ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v40.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 53 of 75 |
| A000 B302 C577 C8442 D309 E093393 E1344 F19280 G9761 H21341 H52203 I369 I70221 J682 K7031 L89200 M06812 M23203 M4841XS M71811 M84529D M87842 N468 O1214 O336XX3 O368234 O714 P913 R062 S0092XA S0303XA S069X2A S14106D S21312S S25809S S31811D S32499S S37012A S42123D S42449D S46329S S52045R S52291A S52552B S56112S S60359A S61509A S62321G S62660D S63637S S66529S S72024G S72114B S72326D S72451B S7711XD S82045J S82251P S8261XA S83521A S89309D S92044S S92426G S96802A T20219S T23229S T25739S T391X5S T444X2S T498X3S T602X4S T7805XS T83728S Z315 Z96641 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S72114B | 08 | 521-522 | S72132S | 08 | 559-561 | S7221XP | 08 | 521-522 | ||
| S72114B | 08 | 535-536 | S72133A | 08 | 521-522 | S7221XP | 08 | 564-566 | ||
| S72114B | 15 | 791 | S72133A | 08 | 535-536 | S7221XQ | 08 | 521-522 | ||
| S72114B | 15 | 793 | S72133A | 15 | 791 | S7221XQ | 08 | 564-566 | ||
| S72114B | 24 | 963-965 | S72133A | 15 | 793 | S7221XR | 08 | 521-522 | ||
| S72114C | 08 | 521-522 | S72133A | 24 | 963-965 | S7221XR | 08 | 564-566 | ||
| S72114C | 08 | 535-536 | S72133B | 08 | 521-522 | S7221XS | 08 | 559-561 | ||
| S72114C | 15 | 791 | S72133B | 08 | 535-536 | S7222XA | 08 | 521-522 | ||
| S72114C | 15 | 793 | S72133B | 15 | 791 | S7222XA | 08 | 535-536 | ||
| S72114C | 24 | 963-965 | S72133B | 15 | 793 | S7222XA | 15 | 791 | ||
| S72114D | 08 | 559-561 | S72133B | 24 | 963-965 | S7222XA | 15 | 793 | ||
| S72114E | 08 | 559-561 | S72133C | 08 | 521-522 | S7222XA | 24 | 963-965 | ||
| S72114F | 08 | 559-561 | S72133C | 08 | 535-536 | S7222XB | 08 | 521-522 | ||
| S72114G | 08 | 521-522 | S72133C | 15 | 791 | S7222XB | 08 | 535-536 | ||
| S72114G | 08 | 559-561 | S72133C | 15 | 793 | S7222XB | 15 | 791 | ||
| S72114H | 08 | 521-522 | S72133C | 24 | 963-965 | S7222XB | 15 | 793 | ||
| S72114H | 08 | 559-561 | S72133D | 08 | 559-561 | S7222XB | 24 | 963-965 | ||
| S72114J | 08 | 521-522 | S72133E | 08 | 559-561 | S7222XC | 08 | 521-522 | ||
| S72114J | 08 | 559-561 | S72133F | 08 | 559-561 | S7222XC | 08 | 535-536 | ||
| S72114K | 08 | 521-522 | S72133G | 08 | 521-522 | S7222XC | 15 | 791 | ||
| S72114K | 08 | 564-566 | S72133G | 08 | 559-561 | S7222XC | 15 | 793 | ||
| S72114M | 08 | 521-522 | S72133H | 08 | 521-522 | S7222XC | 24 | 963-965 | ||
| S72114M | 08 | 564-566 | S72133H | 08 | 559-561 | S7222XD | 08 | 559-561 | ||
| S72114N | 08 | 521-522 | S72133J | 08 | 521-522 | S7222XE | 08 | 559-561 | ||
| S72114N | 08 | 564-566 | S72133J | 08 | 559-561 | S7222XF | 08 | 559-561 | ||
| S72114P | 08 | 521-522 | S72133K | 08 | 521-522 | S7222XG | 08 | 521-522 | ||
| S72114P | 08 | 564-566 | S72133K | 08 | 564-566 | S7222XG | 08 | 559-561 | ||
| S72114Q | 08 | 521-522 | S72133M | 08 | 521-522 | S7222XH | 08 | 521-522 | ||
| S72114Q | 08 | 564-566 | S72133M | 08 | 564-566 | S7222XH | 08 | 559-561 | ||
| S72114R | 08 | 521-522 | S72133N | 08 | 521-522 | S7222XJ | 08 | 521-522 | ||
| S72114R | 08 | 564-566 | S72133N | 08 | 564-566 | S7222XJ | 08 | 559-561 | ||
| S72114S | 08 | 559-561 | S72133P | 08 | 521-522 | S7222XK | 08 | 521-522 | ||
| S72115A | 08 | 521-522 | S72133P | 08 | 564-566 | S7222XK | 08 | 564-566 | ||
| S72115A | 08 | 535-536 | S72133Q | 08 | 521-522 | S7222XM | 08 | 521-522 | ||
| S72115A | 15 | 791 | S72133Q | 08 | 564-566 | S7222XM | 08 | 564-566 | ||
| S72115A | 15 | 793 | S72133R | 08 | 521-522 | S7222XN | 08 | 521-522 | ||
| S72115A | 24 | 963-965 | S72133R | 08 | 564-566 | S7222XN | 08 | 564-566 | ||
| S72115B | 08 | 521-522 | S72133S | 08 | 559-561 | S7222XP | 08 | 521-522 | ||
| S72115B | 08 | 535-536 | S72134A | 08 | 521-522 | S7222XP | 08 | 564-566 | ||
| S72115B | 15 | 791 | S72134A | 08 | 535-536 | S7222XQ | 08 | 521-522 | ||
| S72115B | 15 | 793 | S72134A | 15 | 791 | S7222XQ | 08 | 564-566 | ||
| S72115B | 24 | 963-965 | S72134A | 15 | 793 | S7222XR | 08 | 521-522 | ||
