ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual
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ICD-10-CM/PCS MS-DRG v35.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 48 of 70 |
| A000 B400 C771 C84Z9 D490 E113319 F15188 G930 H2143 H52512 I479 I7401 K08411 L101 M02049 M1A1291 M4104 M66822 M84451D M87332 N6019 O2652 O361915 O43811 O92113 Q512 R791 S02400A S06375A S1244XS S21022D S25302A S31611D S32591K S37092A S42135B S42462B S46909A S52099H S52301K S52562N S56191S S60417A S62001D S62329B S62668A S63682S S66821S S72042A S72322M S72451B S7722XS S82092Q S82255B S8264XD S8410XS S89399D S92055S S92504G S96919A T2039XD T23309D T2652XD T3991XA T45521D T50B13D T63303D T81519D T85510S Z7389 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S66821S | 09 | 604-605 | S68711A | 21 | 913-914 | S72001N | 08 | 564-566 | ||
| S66822A | 08 | 564-566 | S68711A | 24 | 955-965 | S72001P | 08 | 564-566 | ||
| S66822A | 24 | 955-965 | S68711D | 23 | 949-950 | S72001Q | 08 | 564-566 | ||
| S66822D | 23 | 949-950 | S68711S | 08 | 559-561 | S72001R | 08 | 564-566 | ||
| S66822S | 09 | 604-605 | S68712A | 21 | 913-914 | S72001S | 08 | 559-561 | ||
| S66829A | 08 | 564-566 | S68712A | 24 | 955-965 | S72002A | 08 | 535-536 | ||
| S66829A | 24 | 955-965 | S68712D | 23 | 949-950 | S72002A | 15 | 793 | ||
| S66829D | 23 | 949-950 | S68712S | 08 | 559-561 | S72002A | 24 | 955-965 | ||
| S66829S | 09 | 604-605 | S68719A | 21 | 913-914 | S72002B | 08 | 535-536 | ||
| S66891A | 21 | 913-914 | S68719A | 24 | 955-965 | S72002B | 15 | 793 | ||
| S66891A | 24 | 955-965 | S68719D | 23 | 949-950 | S72002B | 24 | 955-965 | ||
| S66891D | 23 | 949-950 | S68719S | 08 | 559-561 | S72002C | 08 | 535-536 | ||
| S66891S | 21 | 913-914 | S68721A | 21 | 913-914 | S72002C | 15 | 793 | ||
| S66892A | 21 | 913-914 | S68721A | 24 | 955-965 | S72002C | 24 | 955-965 | ||
| S66892A | 24 | 955-965 | S68721D | 23 | 949-950 | S72002D | 08 | 559-561 | ||
| S66892D | 23 | 949-950 | S68721S | 08 | 559-561 | S72002E | 08 | 559-561 | ||
| S66892S | 21 | 913-914 | S68722A | 21 | 913-914 | S72002F | 08 | 559-561 | ||
| S66899A | 21 | 913-914 | S68722A | 24 | 955-965 | S72002G | 08 | 559-561 | ||
| S66899A | 24 | 955-965 | S68722D | 23 | 949-950 | S72002H | 08 | 559-561 | ||
| S66899D | 23 | 949-950 | S68722S | 08 | 559-561 | S72002J | 08 | 559-561 | ||
| S66899S | 21 | 913-914 | S68729A | 21 | 913-914 | S72002K | 08 | 564-566 | ||
| S66901A | 21 | 913-914 | S68729A | 24 | 955-965 | S72002M | 08 | 564-566 | ||
| S66901A | 24 | 955-965 | S68729D | 23 | 949-950 | S72002N | 08 | 564-566 | ||
| S66901D | 23 | 949-950 | S68729S | 08 | 559-561 | S72002P | 08 | 564-566 | ||
| S66901S | 21 | 913-914 | S6980XA | 21 | 913-914 | S72002Q | 08 | 564-566 | ||
| S66902A | 21 | 913-914 | S6980XA | 24 | 955-965 | S72002R | 08 | 564-566 | ||
| S66902A | 24 | 955-965 | S6980XD | 23 | 949-950 | S72002S | 08 | 559-561 | ||
| S66902D | 23 | 949-950 | S6980XS | 21 | 913-914 | S72009A | 08 | 535-536 | ||
| S66902S | 21 | 913-914 | S6981XA | 21 | 913-914 | S72009A | 15 | 793 | ||
| S66909A | 21 | 913-914 | S6981XA | 24 | 955-965 | S72009A | 24 | 955-965 | ||
| S66909A | 24 | 955-965 | S6981XD | 23 | 949-950 | S72009B | 08 | 535-536 | ||
| S66909D | 23 | 949-950 | S6981XS | 21 | 913-914 | S72009B | 15 | 793 | ||
| S66909S | 21 | 913-914 | S6982XA | 21 | 913-914 | S72009B | 24 | 955-965 | ||
| S66911A | 08 | 562-563 | S6982XA | 24 | 955-965 | S72009C | 08 | 535-536 | ||
| S66911A | 24 | 955-965 | S6982XD | 23 | 949-950 | S72009C | 15 | 793 | ||
| S66911D | 23 | 949-950 | S6982XS | 21 | 913-914 | S72009C | 24 | 955-965 | ||
| S66911S | 08 | 562-563 | S6990XA | 21 | 913-914 | S72009D | 08 | 559-561 | ||
| S66912A | 08 | 562-563 | S6990XA | 24 | 955-965 | S72009E | 08 | 559-561 | ||
| S66912A | 24 | 955-965 | S6990XD | 23 | 949-950 | S72009F | 08 | 559-561 | ||
| S66912D | 23 | 949-950 | S6990XS | 21 | 913-914 | S72009G | 08 | 559-561 | ||
| S66912S | 08 | 562-563 | S6991XA | 21 | 913-914 | S72009H | 08 | 559-561 | ||
| S66919A | 08 | 562-563 | S6991XA | 24 | 955-965 | S72009J | 08 | 559-561 | ||
