ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual
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DRAFT
ICD-10-CM/PCS MS-DRG v44.0 Definitions Manual |
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| Diagnosis Code/MDC/MS-DRG Index |
| Page 53 of 75 |
| A000 B309 C673 C8441 D220 E0901 E133541 F16280 G809 H18043 H44659 H9554 I673 J1282 K51211 L282 L98A229 M13179 M2650 M62229 M80851P M84673P M929 N99524 O3100X3 O360995 O43892 P0489 Q6680 R928 S0242XD S06369A S12230G S20302D S23163D S31041S S32409G S35404S S40822A S42322P S43491D S50911D S52231N S52363P S53106A S59029A S61151D S62173S S62523D S63255S S65999S S70311S S72059B S72142K S72366J S73122A S81021D S82146S S82431R S82872Q S86219S S91103S S92226D S93325A S99142B T2220XS T24119A T362X2D T420X1A T465X3S T523X1A T63463S T81501D T8482XS Z5301 |
| DX | MDC | MS-DRG | DX | MDC | MS-DRG | DX | MDC | MS-DRG | ||
|---|---|---|---|---|---|---|---|---|---|---|
| S72059B | 08 | 521-522 | S72101S | 08 | 559-561 | S72123P | 08 | 521-522 | ||
| S72059B | 08 | 535-536 | S72102A | 08 | 521-522 | S72123P | 08 | 564-566 | ||
| S72059B | 15 | 791 | S72102A | 08 | 535-536 | S72123Q | 08 | 521-522 | ||
| S72059B | 15 | 793 | S72102A | 15 | 791 | S72123Q | 08 | 564-566 | ||
| S72059B | 24 | 963-965 | S72102A | 15 | 793 | S72123R | 08 | 521-522 | ||
| S72059C | 08 | 521-522 | S72102A | 24 | 963-965 | S72123R | 08 | 564-566 | ||
| S72059C | 08 | 535-536 | S72102B | 08 | 521-522 | S72123S | 08 | 559-561 | ||
| S72059C | 15 | 791 | S72102B | 08 | 535-536 | S72124A | 08 | 521-522 | ||
| S72059C | 15 | 793 | S72102B | 15 | 791 | S72124A | 08 | 535-536 | ||
| S72059C | 24 | 963-965 | S72102B | 15 | 793 | S72124A | 15 | 791 | ||
| S72059D | 08 | 559-561 | S72102B | 24 | 963-965 | S72124A | 15 | 793 | ||
| S72059E | 08 | 559-561 | S72102C | 08 | 521-522 | S72124A | 24 | 963-965 | ||
| S72059F | 08 | 559-561 | S72102C | 08 | 535-536 | S72124B | 08 | 521-522 | ||
| S72059G | 08 | 521-522 | S72102C | 15 | 791 | S72124B | 08 | 535-536 | ||
| S72059G | 08 | 559-561 | S72102C | 15 | 793 | S72124B | 15 | 791 | ||
| S72059H | 08 | 521-522 | S72102C | 24 | 963-965 | S72124B | 15 | 793 | ||
| S72059H | 08 | 559-561 | S72102D | 08 | 559-561 | S72124B | 24 | 963-965 | ||
| S72059J | 08 | 521-522 | S72102E | 08 | 559-561 | S72124C | 08 | 521-522 | ||
| S72059J | 08 | 559-561 | S72102F | 08 | 559-561 | S72124C | 08 | 535-536 | ||
| S72059K | 08 | 521-522 | S72102G | 08 | 521-522 | S72124C | 15 | 791 | ||
| S72059K | 08 | 564-566 | S72102G | 08 | 559-561 | S72124C | 15 | 793 | ||
| S72059M | 08 | 521-522 | S72102H | 08 | 521-522 | S72124C | 24 | 963-965 | ||
| S72059M | 08 | 564-566 | S72102H | 08 | 559-561 | S72124D | 08 | 559-561 | ||
| S72059N | 08 | 521-522 | S72102J | 08 | 521-522 | S72124E | 08 | 559-561 | ||
| S72059N | 08 | 564-566 | S72102J | 08 | 559-561 | S72124F | 08 | 559-561 | ||