| S72115C | 08 | 521-522 | S72134A | 24 | 963-965 | S7222XR | 08 | 564-566 | ||
| S72115C | 08 | 535-536 | S72134B | 08 | 521-522 | S7222XS | 08 | 559-561 | ||
| S72115C | 15 | 791 | S72134B | 08 | 535-536 | S7223XA | 08 | 521-522 | ||
| S72115C | 15 | 793 | S72134B | 15 | 791 | S7223XA | 08 | 535-536 | ||
| S72115C | 24 | 963-965 | S72134B | 15 | 793 | S7223XA | 15 | 791 | ||
| S72115D | 08 | 559-561 | S72134B | 24 | 963-965 | S7223XA | 15 | 793 | ||
| S72115E | 08 | 559-561 | S72134C | 08 | 521-522 | S7223XA | 24 | 963-965 | ||
| S72115F | 08 | 559-561 | S72134C | 08 | 535-536 | S7223XB | 08 | 521-522 | ||
| S72115G | 08 | 521-522 | S72134C | 15 | 791 | S7223XB | 08 | 535-536 | ||
| S72115G | 08 | 559-561 | S72134C | 15 | 793 | S7223XB | 15 | 791 | ||
| S72115H | 08 | 521-522 | S72134C | 24 | 963-965 | S7223XB | 15 | 793 | ||
| S72115H | 08 | 559-561 | S72134D | 08 | 559-561 | S7223XB | 24 | 963-965 | ||
| S72115J | 08 | 521-522 | S72134E | 08 | 559-561 | S7223XC | 08 | 521-522 | ||
| S72115J | 08 | 559-561 | S72134F | 08 | 559-561 | S7223XC | 08 | 535-536 | ||
| S72115K | 08 | 521-522 | S72134G | 08 | 521-522 | S7223XC | 15 | 791 | ||
| S72115K | 08 | 564-566 | S72134G | 08 | 559-561 | S7223XC | 15 | 793 | ||
| S72115M | 08 | 521-522 | S72134H | 08 | 521-522 | S7223XC | 24 | 963-965 | ||
| S72115M | 08 | 564-566 | S72134H | 08 | 559-561 | S7223XD | 08 | 559-561 | ||
| S72115N | 08 | 521-522 | S72134J | 08 | 521-522 | S7223XE | 08 | 559-561 | ||
| S72115N | 08 | 564-566 | S72134J | 08 | 559-561 | S7223XF | 08 | 559-561 | ||
| S72115P | 08 | 521-522 | S72134K | 08 | 521-522 | S7223XG | 08 | 521-522 | ||
| S72115P | 08 | 564-566 | S72134K | 08 | 564-566 | S7223XG | 08 | 559-561 | ||
| S72115Q | 08 | 521-522 | S72134M | 08 | 521-522 | S7223XH | 08 | 521-522 | ||
| S72115Q | 08 | 564-566 | S72134M | 08 | 564-566 | S7223XH | 08 | 559-561 | ||
| S72115R | 08 | 521-522 | S72134N | 08 | 521-522 | S7223XJ | 08 | 521-522 | ||
| S72115R | 08 | 564-566 | S72134N | 08 | 564-566 | S7223XJ | 08 | 559-561 | ||
| S72115S | 08 | 559-561 | S72134P | 08 | 521-522 | S7223XK | 08 | 521-522 | ||
| S72116A | 08 | 521-522 | S72134P | 08 | 564-566 | S7223XK | 08 | 564-566 | ||
| S72116A | 08 | 535-536 | S72134Q | 08 | 521-522 | S7223XM | 08 | 521-522 | ||
| S72116A | 15 | 791 | S72134Q | 08 | 564-566 | S7223XM | 08 | 564-566 | ||
| S72116A | 15 | 793 | S72134R | 08 | 521-522 | S7223XN | 08 | 521-522 | ||
| S72116A | 24 | 963-965 | S72134R | 08 | 564-566 | S7223XN | 08 | 564-566 | ||
| S72116B | 08 | 521-522 | S72134S | 08 | 559-561 | S7223XP | 08 | 521-522 | ||
| S72116B | 08 | 535-536 | S72135A | 08 | 521-522 | S7223XP | 08 | 564-566 | ||
| S72116B | 15 | 791 | S72135A | 08 | 535-536 | S7223XQ | 08 | 521-522 | ||
| S72116B | 15 | 793 | S72135A | 15 | 791 | S7223XQ | 08 | 564-566 | ||
| S72116B | 24 | 963-965 | S72135A | 15 | 793 | S7223XR | 08 | 521-522 | ||
| S72116C | 08 | 521-522 | S72135A | 24 | 963-965 | S7223XR | 08 | 564-566 | ||
| S72116C | 08 | 535-536 | S72135B | 08 | 521-522 | S7223XS | 08 | 559-561 | ||
| S72116C | 15 | 791 | S72135B | 08 | 535-536 | S7224XA | 08 | 521-522 | ||
| S72116C | 15 | 793 | S72135B | 15 | 791 | S7224XA | 08 | 535-536 | ||
| S72116C | 24 | 963-965 | S72135B | 15 | 793 | S7224XA | 15 | 791 | ||
| S72116D | 08 | 559-561 | S72135B | 24 | 963-965 | S7224XA | 15 | 793 | ||
| S72116E | 08 | 559-561 | S72135C | 08 | 521-522 | S7224XA | 24 | 963-965 | ||
| S72116F | 08 | 559-561 | S72135C | 08 | 535-536 | S7224XB | 08 | 521-522 | ||
| S72116G | 08 | 521-522 | S72135C | 15 | 791 | S7224XB | 08 | 535-536 | ||
| S72116G | 08 | 559-561 | S72135C | 15 | 793 | S7224XB | 15 | 791 | ||
| S72116H | 08 | 521-522 | S72135C | 24 | 963-965 | S7224XB | 15 | 793 | ||
| S72116H | 08 | 559-561 | S72135D | 08 | 559-561 | S7224XB | 24 | 963-965 | ||
| S72116J | 08 | 521-522 | S72135E | 08 | 559-561 | S7224XC | 08 | 521-522 | ||
| S72116J | 08 | 559-561 | S72135F | 08 | 559-561 | S7224XC | 08 | 535-536 | ||
| S72116K | 08 | 521-522 | S72135G | 08 | 521-522 | S7224XC | 15 | 791 | ||