| S66919A | 24 | 955-965 | S6991XD | 23 | 949-950 | S72009K | 08 | 564-566 | ||
| S66919D | 23 | 949-950 | S6991XS | 21 | 913-914 | S72009M | 08 | 564-566 | ||
| S66919S | 08 | 562-563 | S6992XA | 21 | 913-914 | S72009N | 08 | 564-566 | ||
| S66921A | 08 | 564-566 | S6992XA | 24 | 955-965 | S72009P | 08 | 564-566 | ||
| S66921A | 24 | 955-965 | S6992XD | 23 | 949-950 | S72009Q | 08 | 564-566 | ||
| S66921D | 23 | 949-950 | S6992XS | 21 | 913-914 | S72009R | 08 | 564-566 | ||
| S66921S | 09 | 604-605 | S7000XA | 09 | 604-605 | S72009S | 08 | 559-561 | ||
| S66922A | 08 | 564-566 | S7000XA | 24 | 955-965 | S72011A | 08 | 535-536 | ||
| S66922A | 24 | 955-965 | S7000XD | 23 | 949-950 | S72011A | 15 | 793 | ||
| S66922D | 23 | 949-950 | S7000XS | 09 | 604-605 | S72011A | 24 | 955-965 | ||
| S66922S | 09 | 604-605 | S7001XA | 09 | 604-605 | S72011B | 08 | 535-536 | ||
| S66929A | 08 | 564-566 | S7001XA | 24 | 955-965 | S72011B | 15 | 793 | ||
| S66929A | 24 | 955-965 | S7001XD | 23 | 949-950 | S72011B | 24 | 955-965 | ||
| S66929D | 23 | 949-950 | S7001XS | 09 | 604-605 | S72011C | 08 | 535-536 | ||
| S66929S | 09 | 604-605 | S7002XA | 09 | 604-605 | S72011C | 15 | 793 | ||
| S66991A | 21 | 913-914 | S7002XA | 24 | 955-965 | S72011C | 24 | 955-965 | ||
| S66991A | 24 | 955-965 | S7002XD | 23 | 949-950 | S72011D | 08 | 559-561 | ||
| S66991D | 23 | 949-950 | S7002XS | 09 | 604-605 | S72011E | 08 | 559-561 | ||
| S66991S | 21 | 913-914 | S7010XA | 09 | 604-605 | S72011F | 08 | 559-561 | ||
| S66992A | 21 | 913-914 | S7010XA | 24 | 955-965 | S72011G | 08 | 559-561 | ||
| S66992A | 24 | 955-965 | S7010XD | 23 | 949-950 | S72011H | 08 | 559-561 | ||
| S66992D | 23 | 949-950 | S7010XS | 09 | 604-605 | S72011J | 08 | 559-561 | ||
| S66992S | 21 | 913-914 | S7011XA | 09 | 604-605 | S72011K | 08 | 564-566 | ||
| S66999A | 21 | 913-914 | S7011XA | 24 | 955-965 | S72011M | 08 | 564-566 | ||
| S66999A | 24 | 955-965 | S7011XD | 23 | 949-950 | S72011N | 08 | 564-566 | ||
| S66999D | 23 | 949-950 | S7011XS | 09 | 604-605 | S72011P | 08 | 564-566 | ||
| S66999S | 21 | 913-914 | S7012XA | 09 | 604-605 | S72011Q | 08 | 564-566 | ||
| S6700XA | 21 | 913-914 | S7012XA | 24 | 955-965 | S72011R | 08 | 564-566 | ||
| S6700XA | 24 | 955-965 | S7012XD | 23 | 949-950 | S72011S | 08 | 559-561 | ||
| S6700XD | 23 | 949-950 | S7012XS | 09 | 604-605 | S72012A | 08 | 535-536 | ||
| S6700XS | 09 | 604-605 | S70211A | 09 | 604-605 | S72012A | 15 | 793 | ||
| S6701XA | 21 | 913-914 | S70211A | 24 | 955-965 | S72012A | 24 | 955-965 | ||
| S6701XA | 24 | 955-965 | S70211D | 23 | 949-950 | S72012B | 08 | 535-536 | ||
| S6701XD | 23 | 949-950 | S70211S | 09 | 604-605 | S72012B | 15 | 793 | ||
| S6701XS | 09 | 604-605 | S70212A | 09 | 604-605 | S72012B | 24 | 955-965 | ||
| S6702XA | 21 | 913-914 | S70212A | 24 | 955-965 | S72012C | 08 | 535-536 | ||
| S6702XA | 24 | 955-965 | S70212D | 23 | 949-950 | S72012C | 15 | 793 | ||
| S6702XD | 23 | 949-950 | S70212S | 09 | 604-605 | S72012C | 24 | 955-965 | ||
| S6702XS | 09 | 604-605 | S70219A | 09 | 604-605 | S72012D | 08 | 559-561 | ||
| S6710XA | 21 | 913-914 | S70219A | 24 | 955-965 | S72012E | 08 | 559-561 | ||
| S6710XA | 24 | 955-965 | S70219D | 23 | 949-950 | S72012F | 08 | 559-561 | ||
| S6710XD | 23 | 949-950 | S70219S | 09 | 604-605 | S72012G | 08 | 559-561 | ||
| S6710XS | 09 | 604-605 | S70221A | 09 | 606-607 | S72012H | 08 | 559-561 | ||
| S67190A | 21 | 913-914 | S70221A | 24 | 955-965 | S72012J | 08 | 559-561 | ||
| S67190A | 24 | 955-965 | S70221D | 23 | 949-950 | S72012K | 08 | 564-566 | ||
| S67190D | 23 | 949-950 | S70221S | 09 | 604-605 | S72012M | 08 | 564-566 | ||
| S67190S | 09 | 604-605 | S70222A | 09 | 606-607 | S72012N | 08 | 564-566 | ||
| S67191A | 21 | 913-914 | S70222A | 24 | 955-965 | S72012P | 08 | 564-566 | ||
| S67191A | 24 | 955-965 | S70222D | 23 | 949-950 | S72012Q | 08 | 564-566 | ||
| S67191D | 23 | 949-950 | S70222S | 09 | 604-605 | S72012R | 08 | 564-566 | ||
| S67191S | 09 | 604-605 | S70229A | 09 | 606-607 | S72012S | 08 | 559-561 | ||