| S72059P | 08 | 521-522 | S72102K | 08 | 521-522 | S72124G | 08 | 521-522 | ||
| S72059P | 08 | 564-566 | S72102K | 08 | 564-566 | S72124G | 08 | 559-561 | ||
| S72059Q | 08 | 521-522 | S72102M | 08 | 521-522 | S72124H | 08 | 521-522 | ||
| S72059Q | 08 | 564-566 | S72102M | 08 | 564-566 | S72124H | 08 | 559-561 | ||
| S72059R | 08 | 521-522 | S72102N | 08 | 521-522 | S72124J | 08 | 521-522 | ||
| S72059R | 08 | 564-566 | S72102N | 08 | 564-566 | S72124J | 08 | 559-561 | ||
| S72059S | 08 | 559-561 | S72102P | 08 | 521-522 | S72124K | 08 | 521-522 | ||
| S72061A | 08 | 521-522 | S72102P | 08 | 564-566 | S72124K | 08 | 564-566 | ||
| S72061A | 08 | 535-536 | S72102Q | 08 | 521-522 | S72124M | 08 | 521-522 | ||
| S72061A | 15 | 791 | S72102Q | 08 | 564-566 | S72124M | 08 | 564-566 | ||
| S72061A | 15 | 793 | S72102R | 08 | 521-522 | S72124N | 08 | 521-522 | ||
| S72061A | 24 | 963-965 | S72102R | 08 | 564-566 | S72124N | 08 | 564-566 | ||
| S72061B | 08 | 521-522 | S72102S | 08 | 559-561 | S72124P | 08 | 521-522 | ||
| S72061B | 08 | 535-536 | S72109A | 08 | 521-522 | S72124P | 08 | 564-566 | ||
| S72061B | 15 | 791 | S72109A | 08 | 535-536 | S72124Q | 08 | 521-522 | ||
| S72061B | 15 | 793 | S72109A | 15 | 791 | S72124Q | 08 | 564-566 | ||
| S72061B | 24 | 963-965 | S72109A | 15 | 793 | S72124R | 08 | 521-522 | ||
| S72061C | 08 | 521-522 | S72109A | 24 | 963-965 | S72124R | 08 | 564-566 | ||
| S72061C | 08 | 535-536 | S72109B | 08 | 521-522 | S72124S | 08 | 559-561 | ||
| S72061C | 15 | 791 | S72109B | 08 | 535-536 | S72125A | 08 | 521-522 | ||
| S72061C | 15 | 793 | S72109B | 15 | 791 | S72125A | 08 | 535-536 | ||
| S72061C | 24 | 963-965 | S72109B | 15 | 793 | S72125A | 15 | 791 | ||
| S72061D | 08 | 559-561 | S72109B | 24 | 963-965 | S72125A | 15 | 793 | ||
| S72061E | 08 | 559-561 | S72109C | 08 | 521-522 | S72125A | 24 | 963-965 | ||
| S72061F | 08 | 559-561 | S72109C | 08 | 535-536 | S72125B | 08 | 521-522 | ||
| S72061G | 08 | 521-522 | S72109C | 15 | 791 | S72125B | 08 | 535-536 | ||
| S72061G | 08 | 559-561 | S72109C | 15 | 793 | S72125B | 15 | 791 | ||
| S72061H | 08 | 521-522 | S72109C | 24 | 963-965 | S72125B | 15 | 793 | ||
| S72061H | 08 | 559-561 | S72109D | 08 | 559-561 | S72125B | 24 | 963-965 | ||
| S72061J | 08 | 521-522 | S72109E | 08 | 559-561 | S72125C | 08 | 521-522 | ||
| S72061J | 08 | 559-561 | S72109F | 08 | 559-561 | S72125C | 08 | 535-536 | ||
| S72061K | 08 | 521-522 | S72109G | 08 | 521-522 | S72125C | 15 | 791 | ||
| S72061K | 08 | 564-566 | S72109G | 08 | 559-561 | S72125C | 15 | 793 | ||
| S72061M | 08 | 521-522 | S72109H | 08 | 521-522 | S72125C | 24 | 963-965 | ||
| S72061M | 08 | 564-566 | S72109H | 08 | 559-561 | S72125D | 08 | 559-561 | ||
| S72061N | 08 | 521-522 | S72109J | 08 | 521-522 | S72125E | 08 | 559-561 | ||
| S72061N | 08 | 564-566 | S72109J | 08 | 559-561 | S72125F | 08 | 559-561 | ||