| S72116K | 08 | 564-566 | S72135G | 08 | 559-561 | S7224XC | 15 | 793 | ||
| S72116M | 08 | 521-522 | S72135H | 08 | 521-522 | S7224XC | 24 | 963-965 | ||
| S72116M | 08 | 564-566 | S72135H | 08 | 559-561 | S7224XD | 08 | 559-561 | ||
| S72116N | 08 | 521-522 | S72135J | 08 | 521-522 | S7224XE | 08 | 559-561 | ||
| S72116N | 08 | 564-566 | S72135J | 08 | 559-561 | S7224XF | 08 | 559-561 | ||
| S72116P | 08 | 521-522 | S72135K | 08 | 521-522 | S7224XG | 08 | 521-522 | ||
| S72116P | 08 | 564-566 | S72135K | 08 | 564-566 | S7224XG | 08 | 559-561 | ||
| S72116Q | 08 | 521-522 | S72135M | 08 | 521-522 | S7224XH | 08 | 521-522 | ||
| S72116Q | 08 | 564-566 | S72135M | 08 | 564-566 | S7224XH | 08 | 559-561 | ||
| S72116R | 08 | 521-522 | S72135N | 08 | 521-522 | S7224XJ | 08 | 521-522 | ||
| S72116R | 08 | 564-566 | S72135N | 08 | 564-566 | S7224XJ | 08 | 559-561 | ||
| S72116S | 08 | 559-561 | S72135P | 08 | 521-522 | S7224XK | 08 | 521-522 | ||
| S72121A | 08 | 521-522 | S72135P | 08 | 564-566 | S7224XK | 08 | 564-566 | ||
| S72121A | 08 | 535-536 | S72135Q | 08 | 521-522 | S7224XM | 08 | 521-522 | ||
| S72121A | 15 | 791 | S72135Q | 08 | 564-566 | S7224XM | 08 | 564-566 | ||
| S72121A | 15 | 793 | S72135R | 08 | 521-522 | S7224XN | 08 | 521-522 | ||
| S72121A | 24 | 963-965 | S72135R | 08 | 564-566 | S7224XN | 08 | 564-566 | ||
| S72121B | 08 | 521-522 | S72135S | 08 | 559-561 | S7224XP | 08 | 521-522 | ||
| S72121B | 08 | 535-536 | S72136A | 08 | 521-522 | S7224XP | 08 | 564-566 | ||
| S72121B | 15 | 791 | S72136A | 08 | 535-536 | S7224XQ | 08 | 521-522 | ||
| S72121B | 15 | 793 | S72136A | 15 | 791 | S7224XQ | 08 | 564-566 | ||
| S72121B | 24 | 963-965 | S72136A | 15 | 793 | S7224XR | 08 | 521-522 | ||
| S72121C | 08 | 521-522 | S72136A | 24 | 963-965 | S7224XR | 08 | 564-566 | ||
| S72121C | 08 | 535-536 | S72136B | 08 | 521-522 | S7224XS | 08 | 559-561 | ||
| S72121C | 15 | 791 | S72136B | 08 | 535-536 | S7225XA | 08 | 521-522 | ||
| S72121C | 15 | 793 | S72136B | 15 | 791 | S7225XA | 08 | 535-536 | ||
| S72121C | 24 | 963-965 | S72136B | 15 | 793 | S7225XA | 15 | 791 | ||
| S72121D | 08 | 559-561 | S72136B | 24 | 963-965 | S7225XA | 15 | 793 | ||
| S72121E | 08 | 559-561 | S72136C | 08 | 521-522 | S7225XA | 24 | 963-965 | ||
| S72121F | 08 | 559-561 | S72136C | 08 | 535-536 | S7225XB | 08 | 521-522 | ||
| S72121G | 08 | 521-522 | S72136C | 15 | 791 | S7225XB | 08 | 535-536 | ||
| S72121G | 08 | 559-561 | S72136C | 15 | 793 | S7225XB | 15 | 791 | ||
| S72121H | 08 | 521-522 | S72136C | 24 | 963-965 | S7225XB | 15 | 793 | ||
| S72121H | 08 | 559-561 | S72136D | 08 | 559-561 | S7225XB | 24 | 963-965 | ||
| S72121J | 08 | 521-522 | S72136E | 08 | 559-561 | S7225XC | 08 | 521-522 | ||
| S72121J | 08 | 559-561 | S72136F | 08 | 559-561 | S7225XC | 08 | 535-536 | ||
| S72121K | 08 | 521-522 | S72136G | 08 | 521-522 | S7225XC | 15 | 791 | ||
| S72121K | 08 | 564-566 | S72136G | 08 | 559-561 | S7225XC | 15 | 793 | ||
| S72121M | 08 | 521-522 | S72136H | 08 | 521-522 | S7225XC | 24 | 963-965 | ||
| S72121M | 08 | 564-566 | S72136H | 08 | 559-561 | S7225XD | 08 | 559-561 | ||
| S72121N | 08 | 521-522 | S72136J | 08 | 521-522 | S7225XE | 08 | 559-561 | ||
| S72121N | 08 | 564-566 | S72136J | 08 | 559-561 | S7225XF | 08 | 559-561 | ||
| S72121P | 08 | 521-522 | S72136K | 08 | 521-522 | S7225XG | 08 | 521-522 | ||
| S72121P | 08 | 564-566 | S72136K | 08 | 564-566 | S7225XG | 08 | 559-561 | ||
| S72121Q | 08 | 521-522 | S72136M | 08 | 521-522 | S7225XH | 08 | 521-522 | ||
| S72121Q | 08 | 564-566 | S72136M | 08 | 564-566 | S7225XH | 08 | 559-561 | ||
| S72121R | 08 | 521-522 | S72136N | 08 | 521-522 | S7225XJ | 08 | 521-522 | ||
| S72121R | 08 | 564-566 | S72136N | 08 | 564-566 | S7225XJ | 08 | 559-561 | ||
| S72121S | 08 | 559-561 | S72136P | 08 | 521-522 | S7225XK | 08 | 521-522 | ||
| S72122A | 08 | 521-522 | S72136P | 08 | 564-566 | S7225XK | 08 | 564-566 | ||
| S72122A | 08 | 535-536 | S72136Q | 08 | 521-522 | S7225XM | 08 | 521-522 | ||