| S67192A | 21 | 913-914 | S70229A | 24 | 955-965 | S72019A | 08 | 535-536 | ||
| S67192A | 24 | 955-965 | S70229D | 23 | 949-950 | S72019A | 15 | 793 | ||
| S67192D | 23 | 949-950 | S70229S | 09 | 604-605 | S72019A | 24 | 955-965 | ||
| S67192S | 09 | 604-605 | S70241A | 09 | 604-605 | S72019B | 08 | 535-536 | ||
| S67193A | 21 | 913-914 | S70241A | 24 | 955-965 | S72019B | 15 | 793 | ||
| S67193A | 24 | 955-965 | S70241D | 23 | 949-950 | S72019B | 24 | 955-965 | ||
| S67193D | 23 | 949-950 | S70241S | 09 | 604-605 | S72019C | 08 | 535-536 | ||
| S67193S | 09 | 604-605 | S70242A | 09 | 604-605 | S72019C | 15 | 793 | ||
| S67194A | 21 | 913-914 | S70242A | 24 | 955-965 | S72019C | 24 | 955-965 | ||
| S67194A | 24 | 955-965 | S70242D | 23 | 949-950 | S72019D | 08 | 559-561 | ||
| S67194D | 23 | 949-950 | S70242S | 09 | 604-605 | S72019E | 08 | 559-561 | ||
| S67194S | 09 | 604-605 | S70249A | 09 | 604-605 | S72019F | 08 | 559-561 | ||
| S67195A | 21 | 913-914 | S70249A | 24 | 955-965 | S72019G | 08 | 559-561 | ||
| S67195A | 24 | 955-965 | S70249D | 23 | 949-950 | S72019H | 08 | 559-561 | ||
| S67195D | 23 | 949-950 | S70249S | 09 | 604-605 | S72019J | 08 | 559-561 | ||
| S67195S | 09 | 604-605 | S70251A | 09 | 604-605 | S72019K | 08 | 564-566 | ||
| S67196A | 21 | 913-914 | S70251A | 24 | 955-965 | S72019M | 08 | 564-566 | ||
| S67196A | 24 | 955-965 | S70251D | 23 | 949-950 | S72019N | 08 | 564-566 | ||
| S67196D | 23 | 949-950 | S70251S | 09 | 604-605 | S72019P | 08 | 564-566 | ||
| S67196S | 09 | 604-605 | S70252A | 09 | 604-605 | S72019Q | 08 | 564-566 | ||
| S67197A | 21 | 913-914 | S70252A | 24 | 955-965 | S72019R | 08 | 564-566 | ||
| S67197A | 24 | 955-965 | S70252D | 23 | 949-950 | S72019S | 08 | 559-561 | ||
| S67197D | 23 | 949-950 | S70252S | 09 | 604-605 | S72021A | 08 | 535-536 | ||
| S67197S | 09 | 604-605 | S70259A | 09 | 604-605 | S72021A | 15 | 793 | ||
| S67198A | 21 | 913-914 | S70259A | 24 | 955-965 | S72021A | 24 | 955-965 | ||
| S67198A | 24 | 955-965 | S70259D | 23 | 949-950 | S72021B | 08 | 535-536 | ||
| S67198D | 23 | 949-950 | S70259S | 09 | 604-605 | S72021B | 15 | 793 | ||
| S67198S | 09 | 604-605 | S70261A | 09 | 606-607 | S72021B | 24 | 955-965 | ||
| S6720XA | 21 | 913-914 | S70261A | 24 | 955-965 | S72021C | 08 | 535-536 | ||
| S6720XA | 24 | 955-965 | S70261D | 23 | 949-950 | S72021C | 15 | 793 | ||
| S6720XD | 23 | 949-950 | S70261S | 09 | 604-605 | S72021C | 24 | 955-965 | ||
| S6720XS | 09 | 604-605 | S70262A | 09 | 606-607 | S72021D | 08 | 559-561 | ||
| S6721XA | 21 | 913-914 | S70262A | 24 | 955-965 | S72021E | 08 | 559-561 | ||
| S6721XA | 24 | 955-965 | S70262D | 23 | 949-950 | S72021F | 08 | 559-561 | ||
| S6721XD | 23 | 949-950 | S70262S | 09 | 604-605 | S72021G | 08 | 559-561 | ||
| S6721XS | 09 | 604-605 | S70269A | 09 | 606-607 | S72021H | 08 | 559-561 | ||
| S6722XA | 21 | 913-914 | S70269A | 24 | 955-965 | S72021J | 08 | 559-561 | ||
| S6722XA | 24 | 955-965 | S70269D | 23 | 949-950 | S72021K | 08 | 564-566 | ||
| S6722XD | 23 | 949-950 | S70269S | 09 | 604-605 | S72021M | 08 | 564-566 | ||
| S6722XS | 09 | 604-605 | S70271A | 09 | 604-605 | S72021N | 08 | 564-566 | ||
| S6730XA | 21 | 913-914 | S70271A | 24 | 955-965 | S72021P | 08 | 564-566 | ||
| S6730XA | 24 | 955-965 | S70271D | 23 | 949-950 | S72021Q | 08 | 564-566 | ||
| S6730XD | 23 | 949-950 | S70271S | 09 | 604-605 | S72021R | 08 | 564-566 | ||
| S6730XS | 09 | 604-605 | S70272A | 09 | 604-605 | S72021S | 08 | 559-561 | ||
| S6731XA | 21 | 913-914 | S70272A | 24 | 955-965 | S72022A | 08 | 535-536 | ||
| S6731XA | 24 | 955-965 | S70272D | 23 | 949-950 | S72022A | 15 | 793 | ||
| S6731XD | 23 | 949-950 | S70272S | 09 | 604-605 | S72022A | 24 | 955-965 | ||
| S6731XS | 09 | 604-605 | S70279A | 09 | 604-605 | S72022B | 08 | 535-536 | ||
| S6732XA | 21 | 913-914 | S70279A | 24 | 955-965 | S72022B | 15 | 793 | ||
| S6732XA | 24 | 955-965 | S70279D | 23 | 949-950 | S72022B | 24 | 955-965 | ||
| S6732XD | 23 | 949-950 | S70279S | 09 | 604-605 | S72022C | 08 | 535-536 | ||
| S6732XS | 09 | 604-605 | S70311A | 09 | 604-605 | S72022C | 15 | 793 | ||
