | 08 | 559-561 | S72344H | 08 | 559-561 | ||
| S72144A | 08 | 521-522 | S72309J | 08 | 559-561 | S72344J | 08 | 559-561 | ||
| S72144A | 08 | 535-536 | S72309K | 08 | 564-566 | S72344K | 08 | 564-566 | ||
| S72144A | 15 | 791 | S72309M | 08 | 564-566 | S72344M | 08 | 564-566 | ||
| S72144A | 15 | 793 | S72309N | 08 | 564-566 | S72344N | 08 | 564-566 | ||
| S72144A | 24 | 963-965 | S72309P | 08 | 564-566 | S72344P | 08 | 564-566 | ||
| S72144B | 08 | 521-522 | S72309Q | 08 | 564-566 | S72344Q | 08 | 564-566 | ||
| S72144B | 08 | 535-536 | S72309R | 08 | 564-566 | S72344R | 08 | 564-566 | ||
| S72144B | 15 | 791 | S72309S | 08 | 559-561 | S72344S | 08 | 559-561 | ||
| S72144B | 15 | 793 | S72321A | 08 | 533-534 | S72345A | 08 | 533-534 | ||
| S72144B | 24 | 963-965 | S72321A | 15 | 791 | S72345A | 15 | 791 | ||
| S72144C | 08 | 521-522 | S72321A | 15 | 793 | S72345A | 15 | 793 | ||
| S72144C | 08 | 535-536 | S72321A | 24 | 963-965 | S72345A | 24 | 963-965 | ||
| S72144C | 15 | 791 | S72321B | 08 | 533-534 | S72345B | 08 | 533-534 | ||
| S72144C | 15 | 793 | S72321B | 15 | 791 | S72345B | 15 | 791 | ||
| S72144C | 24 | 963-965 | S72321B | 15 | 793 | S72345B | 15 | 793 | ||
| S72144D | 08 | 559-561 | S72321B | 24 | 963-965 | S72345B | 24 | 963-965 | ||
| S72144E | 08 | 559-561 | S72321C | 08 | 533-534 | S72345C | 08 | 533-534 | ||
| S72144F | 08 | 559-561 | S72321C | 15 | 791 | S72345C | 15 | 791 | ||
| S72144G | 08 | 521-522 | S72321C | 15 | 793 | S72345C | 15 | 793 | ||
| S72144G | 08 | 559-561 | S72321C | 24 | 963-965 | S72345C | 24 | 963-965 | ||
| S72144H | 08 | 521-522 | S72321D | 08 | 559-561 | S72345D | 08 | 559-561 | ||
| S72144H | 08 | 559-561 | S72321E | 08 | 559-561 | S72345E | 08 | 559-561 | ||
| S72144J | 08 | 521-522 | S72321F | 08 | 559-561 | S72345F | 08 | 559-561 | ||
| S72144J | 08 | 559-561 | S72321G | 08 | 559-561 | S72345G | 08 | 559-561 | ||
| S72144K | 08 | 521-522 | S72321H | 08 | 559-561 | S72345H | 08 | 559-561 | ||
| S72144K | 08 | 564-566 | S72321J | 08 | 559-561 | S72345J | 08 | 559-561 | ||
| S72144M | 08 | 521-522 | S72321K | 08 | 564-566 | S72345K | 08 | 564-566 | ||
| S72144M | 08 | 564-566 | S72321M | 08 | 564-566 | S72345M | 08 | 564-566 | ||
| S72144N | 08 | 521-522 | S72321N | 08 | 564-566 | S72345N | 08 | 564-566 | ||
| S72144N | 08 | 564-566 | S72321P | 08 | 564-566 | S72345P | 08 | 564-566 | ||
| S72144P | 08 | 521-522 | S72321Q | 08 | 564-566 | S72345Q | 08 | 564-566 | ||