| S72122A | 15 | 791 | S72136Q | 08 | 564-566 | S7225XM | 08 | 564-566 | ||
| S72122A | 15 | 793 | S72136R | 08 | 521-522 | S7225XN | 08 | 521-522 | ||
| S72122A | 24 | 963-965 | S72136R | 08 | 564-566 | S7225XN | 08 | 564-566 | ||
| S72122B | 08 | 521-522 | S72136S | 08 | 559-561 | S7225XP | 08 | 521-522 | ||
| S72122B | 08 | 535-536 | S72141A | 08 | 521-522 | S7225XP | 08 | 564-566 | ||
| S72122B | 15 | 791 | S72141A | 08 | 535-536 | S7225XQ | 08 | 521-522 | ||
| S72122B | 15 | 793 | S72141A | 15 | 791 | S7225XQ | 08 | 564-566 | ||
| S72122B | 24 | 963-965 | S72141A | 15 | 793 | S7225XR | 08 | 521-522 | ||
| S72122C | 08 | 521-522 | S72141A | 24 | 963-965 | S7225XR | 08 | 564-566 | ||
| S72122C | 08 | 535-536 | S72141B | 08 | 521-522 | S7225XS | 08 | 559-561 | ||
| S72122C | 15 | 791 | S72141B | 08 | 535-536 | S7226XA | 08 | 521-522 | ||
| S72122C | 15 | 793 | S72141B | 15 | 791 | S7226XA | 08 | 535-536 | ||
| S72122C | 24 | 963-965 | S72141B | 15 | 793 | S7226XA | 15 | 791 | ||
| S72122D | 08 | 559-561 | S72141B | 24 | 963-965 | S7226XA | 15 | 793 | ||
| S72122E | 08 | 559-561 | S72141C | 08 | 521-522 | S7226XA | 24 | 963-965 | ||
| S72122F | 08 | 559-561 | S72141C | 08 | 535-536 | S7226XB | 08 | 521-522 | ||
| S72122G | 08 | 521-522 | S72141C | 15 | 791 | S7226XB | 08 | 535-536 | ||
| S72122G | 08 | 559-561 | S72141C | 15 | 793 | S7226XB | 15 | 791 | ||
| S72122H | 08 | 521-522 | S72141C | 24 | 963-965 | S7226XB | 15 | 793 | ||
| S72122H | 08 | 559-561 | S72141D | 08 | 559-561 | S7226XB | 24 | 963-965 | ||
| S72122J | 08 | 521-522 | S72141E | 08 | 559-561 | S7226XC | 08 | 521-522 | ||
| S72122J | 08 | 559-561 | S72141F | 08 | 559-561 | S7226XC | 08 | 535-536 | ||
| S72122K | 08 | 521-522 | S72141G | 08 | 521-522 | S7226XC | 15 | 791 | ||
| S72122K | 08 | 564-566 | S72141G | 08 | 559-561 | S7226XC | 15 | 793 | ||
| S72122M | 08 | 521-522 | S72141H | 08 | 521-522 | S7226XC | 24 | 963-965 | ||
| S72122M | 08 | 564-566 | S72141H | 08 | 559-561 | S7226XD | 08 | 559-561 | ||
| S72122N | 08 | 521-522 | S72141J | 08 | 521-522 | S7226XE | 08 | 559-561 | ||
| S72122N | 08 | 564-566 | S72141J | 08 | 559-561 | S7226XF | 08 | 559-561 | ||
| S72122P | 08 | 521-522 | S72141K | 08 | 521-522 | S7226XG | 08 | 521-522 | ||
| S72122P | 08 | 564-566 | S72141K | 08 | 564-566 | S7226XG | 08 | 559-561 | ||
| S72122Q | 08 | 521-522 | S72141M | 08 | 521-522 | S7226XH | 08 | 521-522 | ||
| S72122Q | 08 | 564-566 | S72141M | 08 | 564-566 | S7226XH | 08 | 559-561 | ||
| S72122R | 08 | 521-522 | S72141N | 08 | 521-522 | S7226XJ | 08 | 521-522 | ||
| S72122R | 08 | 564-566 | S72141N | 08 | 564-566 | S7226XJ | 08 | 559-561 | ||
| S72122S | 08 | 559-561 | S72141P | 08 | 521-522 | S7226XK | 08 | 521-522 | ||
| S72123A | 08 | 521-522 | S72141P | 08 | 564-566 | S7226XK | 08 | 564-566 | ||
| S72123A | 08 | 535-536 | S72141Q | 08 | 521-522 | S7226XM | 08 | 521-522 | ||
| S72123A | 15 | 791 | S72141Q | 08 | 564-566 | S7226XM | 08 | 564-566 | ||
| S72123A | 15 | 793 | S72141R | 08 | 521-522 | S7226XN | 08 | 521-522 | ||
| S72123A | 24 | 963-965 | S72141R | 08 | 564-566 | S7226XN | 08 | 564-566 | ||
| S72123B | 08 | 521-522 | S72141S | 08 | 559-561 | S7226XP | 08 | 521-522 | ||
| S72123B | 08 | 535-536 | S72142A | 08 | 521-522 | S7226XP | 08 | 564-566 | ||
| S72123B | 15 | 791 | S72142A | 08 | 535-536 | S7226XQ | 08 | 521-522 | ||
| S72123B | 15 | 793 | S72142A | 15 | 791 | S7226XQ | 08 | 564-566 | ||
| S72123B | 24 | 963-965 | S72142A | 15 | 793 | S7226XR | 08 | 521-522 | ||
| S72123C | 08 | 521-522 | S72142A | 24 | 963-965 | S7226XR | 08 | 564-566 | ||
| S72123C | 08 | 535-536 | S72142B | 08 | 521-522 | S7226XS | 08 | 559-561 | ||
| S72123C | 15 | 791 | S72142B | 08 | 535-536 | S72301A | 08 | 533-534 | ||
| S72123C | 15 | 793 | S72142B | 15 | 791 | S72301A | 15 | 791 | ||
| S72123C | 24 | 963-965 | S72142B | 15 | 793 | S72301A | 15 | 793 | ||
| S72123D | 08 | 559-561 | S72142B | 24 | 963-965 | S72301A | 24 | 963-965 | ||
| S72123E | 08 | 559-561 | S72142C | 08 | 521-522 | S72301B | 08 | 533-534 | ||