| S6740XA | 21 | 913-914 | S70311A | 24 | 955-965 | S72022C | 24 | 955-965 | ||
| S6740XA | 24 | 955-965 | S70311D | 23 | 949-950 | S72022D | 08 | 559-561 | ||
| S6740XD | 23 | 949-950 | S70311S | 09 | 604-605 | S72022E | 08 | 559-561 | ||
| S6740XS | 09 | 604-605 | S70312A | 09 | 604-605 | S72022F | 08 | 559-561 | ||
| S6741XA | 21 | 913-914 | S70312A | 24 | 955-965 | S72022G | 08 | 559-561 | ||
| S6741XA | 24 | 955-965 | S70312D | 23 | 949-950 | S72022H | 08 | 559-561 | ||
| S6741XD | 23 | 949-950 | S70312S | 09 | 604-605 | S72022J | 08 | 559-561 | ||
| S6741XS | 09 | 604-605 | S70319A | 09 | 604-605 | S72022K | 08 | 564-566 | ||
| S6742XA | 21 | 913-914 | S70319A | 24 | 955-965 | S72022M | 08 | 564-566 | ||
| S6742XA | 24 | 955-965 | S70319D | 23 | 949-950 | S72022N | 08 | 564-566 | ||
| S6742XD | 23 | 949-950 | S70319S | 09 | 604-605 | S72022P | 08 | 564-566 | ||
| S6742XS | 09 | 604-605 | S70321A | 09 | 606-607 | S72022Q | 08 | 564-566 | ||
| S6790XA | 21 | 913-914 | S70321A | 24 | 955-965 | S72022R | 08 | 564-566 | ||
| S6790XA | 24 | 955-965 | S70321D | 23 | 949-950 | S72022S | 08 | 559-561 | ||
| S6790XD | 23 | 949-950 | S70321S | 09 | 604-605 | S72023A | 08 | 535-536 | ||
| S6790XS | 09 | 604-605 | S70322A | 09 | 606-607 | S72023A | 15 | 793 | ||
| S6791XA | 21 | 913-914 | S70322A | 24 | 955-965 | S72023A | 24 | 955-965 | ||
| S6791XA | 24 | 955-965 | S70322D | 23 | 949-950 | S72023B | 08 | 535-536 | ||
| S6791XD | 23 | 949-950 | S70322S | 09 | 604-605 | S72023B | 15 | 793 | ||
| S6791XS | 09 | 604-605 | S70329A | 09 | 606-607 | S72023B | 24 | 955-965 | ||
| S6792XA | 21 | 913-914 | S70329A | 24 | 955-965 | S72023C | 08 | 535-536 | ||
| S6792XA | 24 | 955-965 | S70329D | 23 | 949-950 | S72023C | 15 | 793 | ||
| S6792XD | 23 | 949-950 | S70329S | 09 | 604-605 | S72023C | 24 | 955-965 | ||
| S6792XS | 09 | 604-605 | S70341A | 09 | 604-605 | S72023D | 08 | 559-561 | ||
| S68011A | 21 | 913-914 | S70341A | 24 | 955-965 | S72023E | 08 | 559-561 | ||
| S68011A | 24 | 955-965 | S70341D | 23 | 949-950 | S72023F | 08 | 559-561 | ||
| S68011D | 23 | 949-950 | S70341S | 09 | 604-605 | S72023G | 08 | 559-561 | ||
| S68011S | 08 | 559-561 | S70342A | 09 | 604-605 | S72023H | 08 | 559-561 | ||
| S68012A | 21 | 913-914 | S70342A | 24 | 955-965 | S72023J | 08 | 559-561 | ||
| S68012A | 24 | 955-965 | S70342D | 23 | 949-950 | S72023K | 08 | 564-566 | ||
| S68012D | 23 | 949-950 | S70342S | 09 | 604-605 | S72023M | 08 | 564-566 | ||
| S68012S | 08 | 559-561 | S70349A | 09 | 604-605 | S72023N | 08 | 564-566 | ||
| S68019A | 21 | 913-914 | S70349A | 24 | 955-965 | S72023P | 08 | 564-566 | ||
| S68019A | 24 | 955-965 | S70349D | 23 | 949-950 | S72023Q | 08 | 564-566 | ||
| S68019D | 23 | 949-950 | S70349S | 09 | 604-605 | S72023R | 08 | 564-566 | ||
| S68019S | 08 | 559-561 | S70351A | 09 | 604-605 | S72023S | 08 | 559-561 | ||
| S68021A | 21 | 913-914 | S70351A | 24 | 955-965 | S72024A | 08 | 535-536 | ||
| S68021A | 24 | 955-965 | S70351D | 23 | 949-950 | S72024A | 15 | 793 | ||
| S68021D | 23 | 949-950 | S70351S | 09 | 604-605 | S72024A | 24 | 955-965 | ||
| S68021S | 08 | 559-561 | S70352A | 09 | 604-605 | S72024B | 08 | 535-536 | ||
| S68022A | 21 | 913-914 | S70352A | 24 | 955-965 | S72024B | 15 | 793 | ||
| S68022A | 24 | 955-965 | S70352D | 23 | 949-950 | S72024B | 24 | 955-965 | ||
| S68022D | 23 | 949-950 | S70352S | 09 | 604-605 | S72024C | 08 | 535-536 | ||
| S68022S | 08 | 559-561 | S70359A | 09 | 604-605 | S72024C | 15 | 793 | ||
| S68029A | 21 | 913-914 | S70359A | 24 | 955-965 | S72024C | 24 | 955-965 | ||
| S68029A | 24 | 955-965 | S70359D | 23 | 949-950 | S72024D | 08 | 559-561 | ||
| S68029D | 23 | 949-950 | S70359S | 09 | 604-605 | S72024E | 08 | 559-561 | ||
| S68029S | 08 | 559-561 | S70361A | 09 | 606-607 | S72024F | 08 | 559-561 | ||
| S68110A | 21 | 913-914 | S70361A | 24 | 955-965 | S72024G | 08 | 559-561 | ||
| S68110A | 24 | 955-965 | S70361D | 23 | 949-950 | S72024H | 08 | 559-561 | ||
| S68110D | 23 | 949-950 | S70361S | 09 | 604-605 | S72024J | 08 | 559-561 | ||