| S72061P | 08 | 521-522 | S72109K | 08 | 521-522 | S72125G | 08 | 521-522 | ||
| S72061P | 08 | 564-566 | S72109K | 08 | 564-566 | S72125G | 08 | 559-561 | ||
| S72061Q | 08 | 521-522 | S72109M | 08 | 521-522 | S72125H | 08 | 521-522 | ||
| S72061Q | 08 | 564-566 | S72109M | 08 | 564-566 | S72125H | 08 | 559-561 | ||
| S72061R | 08 | 521-522 | S72109N | 08 | 521-522 | S72125J | 08 | 521-522 | ||
| S72061R | 08 | 564-566 | S72109N | 08 | 564-566 | S72125J | 08 | 559-561 | ||
| S72061S | 08 | 559-561 | S72109P | 08 | 521-522 | S72125K | 08 | 521-522 | ||
| S72062A | 08 | 521-522 | S72109P | 08 | 564-566 | S72125K | 08 | 564-566 | ||
| S72062A | 08 | 535-536 | S72109Q | 08 | 521-522 | S72125M | 08 | 521-522 | ||
| S72062A | 15 | 791 | S72109Q | 08 | 564-566 | S72125M | 08 | 564-566 | ||
| S72062A | 15 | 793 | S72109R | 08 | 521-522 | S72125N | 08 | 521-522 | ||
| S72062A | 24 | 963-965 | S72109R | 08 | 564-566 | S72125N | 08 | 564-566 | ||
| S72062B | 08 | 521-522 | S72109S | 08 | 559-561 | S72125P | 08 | 521-522 | ||
| S72062B | 08 | 535-536 | S72111A | 08 | 521-522 | S72125P | 08 | 564-566 | ||
| S72062B | 15 | 791 | S72111A | 08 | 535-536 | S72125Q | 08 | 521-522 | ||
| S72062B | 15 | 793 | S72111A | 15 | 791 | S72125Q | 08 | 564-566 | ||
| S72062B | 24 | 963-965 | S72111A | 15 | 793 | S72125R | 08 | 521-522 | ||
| S72062C | 08 | 521-522 | S72111A | 24 | 963-965 | S72125R | 08 | 564-566 | ||
| S72062C | 08 | 535-536 | S72111B | 08 | 521-522 | S72125S | 08 | 559-561 | ||
| S72062C | 15 | 791 | S72111B | 08 | 535-536 | S72126A | 08 | 521-522 | ||
| S72062C | 15 | 793 | S72111B | 15 | 791 | S72126A | 08 | 535-536 | ||
| S72062C | 24 | 963-965 | S72111B | 15 | 793 | S72126A | 15 | 791 | ||
| S72062D | 08 | 559-561 | S72111B | 24 | 963-965 | S72126A | 15 | 793 | ||
| S72062E | 08 | 559-561 | S72111C | 08 | 521-522 | S72126A | 24 | 963-965 | ||
| S72062F | 08 | 559-561 | S72111C | 08 | 535-536 | S72126B | 08 | 521-522 | ||
| S72062G | 08 | 521-522 | S72111C | 15 | 791 | S72126B | 08 | 535-536 | ||
| S72062G | 08 | 559-561 | S72111C | 15 | 793 | S72126B | 15 | 791 | ||
| S72062H | 08 | 521-522 | S72111C | 24 | 963-965 | S72126B | 15 | 793 | ||
| S72062H | 08 | 559-561 | S72111D | 08 | 559-561 | S72126B | 24 | 963-965 | ||
| S72062J | 08 | 521-522 | S72111E | 08 | 559-561 | S72126C | 08 | 521-522 | ||
| S72062J | 08 | 559-561 | S72111F | 08 | 559-561 | S72126C | 08 | 535-536 | ||
| S72062K | 08 | 521-522 | S72111G | 08 | 521-522 | S72126C | 15 | 791 | ||
| S72062K | 08 | 564-566 | S72111G | 08 | 559-561 | S72126C | 15 | 793 | ||
| S72062M | 08 | 521-522 | S72111H | 08 | 521-522 | S72126C | 24 | 963-965 | ||
| S72062M | 08 | 564-566 | S72111H | 08 | 559-561 | S72126D | 08 | 559-561 | ||
| S72062N | 08 | 521-522 | S72111J | 08 | 521-522 | S72126E | 08 | 559-561 | ||