| S72123F | 08 | 559-561 | S72142C | 08 | 535-536 | S72301B | 15 | 791 | ||
| S72123G | 08 | 521-522 | S72142C | 15 | 791 | S72301B | 15 | 793 | ||
| S72123G | 08 | 559-561 | S72142C | 15 | 793 | S72301B | 24 | 963-965 | ||
| S72123H | 08 | 521-522 | S72142C | 24 | 963-965 | S72301C | 08 | 533-534 | ||
| S72123H | 08 | 559-561 | S72142D | 08 | 559-561 | S72301C | 15 | 791 | ||
| S72123J | 08 | 521-522 | S72142E | 08 | 559-561 | S72301C | 15 | 793 | ||
| S72123J | 08 | 559-561 | S72142F | 08 | 559-561 | S72301C | 24 | 963-965 | ||
| S72123K | 08 | 521-522 | S72142G | 08 | 521-522 | S72301D | 08 | 559-561 | ||
| S72123K | 08 | 564-566 | S72142G | 08 | 559-561 | S72301E | 08 | 559-561 | ||
| S72123M | 08 | 521-522 | S72142H | 08 | 521-522 | S72301F | 08 | 559-561 | ||
| S72123M | 08 | 564-566 | S72142H | 08 | 559-561 | S72301G | 08 | 559-561 | ||
| S72123N | 08 | 521-522 | S72142J | 08 | 521-522 | S72301H | 08 | 559-561 | ||
| S72123N | 08 | 564-566 | S72142J | 08 | 559-561 | S72301J | 08 | 559-561 | ||
| S72123P | 08 | 521-522 | S72142K | 08 | 521-522 | S72301K | 08 | 564-566 | ||
| S72123P | 08 | 564-566 | S72142K | 08 | 564-566 | S72301M | 08 | 564-566 | ||
| S72123Q | 08 | 521-522 | S72142M | 08 | 521-522 | S72301N | 08 | 564-566 | ||
| S72123Q | 08 | 564-566 | S72142M | 08 | 564-566 | S72301P | 08 | 564-566 | ||
| S72123R | 08 | 521-522 | S72142N | 08 | 521-522 | S72301Q | 08 | 564-566 | ||
| S72123R | 08 | 564-566 | S72142N | 08 | 564-566 | S72301R | 08 | 564-566 | ||
| S72123S | 08 | 559-561 | S72142P | 08 | 521-522 | S72301S | 08 | 559-561 | ||
| S72124A | 08 | 521-522 | S72142P | 08 | 564-566 | S72302A | 08 | 533-534 | ||
| S72124A | 08 | 535-536 | S72142Q | 08 | 521-522 | S72302A | 15 | 791 | ||
| S72124A | 15 | 791 | S72142Q | 08 | 564-566 | S72302A | 15 | 793 | ||
| S72124A | 15 | 793 | S72142R | 08 | 521-522 | S72302A | 24 | 963-965 | ||
| S72124A | 24 | 963-965 | S72142R | 08 | 564-566 | S72302B | 08 | 533-534 | ||
| S72124B | 08 | 521-522 | S72142S | 08 | 559-561 | S72302B | 15 | 791 | ||
| S72124B | 08 | 535-536 | S72143A | 08 | 521-522 | S72302B | 15 | 793 | ||
| S72124B | 15 | 791 | S72143A | 08 | 535-536 | S72302B | 24 | 963-965 | ||
| S72124B | 15 | 793 | S72143A | 15 | 791 | S72302C | 08 | 533-534 | ||
| S72124B | 24 | 963-965 | S72143A | 15 | 793 | S72302C | 15 | 791 | ||
| S72124C | 08 | 521-522 | S72143A | 24 | 963-965 | S72302C | 15 | 793 | ||
| S72124C | 08 | 535-536 | S72143B | 08 | 521-522 | S72302C | 24 | 963-965 | ||
| S72124C | 15 | 791 | S72143B | 08 | 535-536 | S72302D | 08 | 559-561 | ||
| S72124C | 15 | 793 | S72143B | 15 | 791 | S72302E | 08 | 559-561 | ||
| S72124C | 24 | 963-965 | S72143B | 15 | 793 | S72302F | 08 | 559-561 | ||
| S72124D | 08 | 559-561 | S72143B | 24 | 963-965 | S72302G | 08 | 559-561 | ||
| S72124E | 08 | 559-561 | S72143C | 08 | 521-522 | S72302H | 08 | 559-561 | ||
| S72124F | 08 | 559-561 | S72143C | 08 | 535-536 | S72302J | 08 | 559-561 | ||
| S72124G | 08 | 521-522 | S72143C | 15 | 791 | S72302K | 08 | 564-566 | ||
| S72124G | 08 | 559-561 | S72143C | 15 | 793 | S72302M | 08 | 564-566 | ||
| S72124H | 08 | 521-522 | S72143C | 24 | 963-965 | S72302N | 08 | 564-566 | ||
| S72124H | 08 | 559-561 | S72143D | 08 | 559-561 | S72302P | 08 | 564-566 | ||
| S72124J | 08 | 521-522 | S72143E | 08 | 559-561 | S72302Q | 08 | 564-566 | ||
| S72124J | 08 | 559-561 | S72143F | 08 | 559-561 | S72302R | 08 | 564-566 | ||
| S72124K | 08 | 521-522 | S72143G | 08 | 521-522 | S72302S | 08 | 559-561 | ||
| S72124K | 08 | 564-566 | S72143G | 08 | 559-561 | S72309A | 08 | 533-534 | ||
| S72124M | 08 | 521-522 | S72143H | 08 | 521-522 | S72309A | 15 | 791 | ||
| S72124M | 08 | 564-566 | S72143H | 08 | 559-561 | S72309A | 15 | 793 | ||
| S72124N | 08 | 521-522 | S72143J | 08 | 521-522 | S72309A | 24 | 963-965 | ||
| S72124N | 08 | 564-566 | S72143J | 08 | 559-561 | S72309B | 08 | 533-534 | ||
| S72124P | 08 | 521-522 | S72143K | 08 | 521-522 | S72309B | 15 | 791 | ||
| S72124P | 08 | 564-566 | S72143K | 08 | 564-566 | S72309B | 15 | 793 | ||