| S68110S | 08 | 559-561 | S70362A | 09 | 606-607 | S72024K | 08 | 564-566 | ||
| S68111A | 21 | 913-914 | S70362A | 24 | 955-965 | S72024M | 08 | 564-566 | ||
| S68111A | 24 | 955-965 | S70362D | 23 | 949-950 | S72024N | 08 | 564-566 | ||
| S68111D | 23 | 949-950 | S70362S | 09 | 604-605 | S72024P | 08 | 564-566 | ||
| S68111S | 08 | 559-561 | S70369A | 09 | 606-607 | S72024Q | 08 | 564-566 | ||
| S68112A | 21 | 913-914 | S70369A | 24 | 955-965 | S72024R | 08 | 564-566 | ||
| S68112A | 24 | 955-965 | S70369D | 23 | 949-950 | S72024S | 08 | 559-561 | ||
| S68112D | 23 | 949-950 | S70369S | 09 | 604-605 | S72025A | 08 | 535-536 | ||
| S68112S | 08 | 559-561 | S70371A | 09 | 604-605 | S72025A | 15 | 793 | ||
| S68113A | 21 | 913-914 | S70371A | 24 | 955-965 | S72025A | 24 | 955-965 | ||
| S68113A | 24 | 955-965 | S70371D | 23 | 949-950 | S72025B | 08 | 535-536 | ||
| S68113D | 23 | 949-950 | S70371S | 09 | 604-605 | S72025B | 15 | 793 | ||
| S68113S | 08 | 559-561 | S70372A | 09 | 604-605 | S72025B | 24 | 955-965 | ||
| S68114A | 21 | 913-914 | S70372A | 24 | 955-965 | S72025C | 08 | 535-536 | ||
| S68114A | 24 | 955-965 | S70372D | 23 | 949-950 | S72025C | 15 | 793 | ||
| S68114D | 23 | 949-950 | S70372S | 09 | 604-605 | S72025C | 24 | 955-965 | ||
| S68114S | 08 | 559-561 | S70379A | 09 | 604-605 | S72025D | 08 | 559-561 | ||
| S68115A | 21 | 913-914 | S70379A | 24 | 955-965 | S72025E | 08 | 559-561 | ||
| S68115A | 24 | 955-965 | S70379D | 23 | 949-950 | S72025F | 08 | 559-561 | ||
| S68115D | 23 | 949-950 | S70379S | 09 | 604-605 | S72025G | 08 | 559-561 | ||
| S68115S | 08 | 559-561 | S70911A | 09 | 604-605 | S72025H | 08 | 559-561 | ||
| S68116A | 21 | 913-914 | S70911A | 24 | 955-965 | S72025J | 08 | 559-561 | ||
| S68116A | 24 | 955-965 | S70911D | 23 | 949-950 | S72025K | 08 | 564-566 | ||
| S68116D | 23 | 949-950 | S70911S | 09 | 604-605 | S72025M | 08 | 564-566 | ||
| S68116S | 08 | 559-561 | S70912A | 09 | 604-605 | S72025N | 08 | 564-566 | ||
| S68117A | 21 | 913-914 | S70912A | 24 | 955-965 | S72025P | 08 | 564-566 | ||
| S68117A | 24 | 955-965 | S70912D | 23 | 949-950 | S72025Q | 08 | 564-566 | ||
| S68117D | 23 | 949-950 | S70912S | 09 | 604-605 | S72025R | 08 | 564-566 | ||
| S68117S | 08 | 559-561 | S70919A | 09 | 604-605 | S72025S | 08 | 559-561 | ||
| S68118A | 21 | 913-914 | S70919A | 24 | 955-965 | S72026A | 08 | 535-536 | ||
| S68118A | 24 | 955-965 | S70919D | 23 | 949-950 | S72026A | 15 | 793 | ||
| S68118D | 23 | 949-950 | S70919S | 09 | 604-605 | S72026A | 24 | 955-965 | ||
| S68118S | 08 | 559-561 | S70921A | 09 | 604-605 | S72026B | 08 | 535-536 | ||
| S68119A | 21 | 913-914 | S70921A | 24 | 955-965 | S72026B | 15 | 793 | ||
| S68119A | 24 | 955-965 | S70921D | 23 | 949-950 | S72026B | 24 | 955-965 | ||
| S68119D | 23 | 949-950 | S70921S | 09 | 604-605 | S72026C | 08 | 535-536 | ||
| S68119S | 08 | 559-561 | S70922A | 09 | 604-605 | S72026C | 15 | 793 | ||
| S68120A | 21 | 913-914 | S70922A | 24 | 955-965 | S72026C | 24 | 955-965 | ||
| S68120A | 24 | 955-965 | S70922D | 23 | 949-950 | S72026D | 08 | 559-561 | ||
| S68120D | 23 | 949-950 | S70922S | 09 | 604-605 | S72026E | 08 | 559-561 | ||
| S68120S | 08 | 559-561 | S70929A | 09 | 604-605 | S72026F | 08 | 559-561 | ||
| S68121A | 21 | 913-914 | S70929A | 24 | 955-965 | S72026G | 08 | 559-561 | ||
| S68121A | 24 | 955-965 | S70929D | 23 | 949-950 | S72026H | 08 | 559-561 | ||
| S68121D | 23 | 949-950 | S70929S | 09 | 604-605 | S72026J | 08 | 559-561 | ||
| S68121S | 08 | 559-561 | S71001A | 09 | 604-605 | S72026K | 08 | 564-566 | ||
| S68122A | 21 | 913-914 | S71001A | 24 | 955-965 | S72026M | 08 | 564-566 | ||
| S68122A | 24 | 955-965 | S71001D | 23 | 949-950 | S72026N | 08 | 564-566 | ||
| S68122D | 23 | 949-950 | S71001S | 09 | 604-605 | S72026P | 08 | 564-566 | ||
| S68122S | 08 | 559-561 | S71002A | 09 | 604-605 | S72026Q | 08 | 564-566 | ||
| S68123A | 21 | 913-914 | S71002A | 24 | 955-965 | S72026R | 08 | 564-566 | ||
| S68123A | 24 | 955-965 | S71002D | 23 | 949-950 | S72026S | 08 | 559-561 | ||
| S68123D | 23 | 949-950 | S71002S | 09 | 604-605 | S72031A | 08 | 535-536 | ||