| S72062N | 08 | 564-566 | S72111J | 08 | 559-561 | S72126F | 08 | 559-561 | ||
| S72062P | 08 | 521-522 | S72111K | 08 | 521-522 | S72126G | 08 | 521-522 | ||
| S72062P | 08 | 564-566 | S72111K | 08 | 564-566 | S72126G | 08 | 559-561 | ||
| S72062Q | 08 | 521-522 | S72111M | 08 | 521-522 | S72126H | 08 | 521-522 | ||
| S72062Q | 08 | 564-566 | S72111M | 08 | 564-566 | S72126H | 08 | 559-561 | ||
| S72062R | 08 | 521-522 | S72111N | 08 | 521-522 | S72126J | 08 | 521-522 | ||
| S72062R | 08 | 564-566 | S72111N | 08 | 564-566 | S72126J | 08 | 559-561 | ||
| S72062S | 08 | 559-561 | S72111P | 08 | 521-522 | S72126K | 08 | 521-522 | ||
| S72063A | 08 | 521-522 | S72111P | 08 | 564-566 | S72126K | 08 | 564-566 | ||
| S72063A | 08 | 535-536 | S72111Q | 08 | 521-522 | S72126M | 08 | 521-522 | ||
| S72063A | 15 | 791 | S72111Q | 08 | 564-566 | S72126M | 08 | 564-566 | ||
| S72063A | 15 | 793 | S72111R | 08 | 521-522 | S72126N | 08 | 521-522 | ||
| S72063A | 24 | 963-965 | S72111R | 08 | 564-566 | S72126N | 08 | 564-566 | ||
| S72063B | 08 | 521-522 | S72111S | 08 | 559-561 | S72126P | 08 | 521-522 | ||
| S72063B | 08 | 535-536 | S72112A | 08 | 521-522 | S72126P | 08 | 564-566 | ||
| S72063B | 15 | 791 | S72112A | 08 | 535-536 | S72126Q | 08 | 521-522 | ||
| S72063B | 15 | 793 | S72112A | 15 | 791 | S72126Q | 08 | 564-566 | ||
| S72063B | 24 | 963-965 | S72112A | 15 | 793 | S72126R | 08 | 521-522 | ||
| S72063C | 08 | 521-522 | S72112A | 24 | 963-965 | S72126R | 08 | 564-566 | ||
| S72063C | 08 | 535-536 | S72112B | 08 | 521-522 | S72126S | 08 | 559-561 | ||
| S72063C | 15 | 791 | S72112B | 08 | 535-536 | S72131A | 08 | 521-522 | ||
| S72063C | 15 | 793 | S72112B | 15 | 791 | S72131A | 08 | 535-536 | ||
| S72063C | 24 | 963-965 | S72112B | 15 | 793 | S72131A | 15 | 791 | ||
| S72063D | 08 | 559-561 | S72112B | 24 | 963-965 | S72131A | 15 | 793 | ||
| S72063E | 08 | 559-561 | S72112C | 08 | 521-522 | S72131A | 24 | 963-965 | ||
| S72063F | 08 | 559-561 | S72112C | 08 | 535-536 | S72131B | 08 | 521-522 | ||
| S72063G | 08 | 521-522 | S72112C | 15 | 791 | S72131B | 08 | 535-536 | ||
| S72063G | 08 | 559-561 | S72112C | 15 | 793 | S72131B | 15 | 791 | ||
| S72063H | 08 | 521-522 | S72112C | 24 | 963-965 | S72131B | 15 | 793 | ||
| S72063H | 08 | 559-561 | S72112D | 08 | 559-561 | S72131B | 24 | 963-965 | ||
| S72063J | 08 | 521-522 | S72112E | 08 | 559-561 | S72131C | 08 | 521-522 | ||
| S72063J | 08 | 559-561 | S72112F | 08 | 559-561 | S72131C | 08 | 535-536 | ||
| S72063K | 08 | 521-522 | S72112G | 08 | 521-522 | S72131C | 15 | 791 | ||
| S72063K | 08 | 564-566 | S72112G | 08 | 559-561 | S72131C | 15 | 793 | ||
| S72063M | 08 | 521-522 | S72112H | 08 | 521-522 | S72131C | 24 | 963-965 | ||
| S72063M | 08 | 564-566 | S72112H | 08 | 559-561 | S72131D | 08 | 559-561 | ||
| S72063N | 08 | 521-522 | S72112J | 08 | 521-522 | S72131E | 08 | 559-561 | ||