| S72124Q | 08 | 521-522 | S72143M | 08 | 521-522 | S72309B | 24 | 963-965 | ||
| S72124Q | 08 | 564-566 | S72143M | 08 | 564-566 | S72309C | 08 | 533-534 | ||
| S72124R | 08 | 521-522 | S72143N | 08 | 521-522 | S72309C | 15 | 791 | ||
| S72124R | 08 | 564-566 | S72143N | 08 | 564-566 | S72309C | 15 | 793 | ||
| S72124S | 08 | 559-561 | S72143P | 08 | 521-522 | S72309C | 24 | 963-965 | ||
| S72125A | 08 | 521-522 | S72143P | 08 | 564-566 | S72309D | 08 | 559-561 | ||
| S72125A | 08 | 535-536 | S72143Q | 08 | 521-522 | S72309E | 08 | 559-561 | ||
| S72125A | 15 | 791 | S72143Q | 08 | 564-566 | S72309F | 08 | 559-561 | ||
| S72125A | 15 | 793 | S72143R | 08 | 521-522 | S72309G | 08 | 559-561 | ||
| S72125A | 24 | 963-965 | S72143R | 08 | 564-566 | S72309H | 08 | 559-561 | ||
| S72125B | 08 | 521-522 | S72143S | 08 | 559-561 | S72309J | 08 | 559-561 | ||
| S72125B | 08 | 535-536 | S72144A | 08 | 521-522 | S72309K | 08 | 564-566 | ||
| S72125B | 15 | 791 | S72144A | 08 | 535-536 | S72309M | 08 | 564-566 | ||
| S72125B | 15 | 793 | S72144A | 15 | 791 | S72309N | 08 | 564-566 | ||
| S72125B | 24 | 963-965 | S72144A | 15 | 793 | S72309P | 08 | 564-566 | ||
| S72125C | 08 | 521-522 | S72144A | 24 | 963-965 | S72309Q | 08 | 564-566 | ||
| S72125C | 08 | 535-536 | S72144B | 08 | 521-522 | S72309R | 08 | 564-566 | ||
| S72125C | 15 | 791 | S72144B | 08 | 535-536 | S72309S | 08 | 559-561 | ||
| S72125C | 15 | 793 | S72144B | 15 | 791 | S72321A | 08 | 533-534 | ||
| S72125C | 24 | 963-965 | S72144B | 15 | 793 | S72321A | 15 | 791 | ||
| S72125D | 08 | 559-561 | S72144B | 24 | 963-965 | S72321A | 15 | 793 | ||
| S72125E | 08 | 559-561 | S72144C | 08 | 521-522 | S72321A | 24 | 963-965 | ||
| S72125F | 08 | 559-561 | S72144C | 08 | 535-536 | S72321B | 08 | 533-534 | ||
| S72125G | 08 | 521-522 | S72144C | 15 | 791 | S72321B | 15 | 791 | ||
| S72125G | 08 | 559-561 | S72144C | 15 | 793 | S72321B | 15 | 793 | ||
| S72125H | 08 | 521-522 | S72144C | 24 | 963-965 | S72321B | 24 | 963-965 | ||
| S72125H | 08 | 559-561 | S72144D | 08 | 559-561 | S72321C | 08 | 533-534 | ||
| S72125J | 08 | 521-522 | S72144E | 08 | 559-561 | S72321C | 15 | 791 | ||
| S72125J | 08 | 559-561 | S72144F | 08 | 559-561 | S72321C | 15 | 793 | ||
| S72125K | 08 | 521-522 | S72144G | 08 | 521-522 | S72321C | 24 | 963-965 | ||
| S72125K | 08 | 564-566 | S72144G | 08 | 559-561 | S72321D | 08 | 559-561 | ||
| S72125M | 08 | 521-522 | S72144H | 08 | 521-522 | S72321E | 08 | 559-561 | ||
| S72125M | 08 | 564-566 | S72144H | 08 | 559-561 | S72321F | 08 | 559-561 | ||
| S72125N | 08 | 521-522 | S72144J | 08 | 521-522 | S72321G | 08 | 559-561 | ||
| S72125N | 08 | 564-566 | S72144J | 08 | 559-561 | S72321H | 08 | 559-561 | ||
| S72125P | 08 | 521-522 | S72144K | 08 | 521-522 | S72321J | 08 | 559-561 | ||
| S72125P | 08 | 564-566 | S72144K | 08 | 564-566 | S72321K | 08 | 564-566 | ||
| S72125Q | 08 | 521-522 | S72144M | 08 | 521-522 | S72321M | 08 | 564-566 | ||
| S72125Q | 08 | 564-566 | S72144M | 08 | 564-566 | S72321N | 08 | 564-566 | ||
| S72125R | 08 | 521-522 | S72144N | 08 | 521-522 | S72321P | 08 | 564-566 | ||
| S72125R | 08 | 564-566 | S72144N | 08 | 564-566 | S72321Q | 08 | 564-566 | ||
| S72125S | 08 | 559-561 | S72144P | 08 | 521-522 | S72321R | 08 | 564-566 | ||
| S72126A | 08 | 521-522 | S72144P | 08 | 564-566 | S72321S | 08 | 559-561 | ||
| S72126A | 08 | 535-536 | S72144Q | 08 | 521-522 | S72322A | 08 | 533-534 | ||
| S72126A | 15 | 791 | S72144Q | 08 | 564-566 | S72322A | 15 | 791 | ||
| S72126A | 15 | 793 | S72144R | 08 | 521-522 | S72322A | 15 | 793 | ||
| S72126A | 24 | 963-965 | S72144R | 08 | 564-566 | S72322A | 24 | 963-965 | ||
| S72126B | 08 | 521-522 | S72144S | 08 | 559-561 | S72322B | 08 | 533-534 | ||
| S72126B | 08 | 535-536 | S72145A | 08 | 521-522 | S72322B | 15 | 791 | ||
| S72126B | 15 | 791 | S72145A | 08 | 535-536 | S72322B | 15 | 793 | ||
| S72126B | 15 | 793 | S72145A | 15 | 791 | S72322B | 24 | 963-965 | ||