| S68123S | 08 | 559-561 | S71009A | 09 | 604-605 | S72031A | 15 | 793 | ||
| S68124A | 21 | 913-914 | S71009A | 24 | 955-965 | S72031A | 24 | 955-965 | ||
| S68124A | 24 | 955-965 | S71009D | 23 | 949-950 | S72031B | 08 | 535-536 | ||
| S68124D | 23 | 949-950 | S71009S | 09 | 604-605 | S72031B | 15 | 793 | ||
| S68124S | 08 | 559-561 | S71011A | 09 | 604-605 | S72031B | 24 | 955-965 | ||
| S68125A | 21 | 913-914 | S71011A | 24 | 955-965 | S72031C | 08 | 535-536 | ||
| S68125A | 24 | 955-965 | S71011D | 23 | 949-950 | S72031C | 15 | 793 | ||
| S68125D | 23 | 949-950 | S71011S | 09 | 604-605 | S72031C | 24 | 955-965 | ||
| S68125S | 08 | 559-561 | S71012A | 09 | 604-605 | S72031D | 08 | 559-561 | ||
| S68126A | 21 | 913-914 | S71012A | 24 | 955-965 | S72031E | 08 | 559-561 | ||
| S68126A | 24 | 955-965 | S71012D | 23 | 949-950 | S72031F | 08 | 559-561 | ||
| S68126D | 23 | 949-950 | S71012S | 09 | 604-605 | S72031G | 08 | 559-561 | ||
| S68126S | 08 | 559-561 | S71019A | 09 | 604-605 | S72031H | 08 | 559-561 | ||
| S68127A | 21 | 913-914 | S71019A | 24 | 955-965 | S72031J | 08 | 559-561 | ||
| S68127A | 24 | 955-965 | S71019D | 23 | 949-950 | S72031K | 08 | 564-566 | ||
| S68127D | 23 | 949-950 | S71019S | 09 | 604-605 | S72031M | 08 | 564-566 | ||
| S68127S | 08 | 559-561 | S71021A | 21 | 913-914 | S72031N | 08 | 564-566 | ||
| S68128A | 21 | 913-914 | S71021A | 24 | 955-965 | S72031P | 08 | 564-566 | ||
| S68128A | 24 | 955-965 | S71021D | 23 | 949-950 | S72031Q | 08 | 564-566 | ||
| S68128D | 23 | 949-950 | S71021S | 09 | 604-605 | S72031R | 08 | 564-566 | ||
| S68128S | 08 | 559-561 | S71022A | 21 | 913-914 | S72031S | 08 | 559-561 | ||
| S68129A | 21 | 913-914 | S71022A | 24 | 955-965 | S72032A | 08 | 535-536 | ||
| S68129A | 24 | 955-965 | S71022D | 23 | 949-950 | S72032A | 15 | 793 | ||
| S68129D | 23 | 949-950 | S71022S | 09 | 604-605 | S72032A | 24 | 955-965 | ||
| S68129S | 08 | 559-561 | S71029A | 21 | 913-914 | S72032B | 08 | 535-536 | ||
| S68411A | 21 | 913-914 | S71029A | 24 | 955-965 | S72032B | 15 | 793 | ||
| S68411A | 24 | 955-965 | S71029D | 23 | 949-950 | S72032B | 24 | 955-965 | ||
| S68411D | 23 | 949-950 | S71029S | 09 | 604-605 | S72032C | 08 | 535-536 | ||
| S68411S | 08 | 559-561 | S71031A | 09 | 604-605 | S72032C | 15 | 793 | ||
| S68412A | 21 | 913-914 | S71031A | 24 | 955-965 | S72032C | 24 | 955-965 | ||
| S68412A | 24 | 955-965 | S71031D | 23 | 949-950 | S72032D | 08 | 559-561 | ||
| S68412D | 23 | 949-950 | S71031S | 09 | 604-605 | S72032E | 08 | 559-561 | ||
| S68412S | 08 | 559-561 | S71032A | 09 | 604-605 | S72032F | 08 | 559-561 | ||
| S68419A | 21 | 913-914 | S71032A | 24 | 955-965 | S72032G | 08 | 559-561 | ||
| S68419A | 24 | 955-965 | S71032D | 23 | 949-950 | S72032H | 08 | 559-561 | ||
| S68419D | 23 | 949-950 | S71032S | 09 | 604-605 | S72032J | 08 | 559-561 | ||
| S68419S | 08 | 559-561 | S71039A | 09 | 604-605 | S72032K | 08 | 564-566 | ||
| S68421A | 21 | 913-914 | S71039A | 24 | 955-965 | S72032M | 08 | 564-566 | ||
| S68421A | 24 | 955-965 | S71039D | 23 | 949-950 | S72032N | 08 | 564-566 | ||
| S68421D | 23 | 949-950 | S71039S | 09 | 604-605 | S72032P | 08 | 564-566 | ||
| S68421S | 08 | 559-561 | S71041A | 21 | 913-914 | S72032Q | 08 | 564-566 | ||
| S68422A | 21 | 913-914 | S71041A | 24 | 955-965 | S72032R | 08 | 564-566 | ||
| S68422A | 24 | 955-965 | S71041D | 23 | 949-950 | S72032S | 08 | 559-561 | ||
| S68422D | 23 | 949-950 | S71041S | 09 | 604-605 | S72033A | 08 | 535-536 | ||
| S68422S | 08 | 559-561 | S71042A | 21 | 913-914 | S72033A | 15 | 793 | ||
| S68429A | 21 | 913-914 | S71042A | 24 | 955-965 | S72033A | 24 | 955-965 | ||
| S68429A | 24 | 955-965 | S71042D | 23 | 949-950 | S72033B | 08 | 535-536 | ||
| S68429D | 23 | 949-950 | S71042S | 09 | 604-605 | S72033B | 15 | 793 | ||
| S68429S | 08 | 559-561 | S71049A | 21 | 913-914 | S72033B | 24 | 955-965 | ||
| S68511A | 21 | 913-914 | S71049A | 24 | 955-965 | S72033C | 08 | 535-536 | ||
| S68511A | 24 | 955-965 | S71049D | 23 | 949-950 | S72033C | 15 | 793 | ||