| S72063N | 08 | 564-566 | S72112J | 08 | 559-561 | S72131F | 08 | 559-561 | ||
| S72063P | 08 | 521-522 | S72112K | 08 | 521-522 | S72131G | 08 | 521-522 | ||
| S72063P | 08 | 564-566 | S72112K | 08 | 564-566 | S72131G | 08 | 559-561 | ||
| S72063Q | 08 | 521-522 | S72112M | 08 | 521-522 | S72131H | 08 | 521-522 | ||
| S72063Q | 08 | 564-566 | S72112M | 08 | 564-566 | S72131H | 08 | 559-561 | ||
| S72063R | 08 | 521-522 | S72112N | 08 | 521-522 | S72131J | 08 | 521-522 | ||
| S72063R | 08 | 564-566 | S72112N | 08 | 564-566 | S72131J | 08 | 559-561 | ||
| S72063S | 08 | 559-561 | S72112P | 08 | 521-522 | S72131K | 08 | 521-522 | ||
| S72064A | 08 | 521-522 | S72112P | 08 | 564-566 | S72131K | 08 | 564-566 | ||
| S72064A | 08 | 535-536 | S72112Q | 08 | 521-522 | S72131M | 08 | 521-522 | ||
| S72064A | 15 | 791 | S72112Q | 08 | 564-566 | S72131M | 08 | 564-566 | ||
| S72064A | 15 | 793 | S72112R | 08 | 521-522 | S72131N | 08 | 521-522 | ||
| S72064A | 24 | 963-965 | S72112R | 08 | 564-566 | S72131N | 08 | 564-566 | ||
| S72064B | 08 | 521-522 | S72112S | 08 | 559-561 | S72131P | 08 | 521-522 | ||
| S72064B | 08 | 535-536 | S72113A | 08 | 521-522 | S72131P | 08 | 564-566 | ||
| S72064B | 15 | 791 | S72113A | 08 | 535-536 | S72131Q | 08 | 521-522 | ||
| S72064B | 15 | 793 | S72113A | 15 | 791 | S72131Q | 08 | 564-566 | ||
| S72064B | 24 | 963-965 | S72113A | 15 | 793 | S72131R | 08 | 521-522 | ||
| S72064C | 08 | 521-522 | S72113A | 24 | 963-965 | S72131R | 08 | 564-566 | ||
| S72064C | 08 | 535-536 | S72113B | 08 | 521-522 | S72131S | 08 | 559-561 | ||
| S72064C | 15 | 791 | S72113B | 08 | 535-536 | S72132A | 08 | 521-522 | ||
| S72064C | 15 | 793 | S72113B | 15 | 791 | S72132A | 08 | 535-536 | ||
| S72064C | 24 | 963-965 | S72113B | 15 | 793 | S72132A | 15 | 791 | ||
| S72064D | 08 | 559-561 | S72113B | 24 | 963-965 | S72132A | 15 | 793 | ||
| S72064E | 08 | 559-561 | S72113C | 08 | 521-522 | S72132A | 24 | 963-965 | ||
| S72064F | 08 | 559-561 | S72113C | 08 | 535-536 | S72132B | 08 | 521-522 | ||
| S72064G | 08 | 521-522 | S72113C | 15 | 791 | S72132B | 08 | 535-536 | ||
| S72064G | 08 | 559-561 | S72113C | 15 | 793 | S72132B | 15 | 791 | ||
| S72064H | 08 | 521-522 | S72113C | 24 | 963-965 | S72132B | 15 | 793 | ||
| S72064H | 08 | 559-561 | S72113D | 08 | 559-561 | S72132B | 24 | 963-965 | ||
| S72064J | 08 | 521-522 | S72113E | 08 | 559-561 | S72132C | 08 | 521-522 | ||
| S72064J | 08 | 559-561 | S72113F | 08 | 559-561 | S72132C | 08 | 535-536 | ||
| S72064K | 08 | 521-522 | S72113G | 08 | 521-522 | S72132C | 15 | 791 | ||
| S72064K | 08 | 564-566 | S72113G | 08 | 559-561 | S72132C | 15 | 793 | ||
| S72064M | 08 | 521-522 | S72113H | 08 | 521-522 | S72132C | 24 | 963-965 | ||
| S72064M | 08 | 564-566 | S72113H | 08 | 559-561 | S72132D | 08 | 559-561 | ||
| S72064N | 08 | 521-522 | S72113J | 08 | 521-522 | S72132E | 08 | 559-561 | ||