| S72126B | 24 | 963-965 | S72145A | 15 | 793 | S72322C | 08 | 533-534 | ||
| S72126C | 08 | 521-522 | S72145A | 24 | 963-965 | S72322C | 15 | 791 | ||
| S72126C | 08 | 535-536 | S72145B | 08 | 521-522 | S72322C | 15 | 793 | ||
| S72126C | 15 | 791 | S72145B | 08 | 535-536 | S72322C | 24 | 963-965 | ||
| S72126C | 15 | 793 | S72145B | 15 | 791 | S72322D | 08 | 559-561 | ||
| S72126C | 24 | 963-965 | S72145B | 15 | 793 | S72322E | 08 | 559-561 | ||
| S72126D | 08 | 559-561 | S72145B | 24 | 963-965 | S72322F | 08 | 559-561 | ||
| S72126E | 08 | 559-561 | S72145C | 08 | 521-522 | S72322G | 08 | 559-561 | ||
| S72126F | 08 | 559-561 | S72145C | 08 | 535-536 | S72322H | 08 | 559-561 | ||
| S72126G | 08 | 521-522 | S72145C | 15 | 791 | S72322J | 08 | 559-561 | ||
| S72126G | 08 | 559-561 | S72145C | 15 | 793 | S72322K | 08 | 564-566 | ||
| S72126H | 08 | 521-522 | S72145C | 24 | 963-965 | S72322M | 08 | 564-566 | ||
| S72126H | 08 | 559-561 | S72145D | 08 | 559-561 | S72322N | 08 | 564-566 | ||
| S72126J | 08 | 521-522 | S72145E | 08 | 559-561 | S72322P | 08 | 564-566 | ||
| S72126J | 08 | 559-561 | S72145F | 08 | 559-561 | S72322Q | 08 | 564-566 | ||
| S72126K | 08 | 521-522 | S72145G | 08 | 521-522 | S72322R | 08 | 564-566 | ||
| S72126K | 08 | 564-566 | S72145G | 08 | 559-561 | S72322S | 08 | 559-561 | ||
| S72126M | 08 | 521-522 | S72145H | 08 | 521-522 | S72323A | 08 | 533-534 | ||
| S72126M | 08 | 564-566 | S72145H | 08 | 559-561 | S72323A | 15 | 791 | ||
| S72126N | 08 | 521-522 | S72145J | 08 | 521-522 | S72323A | 15 | 793 | ||
| S72126N | 08 | 564-566 | S72145J | 08 | 559-561 | S72323A | 24 | 963-965 | ||
| S72126P | 08 | 521-522 | S72145K | 08 | 521-522 | S72323B | 08 | 533-534 | ||
| S72126P | 08 | 564-566 | S72145K | 08 | 564-566 | S72323B | 15 | 791 | ||
| S72126Q | 08 | 521-522 | S72145M | 08 | 521-522 | S72323B | 15 | 793 | ||
| S72126Q | 08 | 564-566 | S72145M | 08 | 564-566 | S72323B | 24 | 963-965 | ||
| S72126R | 08 | 521-522 | S72145N | 08 | 521-522 | S72323C | 08 | 533-534 | ||
| S72126R | 08 | 564-566 | S72145N | 08 | 564-566 | S72323C | 15 | 791 | ||
| S72126S | 08 | 559-561 | S72145P | 08 | 521-522 | S72323C | 15 | 793 | ||
| S72131A | 08 | 521-522 | S72145P | 08 | 564-566 | S72323C | 24 | 963-965 | ||
| S72131A | 08 | 535-536 | S72145Q | 08 | 521-522 | S72323D | 08 | 559-561 | ||
| S72131A | 15 | 791 | S72145Q | 08 | 564-566 | S72323E | 08 | 559-561 | ||
| S72131A | 15 | 793 | S72145R | 08 | 521-522 | S72323F | 08 | 559-561 | ||
| S72131A | 24 | 963-965 | S72145R | 08 | 564-566 | S72323G | 08 | 559-561 | ||
| S72131B | 08 | 521-522 | S72145S | 08 | 559-561 | S72323H | 08 | 559-561 | ||
| S72131B | 08 | 535-536 | S72146A | 08 | 521-522 | S72323J | 08 | 559-561 | ||
| S72131B | 15 | 791 | S72146A | 08 | 535-536 | S72323K | 08 | 564-566 | ||
| S72131B | 15 | 793 | S72146A | 15 | 791 | S72323M | 08 | 564-566 | ||
| S72131B | 24 | 963-965 | S72146A | 15 | 793 | S72323N | 08 | 564-566 | ||
| S72131C | 08 | 521-522 | S72146A | 24 | 963-965 | S72323P | 08 | 564-566 | ||
| S72131C | 08 | 535-536 | S72146B | 08 | 521-522 | S72323Q | 08 | 564-566 | ||
| S72131C | 15 | 791 | S72146B | 08 | 535-536 | S72323R | 08 | 564-566 | ||
| S72131C | 15 | 793 | S72146B | 15 | 791 | S72323S | 08 | 559-561 | ||
| S72131C | 24 | 963-965 | S72146B | 15 | 793 | S72324A | 08 | 533-534 | ||
| S72131D | 08 | 559-561 | S72146B | 24 | 963-965 | S72324A | 15 | 791 | ||
| S72131E | 08 | 559-561 | S72146C | 08 | 521-522 | S72324A | 15 | 793 | ||
| S72131F | 08 | 559-561 | S72146C | 08 | 535-536 | S72324A | 24 | 963-965 | ||
| S72131G | 08 | 521-522 | S72146C | 15 | 791 | S72324B | 08 | 533-534 | ||
| S72131G | 08 | 559-561 | S72146C | 15 | 793 | S72324B | 15 | 791 | ||
| S72131H | 08 | 521-522 | S72146C | 24 | 963-965 | S72324B | 15 | 793 | ||
| S72131H | 08 | 559-561 | S72146D | 08 | 559-561 | S72324B | 24 | 963-965 | ||
| S72131J | 08 | 521-522 | S72146E | 08 | 559-561 | S72324C | 08 | 533-534 | ||
| S72131J | 08 | 559-561 | S72146F | 08 | 559-561 | S72324C | 15 | 791 | ||