| S72144P | 08 | 564-566 | S72321R | 08 | 564-566 | S72345R | 08 | 564-566 | ||
| S72144Q | 08 | 521-522 | S72321S | 08 | 559-561 | S72345S | 08 | 559-561 | ||
| S72144Q | 08 | 564-566 | S72322A | 08 | 533-534 | S72346A | 08 | 533-534 | ||
| S72144R | 08 | 521-522 | S72322A | 15 | 791 | S72346A | 15 | 791 | ||
| S72144R | 08 | 564-566 | S72322A | 15 | 793 | S72346A | 15 | 793 | ||
| S72144S | 08 | 559-561 | S72322A | 24 | 963-965 | S72346A | 24 | 963-965 | ||
| S72145A | 08 | 521-522 | S72322B | 08 | 533-534 | S72346B | 08 | 533-534 | ||
| S72145A | 08 | 535-536 | S72322B | 15 | 791 | S72346B | 15 | 791 | ||
| S72145A | 15 | 791 | S72322B | 15 | 793 | S72346B | 15 | 793 | ||
| S72145A | 15 | 793 | S72322B | 24 | 963-965 | S72346B | 24 | 963-965 | ||
| S72145A | 24 | 963-965 | S72322C | 08 | 533-534 | S72346C | 08 | 533-534 | ||
| S72145B | 08 | 521-522 | S72322C | 15 | 791 | S72346C | 15 | 791 | ||
| S72145B | 08 | 535-536 | S72322C | 15 | 793 | S72346C | 15 | 793 | ||
| S72145B | 15 | 791 | S72322C | 24 | 963-965 | S72346C | 24 | 963-965 | ||
| S72145B | 15 | 793 | S72322D | 08 | 559-561 | S72346D | 08 | 559-561 | ||
| S72145B | 24 | 963-965 | S72322E | 08 | 559-561 | S72346E | 08 | 559-561 | ||
| S72145C | 08 | 521-522 | S72322F | 08 | 559-561 | S72346F | 08 | 559-561 | ||
| S72145C | 08 | 535-536 | S72322G | 08 | 559-561 | S72346G | 08 | 559-561 | ||
| S72145C | 15 | 791 | S72322H | 08 | 559-561 | S72346H | 08 | 559-561 | ||
| S72145C | 15 | 793 | S72322J | 08 | 559-561 | S72346J | 08 | 559-561 | ||
| S72145C | 24 | 963-965 | S72322K | 08 | 564-566 | S72346K | 08 | 564-566 | ||
| S72145D | 08 | 559-561 | S72322M | 08 | 564-566 | S72346M | 08 | 564-566 | ||
| S72145E | 08 | 559-561 | S72322N | 08 | 564-566 | S72346N | 08 | 564-566 | ||
| S72145F | 08 | 559-561 | S72322P | 08 | 564-566 | S72346P | 08 | 564-566 | ||
| S72145G | 08 | 521-522 | S72322Q | 08 | 564-566 | S72346Q | 08 | 564-566 | ||
| S72145G | 08 | 559-561 | S72322R | 08 | 564-566 | S72346R | 08 | 564-566 | ||
| S72145H | 08 | 521-522 | S72322S | 08 | 559-561 | S72346S | 08 | 559-561 | ||
| S72145H | 08 | 559-561 | S72323A | 08 | 533-534 | S72351A | 08 | 533-534 | ||
| S72145J | 08 | 521-522 | S72323A | 15 | 791 | S72351A | 15 | 791 | ||
| S72145J | 08 | 559-561 | S72323A | 15 | 793 | S72351A | 15 | 793 | ||
| S72145K | 08 | 521-522 | S72323A | 24 | 963-965 | S72351A | 24 | 963-965 | ||
| S72145K | 08 | 564-566 | S72323B | 08 | 533-534 | S72351B | 08 | 533-534 | ||
| S72145M | 08 | 521-522 | S72323B | 15 | 791 | S72351B | 15 | 791 | ||