| S72064N | 08 | 564-566 | S72113J | 08 | 559-561 | S72132F | 08 | 559-561 | ||
| S72064P | 08 | 521-522 | S72113K | 08 | 521-522 | S72132G | 08 | 521-522 | ||
| S72064P | 08 | 564-566 | S72113K | 08 | 564-566 | S72132G | 08 | 559-561 | ||
| S72064Q | 08 | 521-522 | S72113M | 08 | 521-522 | S72132H | 08 | 521-522 | ||
| S72064Q | 08 | 564-566 | S72113M | 08 | 564-566 | S72132H | 08 | 559-561 | ||
| S72064R | 08 | 521-522 | S72113N | 08 | 521-522 | S72132J | 08 | 521-522 | ||
| S72064R | 08 | 564-566 | S72113N | 08 | 564-566 | S72132J | 08 | 559-561 | ||
| S72064S | 08 | 559-561 | S72113P | 08 | 521-522 | S72132K | 08 | 521-522 | ||
| S72065A | 08 | 521-522 | S72113P | 08 | 564-566 | S72132K | 08 | 564-566 | ||
| S72065A | 08 | 535-536 | S72113Q | 08 | 521-522 | S72132M | 08 | 521-522 | ||
| S72065A | 15 | 791 | S72113Q | 08 | 564-566 | S72132M | 08 | 564-566 | ||
| S72065A | 15 | 793 | S72113R | 08 | 521-522 | S72132N | 08 | 521-522 | ||
| S72065A | 24 | 963-965 | S72113R | 08 | 564-566 | S72132N | 08 | 564-566 | ||
| S72065B | 08 | 521-522 | S72113S | 08 | 559-561 | S72132P | 08 | 521-522 | ||
| S72065B | 08 | 535-536 | S72114A | 08 | 521-522 | S72132P | 08 | 564-566 | ||
| S72065B | 15 | 791 | S72114A | 08 | 535-536 | S72132Q | 08 | 521-522 | ||
| S72065B | 15 | 793 | S72114A | 15 | 791 | S72132Q | 08 | 564-566 | ||
| S72065B | 24 | 963-965 | S72114A | 15 | 793 | S72132R | 08 | 521-522 | ||
| S72065C | 08 | 521-522 | S72114A | 24 | 963-965 | S72132R | 08 | 564-566 | ||
| S72065C | 08 | 535-536 | S72114B | 08 | 521-522 | S72132S | 08 | 559-561 | ||
| S72065C | 15 | 791 | S72114B | 08 | 535-536 | S72133A | 08 | 521-522 | ||
| S72065C | 15 | 793 | S72114B | 15 | 791 | S72133A | 08 | 535-536 | ||
| S72065C | 24 | 963-965 | S72114B | 15 | 793 | S72133A | 15 | 791 | ||
| S72065D | 08 | 559-561 | S72114B | 24 | 963-965 | S72133A | 15 | 793 | ||
| S72065E | 08 | 559-561 | S72114C | 08 | 521-522 | S72133A | 24 | 963-965 | ||
| S72065F | 08 | 559-561 | S72114C | 08 | 535-536 | S72133B | 08 | 521-522 | ||
| S72065G | 08 | 521-522 | S72114C | 15 | 791 | S72133B | 08 | 535-536 | ||
| S72065G | 08 | 559-561 | S72114C | 15 | 793 | S72133B | 15 | 791 | ||
| S72065H | 08 | 521-522 | S72114C | 24 | 963-965 | S72133B | 15 | 793 | ||
| S72065H | 08 | 559-561 | S72114D | 08 | 559-561 | S72133B | 24 | 963-965 | ||
| S72065J | 08 | 521-522 | S72114E | 08 | 559-561 | S72133C | 08 | 521-522 | ||
| S72065J | 08 | 559-561 | S72114F | 08 | 559-561 | S72133C | 08 | 535-536 | ||
| S72065K | 08 | 521-522 | S72114G | 08 | 521-522 | S72133C | 15 | 791 | ||
| S72065K | 08 | 564-566 | S72114G | 08 | 559-561 | S72133C | 15 | 793 | ||
| S72065M | 08 | 521-522 | S72114H | 08 | 521-522 | S72133C | 24 | 963-965 | ||
| S72065M | 08 | 564-566 | S72114H | 08 | 559-561 | S72133D | 08 | 559-561 | ||