| S68511D | 23 | 949-950 | S71049S | 09 | 604-605 | S72033C | 24 | 955-965 | ||
| S68511S | 08 | 559-561 | S71051A | 09 | 604-605 | S72033D | 08 | 559-561 | ||
| S68512A | 21 | 913-914 | S71051A | 24 | 955-965 | S72033E | 08 | 559-561 | ||
| S68512A | 24 | 955-965 | S71051D | 23 | 949-950 | S72033F | 08 | 559-561 | ||
| S68512D | 23 | 949-950 | S71051S | 09 | 604-605 | S72033G | 08 | 559-561 | ||
| S68512S | 08 | 559-561 | S71052A | 09 | 604-605 | S72033H | 08 | 559-561 | ||
| S68519A | 21 | 913-914 | S71052A | 24 | 955-965 | S72033J | 08 | 559-561 | ||
| S68519A | 24 | 955-965 | S71052D | 23 | 949-950 | S72033K | 08 | 564-566 | ||
| S68519D | 23 | 949-950 | S71052S | 09 | 604-605 | S72033M | 08 | 564-566 | ||
| S68519S | 08 | 559-561 | S71059A | 09 | 604-605 | S72033N | 08 | 564-566 | ||
| S68521A | 21 | 913-914 | S71059A | 24 | 955-965 | S72033P | 08 | 564-566 | ||
| S68521A | 24 | 955-965 | S71059D | 23 | 949-950 | S72033Q | 08 | 564-566 | ||
| S68521D | 23 | 949-950 | S71059S | 09 | 604-605 | S72033R | 08 | 564-566 | ||
| S68521S | 08 | 559-561 | S71101A | 09 | 604-605 | S72033S | 08 | 559-561 | ||
| S68522A | 21 | 913-914 | S71101A | 24 | 955-965 | S72034A | 08 | 535-536 | ||
| S68522A | 24 | 955-965 | S71101D | 23 | 949-950 | S72034A | 15 | 793 | ||
| S68522D | 23 | 949-950 | S71101S | 09 | 604-605 | S72034A | 24 | 955-965 | ||
| S68522S | 08 | 559-561 | S71102A | 09 | 604-605 | S72034B | 08 | 535-536 | ||
| S68529A | 21 | 913-914 | S71102A | 24 | 955-965 | S72034B | 15 | 793 | ||
| S68529A | 24 | 955-965 | S71102D | 23 | 949-950 | S72034B | 24 | 955-965 | ||
| S68529D | 23 | 949-950 | S71102S | 09 | 604-605 | S72034C | 08 | 535-536 | ||
| S68529S | 08 | 559-561 | S71109A | 09 | 604-605 | S72034C | 15 | 793 | ||
| S68610A | 21 | 913-914 | S71109A | 24 | 955-965 | S72034C | 24 | 955-965 | ||
| S68610A | 24 | 955-965 | S71109D | 23 | 949-950 | S72034D | 08 | 559-561 | ||
| S68610D | 23 | 949-950 | S71109S | 09 | 604-605 | S72034E | 08 | 559-561 | ||
| S68610S | 08 | 559-561 | S71111A | 09 | 604-605 | S72034F | 08 | 559-561 | ||
| S68611A | 21 | 913-914 | S71111A | 24 | 955-965 | S72034G | 08 | 559-561 | ||
| S68611A | 24 | 955-965 | S71111D | 23 | 949-950 | S72034H | 08 | 559-561 | ||
| S68611D | 23 | 949-950 | S71111S | 09 | 604-605 | S72034J | 08 | 559-561 | ||
| S68611S | 08 | 559-561 | S71112A | 09 | 604-605 | S72034K | 08 | 564-566 | ||
| S68612A | 21 | 913-914 | S71112A | 24 | 955-965 | S72034M | 08 | 564-566 | ||
| S68612A | 24 | 955-965 | S71112D | 23 | 949-950 | S72034N | 08 | 564-566 | ||
| S68612D | 23 | 949-950 | S71112S | 09 | 604-605 | S72034P | 08 | 564-566 | ||
| S68612S | 08 | 559-561 | S71119A | 09 | 604-605 | S72034Q | 08 | 564-566 | ||
| S68613A | 21 | 913-914 | S71119A | 24 | 955-965 | S72034R | 08 | 564-566 | ||
| S68613A | 24 | 955-965 | S71119D | 23 | 949-950 | S72034S | 08 | 559-561 | ||
| S68613D | 23 | 949-950 | S71119S | 09 | 604-605 | S72035A | 08 | 535-536 | ||
| S68613S | 08 | 559-561 | S71121A | 21 | 913-914 | S72035A | 15 | 793 | ||
| S68614A | 21 | 913-914 | S71121A | 24 | 955-965 | S72035A | 24 | 955-965 | ||
| S68614A | 24 | 955-965 | S71121D | 23 | 949-950 | S72035B | 08 | 535-536 | ||
| S68614D | 23 | 949-950 | S71121S | 09 | 604-605 | S72035B | 15 | 793 | ||
| S68614S | 08 | 559-561 | S71122A | 21 | 913-914 | S72035B | 24 | 955-965 | ||
| S68615A | 21 | 913-914 | S71122A | 24 | 955-965 | S72035C | 08 | 535-536 | ||
| S68615A | 24 | 955-965 | S71122D | 23 | 949-950 | S72035C | 15 | 793 | ||
| S68615D | 23 | 949-950 | S71122S | 09 | 604-605 | S72035C | 24 | 955-965 | ||
| S68615S | 08 | 559-561 | S71129A | 21 | 913-914 | S72035D | 08 | 559-561 | ||
| S68616A | 21 | 913-914 | S71129A | 24 | 955-965 | S72035E | 08 | 559-561 | ||
| S68616A | 24 | 955-965 | S71129D | 23 | 949-950 | S72035F | 08 | 559-561 | ||
| S68616D | 23 | 949-950 | S71129S | 09 | 604-605 | S72035G | 08 | 559-561 | ||
| S68616S | 08 | 559-561 | S71131A | 09 | 604-605 | S72035H | 08 | 559-561 | ||
| S68617A | 21 | 913-914 | S71131A | 24 | 955-965 | S72035J | 08 | 559-561 | ||
| S68617A | 24 | 955-965 | S71131D | 23 | 949-950 | S72035K | 08 | 564-566 | ||