| S72145M | 08 | 564-566 | S72323B | 15 | 793 | S72351B | 15 | 793 | ||
| S72145N | 08 | 521-522 | S72323B | 24 | 963-965 | S72351B | 24 | 963-965 | ||
| S72145N | 08 | 564-566 | S72323C | 08 | 533-534 | S72351C | 08 | 533-534 | ||
| S72145P | 08 | 521-522 | S72323C | 15 | 791 | S72351C | 15 | 791 | ||
| S72145P | 08 | 564-566 | S72323C | 15 | 793 | S72351C | 15 | 793 | ||
| S72145Q | 08 | 521-522 | S72323C | 24 | 963-965 | S72351C | 24 | 963-965 | ||
| S72145Q | 08 | 564-566 | S72323D | 08 | 559-561 | S72351D | 08 | 559-561 | ||
| S72145R | 08 | 521-522 | S72323E | 08 | 559-561 | S72351E | 08 | 559-561 | ||
| S72145R | 08 | 564-566 | S72323F | 08 | 559-561 | S72351F | 08 | 559-561 | ||
| S72145S | 08 | 559-561 | S72323G | 08 | 559-561 | S72351G | 08 | 559-561 | ||
| S72146A | 08 | 521-522 | S72323H | 08 | 559-561 | S72351H | 08 | 559-561 | ||
| S72146A | 08 | 535-536 | S72323J | 08 | 559-561 | S72351J | 08 | 559-561 | ||
| S72146A | 15 | 791 | S72323K | 08 | 564-566 | S72351K | 08 | 564-566 | ||
| S72146A | 15 | 793 | S72323M | 08 | 564-566 | S72351M | 08 | 564-566 | ||
| S72146A | 24 | 963-965 | S72323N | 08 | 564-566 | S72351N | 08 | 564-566 | ||
| S72146B | 08 | 521-522 | S72323P | 08 | 564-566 | S72351P | 08 | 564-566 | ||
| S72146B | 08 | 535-536 | S72323Q | 08 | 564-566 | S72351Q | 08 | 564-566 | ||
| S72146B | 15 | 791 | S72323R | 08 | 564-566 | S72351R | 08 | 564-566 | ||
| S72146B | 15 | 793 | S72323S | 08 | 559-561 | S72351S | 08 | 559-561 | ||
| S72146B | 24 | 963-965 | S72324A | 08 | 533-534 | S72352A | 08 | 533-534 | ||
| S72146C | 08 | 521-522 | S72324A | 15 | 791 | S72352A | 15 | 791 | ||
| S72146C | 08 | 535-536 | S72324A | 15 | 793 | S72352A | 15 | 793 | ||
| S72146C | 15 | 791 | S72324A | 24 | 963-965 | S72352A | 24 | 963-965 | ||
| S72146C | 15 | 793 | S72324B | 08 | 533-534 | S72352B | 08 | 533-534 | ||
| S72146C | 24 | 963-965 | S72324B | 15 | 791 | S72352B | 15 | 791 | ||
| S72146D | 08 | 559-561 | S72324B | 15 | 793 | S72352B | 15 | 793 | ||
| S72146E | 08 | 559-561 | S72324B | 24 | 963-965 | S72352B | 24 | 963-965 | ||
| S72146F | 08 | 559-561 | S72324C | 08 | 533-534 | S72352C | 08 | 533-534 | ||
| S72146G | 08 | 521-522 | S72324C | 15 | 791 | S72352C | 15 | 791 | ||
| S72146G | 08 | 559-561 | S72324C | 15 | 793 | S72352C | 15 | 793 | ||
| S72146H | 08 | 521-522 | S72324C | 24 | 963-965 | S72352C | 24 | 963-965 | ||
| S72146H | 08 | 559-561 | S72324D | 08 | 559-561 | S72352D | 08 | 559-561 | ||