| S72065N | 08 | 521-522 | S72114J | 08 | 521-522 | S72133E | 08 | 559-561 | ||
| S72065N | 08 | 564-566 | S72114J | 08 | 559-561 | S72133F | 08 | 559-561 | ||
| S72065P | 08 | 521-522 | S72114K | 08 | 521-522 | S72133G | 08 | 521-522 | ||
| S72065P | 08 | 564-566 | S72114K | 08 | 564-566 | S72133G | 08 | 559-561 | ||
| S72065Q | 08 | 521-522 | S72114M | 08 | 521-522 | S72133H | 08 | 521-522 | ||
| S72065Q | 08 | 564-566 | S72114M | 08 | 564-566 | S72133H | 08 | 559-561 | ||
| S72065R | 08 | 521-522 | S72114N | 08 | 521-522 | S72133J | 08 | 521-522 | ||
| S72065R | 08 | 564-566 | S72114N | 08 | 564-566 | S72133J | 08 | 559-561 | ||
| S72065S | 08 | 559-561 | S72114P | 08 | 521-522 | S72133K | 08 | 521-522 | ||
| S72066A | 08 | 521-522 | S72114P | 08 | 564-566 | S72133K | 08 | 564-566 | ||
| S72066A | 08 | 535-536 | S72114Q | 08 | 521-522 | S72133M | 08 | 521-522 | ||
| S72066A | 15 | 791 | S72114Q | 08 | 564-566 | S72133M | 08 | 564-566 | ||
| S72066A | 15 | 793 | S72114R | 08 | 521-522 | S72133N | 08 | 521-522 | ||
| S72066A | 24 | 963-965 | S72114R | 08 | 564-566 | S72133N | 08 | 564-566 | ||
| S72066B | 08 | 521-522 | S72114S | 08 | 559-561 | S72133P | 08 | 521-522 | ||
| S72066B | 08 | 535-536 | S72115A | 08 | 521-522 | S72133P | 08 | 564-566 | ||
| S72066B | 15 | 791 | S72115A | 08 | 535-536 | S72133Q | 08 | 521-522 | ||
| S72066B | 15 | 793 | S72115A | 15 | 791 | S72133Q | 08 | 564-566 | ||
| S72066B | 24 | 963-965 | S72115A | 15 | 793 | S72133R | 08 | 521-522 | ||
| S72066C | 08 | 521-522 | S72115A | 24 | 963-965 | S72133R | 08 | 564-566 | ||
| S72066C | 08 | 535-536 | S72115B | 08 | 521-522 | S72133S | 08 | 559-561 | ||
| S72066C | 15 | 791 | S72115B | 08 | 535-536 | S72134A | 08 | 521-522 | ||
| S72066C | 15 | 793 | S72115B | 15 | 791 | S72134A | 08 | 535-536 | ||
| S72066C | 24 | 963-965 | S72115B | 15 | 793 | S72134A | 15 | 791 | ||
| S72066D | 08 | 559-561 | S72115B | 24 | 963-965 | S72134A | 15 | 793 | ||
| S72066E | 08 | 559-561 | S72115C | 08 | 521-522 | S72134A | 24 | 963-965 | ||
| S72066F | 08 | 559-561 | S72115C | 08 | 535-536 | S72134B | 08 | 521-522 | ||
| S72066G | 08 | 521-522 | S72115C | 15 | 791 | S72134B | 08 | 535-536 | ||
| S72066G | 08 | 559-561 | S72115C | 15 | 793 | S72134B | 15 | 791 | ||
| S72066H | 08 | 521-522 | S72115C | 24 | 963-965 | S72134B | 15 | 793 | ||
| S72066H | 08 | 559-561 | S72115D | 08 | 559-561 | S72134B | 24 | 963-965 | ||
| S72066J | 08 | 521-522 | S72115E | 08 | 559-561 | S72134C | 08 | 521-522 | ||
| S72066J | 08 | 559-561 | S72115F | 08 | 559-561 | S72134C | 08 | 535-536 | ||
| S72066K | 08 | 521-522 | S72115G | 08 | 521-522 | S72134C | 15 | 791 | ||
| S72066K | 08 | 564-566 | S72115G | 08 | 559-561 | S72134C | 15 | 793 | ||
| S72066M | 08 | 521-522 | S72115H | 08 | 521-522 | S72134C | 24 | 963-965 | ||
| S72066M | 08 | 564-566 | S72115H | 08 | 559-561 | S72134D | 08 | 559-561 | ||