| S72131K | 08 | 521-522 | S72146G | 08 | 521-522 | S72324C | 15 | 793 | ||
| S72131K | 08 | 564-566 | S72146G | 08 | 559-561 | S72324C | 24 | 963-965 | ||
| S72131M | 08 | 521-522 | S72146H | 08 | 521-522 | S72324D | 08 | 559-561 | ||
| S72131M | 08 | 564-566 | S72146H | 08 | 559-561 | S72324E | 08 | 559-561 | ||
| S72131N | 08 | 521-522 | S72146J | 08 | 521-522 | S72324F | 08 | 559-561 | ||
| S72131N | 08 | 564-566 | S72146J | 08 | 559-561 | S72324G | 08 | 559-561 | ||
| S72131P | 08 | 521-522 | S72146K | 08 | 521-522 | S72324H | 08 | 559-561 | ||
| S72131P | 08 | 564-566 | S72146K | 08 | 564-566 | S72324J | 08 | 559-561 | ||
| S72131Q | 08 | 521-522 | S72146M | 08 | 521-522 | S72324K | 08 | 564-566 | ||
| S72131Q | 08 | 564-566 | S72146M | 08 | 564-566 | S72324M | 08 | 564-566 | ||
| S72131R | 08 | 521-522 | S72146N | 08 | 521-522 | S72324N | 08 | 564-566 | ||
| S72131R | 08 | 564-566 | S72146N | 08 | 564-566 | S72324P | 08 | 564-566 | ||
| S72131S | 08 | 559-561 | S72146P | 08 | 521-522 | S72324Q | 08 | 564-566 | ||
| S72132A | 08 | 521-522 | S72146P | 08 | 564-566 | S72324R | 08 | 564-566 | ||
| S72132A | 08 | 535-536 | S72146Q | 08 | 521-522 | S72324S | 08 | 559-561 | ||
| S72132A | 15 | 791 | S72146Q | 08 | 564-566 | S72325A | 08 | 533-534 | ||
| S72132A | 15 | 793 | S72146R | 08 | 521-522 | S72325A | 15 | 791 | ||
| S72132A | 24 | 963-965 | S72146R | 08 | 564-566 | S72325A | 15 | 793 | ||
| S72132B | 08 | 521-522 | S72146S | 08 | 559-561 | S72325A | 24 | 963-965 | ||
| S72132B | 08 | 535-536 | S7221XA | 08 | 521-522 | S72325B | 08 | 533-534 | ||
| S72132B | 15 | 791 | S7221XA | 08 | 535-536 | S72325B | 15 | 791 | ||
| S72132B | 15 | 793 | S7221XA | 15 | 791 | S72325B | 15 | 793 | ||
| S72132B | 24 | 963-965 | S7221XA | 15 | 793 | S72325B | 24 | 963-965 | ||
| S72132C | 08 | 521-522 | S7221XA | 24 | 963-965 | S72325C | 08 | 533-534 | ||
| S72132C | 08 | 535-536 | S7221XB | 08 | 521-522 | S72325C | 15 | 791 | ||
| S72132C | 15 | 791 | S7221XB | 08 | 535-536 | S72325C | 15 | 793 | ||
| S72132C | 15 | 793 | S7221XB | 15 | 791 | S72325C | 24 | 963-965 | ||
| S72132C | 24 | 963-965 | S7221XB | 15 | 793 | S72325D | 08 | 559-561 | ||
| S72132D | 08 | 559-561 | S7221XB | 24 | 963-965 | S72325E | 08 | 559-561 | ||
| S72132E | 08 | 559-561 | S7221XC | 08 | 521-522 | S72325F | 08 | 559-561 | ||
| S72132F | 08 | 559-561 | S7221XC | 08 | 535-536 | S72325G | 08 | 559-561 | ||
| S72132G | 08 | 521-522 | S7221XC | 15 | 791 | S72325H | 08 | 559-561 | ||
| S72132G | 08 | 559-561 | S7221XC | 15 | 793 | S72325J | 08 | 559-561 | ||
| S72132H | 08 | 521-522 | S7221XC | 24 | 963-965 | S72325K | 08 | 564-566 | ||
| S72132H | 08 | 559-561 | S7221XD | 08 | 559-561 | S72325M | 08 | 564-566 | ||
| S72132J | 08 | 521-522 | S7221XE | 08 | 559-561 | S72325N | 08 | 564-566 | ||
| S72132J | 08 | 559-561 | S7221XF | 08 | 559-561 | S72325P | 08 | 564-566 | ||
| S72132K | 08 | 521-522 | S7221XG | 08 | 521-522 | S72325Q | 08 | 564-566 | ||
| S72132K | 08 | 564-566 | S7221XG | 08 | 559-561 | S72325R | 08 | 564-566 | ||
| S72132M | 08 | 521-522 | S7221XH | 08 | 521-522 | S72325S | 08 | 559-561 | ||
| S72132M | 08 | 564-566 | S7221XH | 08 | 559-561 | S72326A | 08 | 533-534 | ||
| S72132N | 08 | 521-522 | S7221XJ | 08 | 521-522 | S72326A | 15 | 791 | ||
| S72132N | 08 | 564-566 | S7221XJ | 08 | 559-561 | S72326A | 15 | 793 | ||
| S72132P | 08 | 521-522 | S7221XK | 08 | 521-522 | S72326A | 24 | 963-965 | ||
| S72132P | 08 | 564-566 | S7221XK | 08 | 564-566 | S72326B | 08 | 533-534 | ||
| S72132Q | 08 | 521-522 | S7221XM | 08 | 521-522 | S72326B | 15 | 791 | ||
| S72132Q | 08 | 564-566 | S7221XM | 08 | 564-566 | S72326B | 15 | 793 | ||
| S72132R | 08 | 521-522 | S7221XN | 08 | 521-522 | S72326B | 24 | 963-965 | ||
| S72132R | 08 | 564-566 | S7221XN | 08 | 564-566 | S72326C | 08 | 533-534 | ||
| S72326C | 15 | 791 | ||||||||
| S72326C | 15 | 793 | ||||||||
| S72326C | 24 | 963-965 |
|
Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 16 Mar 2022 17:08:13 CMS, code-revision=333, description-revision=1331 |