| S72146J | 08 | 521-522 | S72324E | 08 | 559-561 | S72352E | 08 | 559-561 | ||
| S72146J | 08 | 559-561 | S72324F | 08 | 559-561 | S72352F | 08 | 559-561 | ||
| S72146K | 08 | 521-522 | S72324G | 08 | 559-561 | S72352G | 08 | 559-561 | ||
| S72146K | 08 | 564-566 | S72324H | 08 | 559-561 | S72352H | 08 | 559-561 | ||
| S72146M | 08 | 521-522 | S72324J | 08 | 559-561 | S72352J | 08 | 559-561 | ||
| S72146M | 08 | 564-566 | S72324K | 08 | 564-566 | S72352K | 08 | 564-566 | ||
| S72146N | 08 | 521-522 | S72324M | 08 | 564-566 | S72352M | 08 | 564-566 | ||
| S72146N | 08 | 564-566 | S72324N | 08 | 564-566 | S72352N | 08 | 564-566 | ||
| S72146P | 08 | 521-522 | S72324P | 08 | 564-566 | S72352P | 08 | 564-566 | ||
| S72146P | 08 | 564-566 | S72324Q | 08 | 564-566 | S72352Q | 08 | 564-566 | ||
| S72146Q | 08 | 521-522 | S72324R | 08 | 564-566 | S72352R | 08 | 564-566 | ||
| S72146Q | 08 | 564-566 | S72324S | 08 | 559-561 | S72352S | 08 | 559-561 | ||
| S72146R | 08 | 521-522 | S72325A | 08 | 533-534 | S72353A | 08 | 533-534 | ||
| S72146R | 08 | 564-566 | S72325A | 15 | 791 | S72353A | 15 | 791 | ||
| S72146S | 08 | 559-561 | S72325A | 15 | 793 | S72353A | 15 | 793 | ||
| S7221XA | 08 | 521-522 | S72325A | 24 | 963-965 | S72353A | 24 | 963-965 | ||
| S7221XA | 08 | 535-536 | S72325B | 08 | 533-534 | S72353B | 08 | 533-534 | ||
| S7221XA | 15 | 791 | S72325B | 15 | 791 | S72353B | 15 | 791 | ||
| S7221XA | 15 | 793 | S72325B | 15 | 793 | S72353B | 15 | 793 | ||
| S7221XA | 24 | 963-965 | S72325B | 24 | 963-965 | S72353B | 24 | 963-965 | ||
| S7221XB | 08 | 521-522 | S72325C | 08 | 533-534 | S72353C | 08 | 533-534 | ||
| S7221XB | 08 | 535-536 | S72325C | 15 | 791 | S72353C | 15 | 791 | ||
| S7221XB | 15 | 791 | S72325C | 15 | 793 | S72353C | 15 | 793 | ||
| S7221XB | 15 | 793 | S72325C | 24 | 963-965 | S72353C | 24 | 963-965 | ||
| S7221XB | 24 | 963-965 | S72325D | 08 | 559-561 | S72353D | 08 | 559-561 | ||
| S7221XC | 08 | 521-522 | S72325E | 08 | 559-561 | S72353E | 08 | 559-561 | ||
| S7221XC | 08 | 535-536 | S72325F | 08 | 559-561 | S72353F | 08 | 559-561 | ||
| S7221XC | 15 | 791 | S72325G | 08 | 559-561 | S72353G | 08 | 559-561 | ||
| S7221XC | 15 | 793 | S72325H | 08 | 559-561 | S72353H | 08 | 559-561 | ||
| S7221XC | 24 | 963-965 | S72325J | 08 | 559-561 | S72353J | 08 | 559-561 | ||
| S7221XD | 08 | 559-561 | S72325K | 08 | 564-566 | S72353K | 08 | 564-566 | ||
| S7221XE | 08 | 559-561 | S72325M | 08 | 564-566 | S72353M | 08 | 564-566 | ||