| S68617D | 23 | 949-950 | S71131S | 09 | 604-605 | S72035M | 08 | 564-566 | ||
| S68617S | 08 | 559-561 | S71132A | 09 | 604-605 | S72035N | 08 | 564-566 | ||
| S68618A | 21 | 913-914 | S71132A | 24 | 955-965 | S72035P | 08 | 564-566 | ||
| S68618A | 24 | 955-965 | S71132D | 23 | 949-950 | S72035Q | 08 | 564-566 | ||
| S68618D | 23 | 949-950 | S71132S | 09 | 604-605 | S72035R | 08 | 564-566 | ||
| S68618S | 08 | 559-561 | S71139A | 09 | 604-605 | S72035S | 08 | 559-561 | ||
| S68619A | 21 | 913-914 | S71139A | 24 | 955-965 | S72036A | 08 | 535-536 | ||
| S68619A | 24 | 955-965 | S71139D | 23 | 949-950 | S72036A | 15 | 793 | ||
| S68619D | 23 | 949-950 | S71139S | 09 | 604-605 | S72036A | 24 | 955-965 | ||
| S68619S | 08 | 559-561 | S71141A | 21 | 913-914 | S72036B | 08 | 535-536 | ||
| S68620A | 21 | 913-914 | S71141A | 24 | 955-965 | S72036B | 15 | 793 | ||
| S68620A | 24 | 955-965 | S71141D | 23 | 949-950 | S72036B | 24 | 955-965 | ||
| S68620D | 23 | 949-950 | S71141S | 09 | 604-605 | S72036C | 08 | 535-536 | ||
| S68620S | 08 | 559-561 | S71142A | 21 | 913-914 | S72036C | 15 | 793 | ||
| S68621A | 21 | 913-914 | S71142A | 24 | 955-965 | S72036C | 24 | 955-965 | ||
| S68621A | 24 | 955-965 | S71142D | 23 | 949-950 | S72036D | 08 | 559-561 | ||
| S68621D | 23 | 949-950 | S71142S | 09 | 604-605 | S72036E | 08 | 559-561 | ||
| S68621S | 08 | 559-561 | S71149A | 21 | 913-914 | S72036F | 08 | 559-561 | ||
| S68622A | 21 | 913-914 | S71149A | 24 | 955-965 | S72036G | 08 | 559-561 | ||
| S68622A | 24 | 955-965 | S71149D | 23 | 949-950 | S72036H | 08 | 559-561 | ||
| S68622D | 23 | 949-950 | S71149S | 09 | 604-605 | S72036J | 08 | 559-561 | ||
| S68622S | 08 | 559-561 | S71151A | 09 | 604-605 | S72036K | 08 | 564-566 | ||
| S68623A | 21 | 913-914 | S71151A | 24 | 955-965 | S72036M | 08 | 564-566 | ||
| S68623A | 24 | 955-965 | S71151D | 23 | 949-950 | S72036N | 08 | 564-566 | ||
| S68623D | 23 | 949-950 | S71151S | 09 | 604-605 | S72036P | 08 | 564-566 | ||
| S68623S | 08 | 559-561 | S71152A | 09 | 604-605 | S72036Q | 08 | 564-566 | ||
| S68624A | 21 | 913-914 | S71152A | 24 | 955-965 | S72036R | 08 | 564-566 | ||
| S68624A | 24 | 955-965 | S71152D | 23 | 949-950 | S72036S | 08 | 559-561 | ||
| S68624D | 23 | 949-950 | S71152S | 09 | 604-605 | S72041A | 08 | 535-536 | ||
| S68624S | 08 | 559-561 | S71159A | 09 | 604-605 | S72041A | 15 | 793 | ||
| S68625A | 21 | 913-914 | S71159A | 24 | 955-965 | S72041A | 24 | 955-965 | ||
| S68625A | 24 | 955-965 | S71159D | 23 | 949-950 | S72041B | 08 | 535-536 | ||
| S68625D | 23 | 949-950 | S71159S | 09 | 604-605 | S72041B | 15 | 793 | ||
| S68625S | 08 | 559-561 | S72001A | 08 | 535-536 | S72041B | 24 | 955-965 | ||
| S68626A | 21 | 913-914 | S72001A | 15 | 793 | S72041C | 08 | 535-536 | ||
| S68626A | 24 | 955-965 | S72001A | 24 | 955-965 | S72041C | 15 | 793 | ||
| S68626D | 23 | 949-950 | S72001B | 08 | 535-536 | S72041C | 24 | 955-965 | ||
| S68626S | 08 | 559-561 | S72001B | 15 | 793 | S72041D | 08 | 559-561 | ||
| S68627A | 21 | 913-914 | S72001B | 24 | 955-965 | S72041E | 08 | 559-561 | ||
| S68627A | 24 | 955-965 | S72001C | 08 | 535-536 | S72041F | 08 | 559-561 | ||
| S68627D | 23 | 949-950 | S72001C | 15 | 793 | S72041G | 08 | 559-561 | ||
| S68627S | 08 | 559-561 | S72001C | 24 | 955-965 | S72041H | 08 | 559-561 | ||
| S68628A | 21 | 913-914 | S72001D | 08 | 559-561 | S72041J | 08 | 559-561 | ||
| S68628A | 24 | 955-965 | S72001E | 08 | 559-561 | S72041K | 08 | 564-566 | ||
| S68628D | 23 | 949-950 | S72001F | 08 | 559-561 | S72041M | 08 | 564-566 | ||
| S68628S | 08 | 559-561 | S72001G | 08 | 559-561 | S72041N | 08 | 564-566 | ||
| S68629A | 21 | 913-914 | S72001H | 08 | 559-561 | S72041P | 08 | 564-566 | ||
| S68629A | 24 | 955-965 | S72001J | 08 | 559-561 | S72041Q | 08 | 564-566 | ||
| S68629D | 23 | 949-950 | S72001K | 08 | 564-566 | S72041R | 08 | 564-566 | ||
| S68629S | 08 | 559-561 | S72001M | 08 | 564-566 | S72041S | 08 | 559-561 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Aug 2017 11:52:25 CMS, code-revision=63, description-revision=616 |