| S7221XF | 08 | 559-561 | S72325N | 08 | 564-566 | S72353N | 08 | 564-566 | ||
| S7221XG | 08 | 521-522 | S72325P | 08 | 564-566 | S72353P | 08 | 564-566 | ||
| S7221XG | 08 | 559-561 | S72325Q | 08 | 564-566 | S72353Q | 08 | 564-566 | ||
| S7221XH | 08 | 521-522 | S72325R | 08 | 564-566 | S72353R | 08 | 564-566 | ||
| S7221XH | 08 | 559-561 | S72325S | 08 | 559-561 | S72353S | 08 | 559-561 | ||
| S7221XJ | 08 | 521-522 | S72326A | 08 | 533-534 | S72354A | 08 | 533-534 | ||
| S7221XJ | 08 | 559-561 | S72326A | 15 | 791 | S72354A | 15 | 791 | ||
| S7221XK | 08 | 521-522 | S72326A | 15 | 793 | S72354A | 15 | 793 | ||
| S7221XK | 08 | 564-566 | S72326A | 24 | 963-965 | S72354A | 24 | 963-965 | ||
| S7221XM | 08 | 521-522 | S72326B | 08 | 533-534 | S72354B | 08 | 533-534 | ||
| S7221XM | 08 | 564-566 | S72326B | 15 | 791 | S72354B | 15 | 791 | ||
| S7221XN | 08 | 521-522 | S72326B | 15 | 793 | S72354B | 15 | 793 | ||
| S7221XN | 08 | 564-566 | S72326B | 24 | 963-965 | S72354B | 24 | 963-965 | ||
| S7221XP | 08 | 521-522 | S72326C | 08 | 533-534 | S72354C | 08 | 533-534 | ||
| S7221XP | 08 | 564-566 | S72326C | 15 | 791 | S72354C | 15 | 791 | ||
| S7221XQ | 08 | 521-522 | S72326C | 15 | 793 | S72354C | 15 | 793 | ||
| S7221XQ | 08 | 564-566 | S72326C | 24 | 963-965 | S72354C | 24 | 963-965 | ||
| S7221XR | 08 | 521-522 | S72326D | 08 | 559-561 | S72354D | 08 | 559-561 | ||
| S7221XR | 08 | 564-566 | S72326E | 08 | 559-561 | S72354E | 08 | 559-561 | ||
| S7221XS | 08 | 559-561 | S72326F | 08 | 559-561 | S72354F | 08 | 559-561 | ||
| S7222XA | 08 | 521-522 | S72326G | 08 | 559-561 | S72354G | 08 | 559-561 | ||
| S7222XA | 08 | 535-536 | S72326H | 08 | 559-561 | S72354H | 08 | 559-561 | ||
| S7222XA | 15 | 791 | S72326J | 08 | 559-561 | S72354J | 08 | 559-561 | ||
| S7222XA | 15 | 793 | S72326K | 08 | 564-566 | S72354K | 08 | 564-566 | ||
| S7222XA | 24 | 963-965 | S72326M | 08 | 564-566 | S72354M | 08 | 564-566 | ||
| S7222XB | 08 | 521-522 | S72326N | 08 | 564-566 | S72354N | 08 | 564-566 | ||
| S7222XB | 08 | 535-536 | S72326P | 08 | 564-566 | S72354P | 08 | 564-566 | ||
| S7222XB | 15 | 791 | S72326Q | 08 | 564-566 | S72354Q | 08 | 564-566 | ||
| S7222XB | 15 | 793 | S72326R | 08 | 564-566 | S72354R | 08 | 564-566 | ||
| S7222XB | 24 | 963-965 | S72326S | 08 | 559-561 | S72354S | 08 | 559-561 |
| | |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 06 Sep 2024 16:41:54 CMS, code-revision=366, description-revision=1405 |