| S72066N | 08 | 521-522 | S72115J | 08 | 521-522 | S72134E | 08 | 559-561 | ||
| S72066N | 08 | 564-566 | S72115J | 08 | 559-561 | S72134F | 08 | 559-561 | ||
| S72066P | 08 | 521-522 | S72115K | 08 | 521-522 | S72134G | 08 | 521-522 | ||
| S72066P | 08 | 564-566 | S72115K | 08 | 564-566 | S72134G | 08 | 559-561 | ||
| S72066Q | 08 | 521-522 | S72115M | 08 | 521-522 | S72134H | 08 | 521-522 | ||
| S72066Q | 08 | 564-566 | S72115M | 08 | 564-566 | S72134H | 08 | 559-561 | ||
| S72066R | 08 | 521-522 | S72115N | 08 | 521-522 | S72134J | 08 | 521-522 | ||
| S72066R | 08 | 564-566 | S72115N | 08 | 564-566 | S72134J | 08 | 559-561 | ||
| S72066S | 08 | 559-561 | S72115P | 08 | 521-522 | S72134K | 08 | 521-522 | ||
| S72091A | 08 | 521-522 | S72115P | 08 | 564-566 | S72134K | 08 | 564-566 | ||
| S72091A | 08 | 535-536 | S72115Q | 08 | 521-522 | S72134M | 08 | 521-522 | ||
| S72091A | 15 | 791 | S72115Q | 08 | 564-566 | S72134M | 08 | 564-566 | ||
| S72091A | 15 | 793 | S72115R | 08 | 521-522 | S72134N | 08 | 521-522 | ||
| S72091A | 24 | 963-965 | S72115R | 08 | 564-566 | S72134N | 08 | 564-566 | ||
| S72091B | 08 | 521-522 | S72115S | 08 | 559-561 | S72134P | 08 | 521-522 | ||
| S72091B | 08 | 535-536 | S72116A | 08 | 521-522 | S72134P | 08 | 564-566 | ||
| S72091B | 15 | 791 | S72116A | 08 | 535-536 | S72134Q | 08 | 521-522 | ||
| S72091B | 15 | 793 | S72116A | 15 | 791 | S72134Q | 08 | 564-566 | ||
| S72091B | 24 | 963-965 | S72116A | 15 | 793 | S72134R | 08 | 521-522 | ||
| S72091C | 08 | 521-522 | S72116A | 24 | 963-965 | S72134R | 08 | 564-566 | ||
| S72091C | 08 | 535-536 | S72116B | 08 | 521-522 | S72134S | 08 | 559-561 | ||
| S72091C | 15 | 791 | S72116B | 08 | 535-536 | S72135A | 08 | 521-522 | ||
| S72091C | 15 | 793 | S72116B | 15 | 791 | S72135A | 08 | 535-536 | ||
| S72091C | 24 | 963-965 | S72116B | 15 | 793 | S72135A | 15 | 791 | ||
| S72091D | 08 | 559-561 | S72116B | 24 | 963-965 | S72135A | 15 | 793 | ||
| S72091E | 08 | 559-561 | S72116C | 08 | 521-522 | S72135A | 24 | 963-965 | ||
| S72091F | 08 | 559-561 | S72116C | 08 | 535-536 | S72135B | 08 | 521-522 | ||
| S72091G | 08 | 521-522 | S72116C | 15 | 791 | S72135B | 08 | 535-536 | ||
| S72091G | 08 | 559-561 | S72116C | 15 | 793 | S72135B | 15 | 791 | ||
| S72091H | 08 | 521-522 | S72116C | 24 | 963-965 | S72135B | 15 | 793 | ||
| S72091H | 08 | 559-561 | S72116D | 08 | 559-561 | S72135B | 24 | 963-965 | ||
| S72091J | 08 | 521-522 | S72116E | 08 | 559-561 | S72135C | 08 | 521-522 | ||
| S72091J | 08 | 559-561 | S72116F | 08 | 559-561 | S72135C | 08 | 535-536 | ||
| S72091K | 08 | 521-522 | S72116G | 08 | 521-522 | S72135C | 15 | 791 | ||
| S72091K | 08 | 564-566 | S72116G | 08 | 559-561 | S72135C | 15 | 793 | ||
| S72091M | 08 | 521-522 | S72116H | 08 | 521-522 | S72135C | 24 | 963-965 | ||
| S72091M | 08 | 564-566 | S72116H | 08 | 559-561 | S72135D | 08 | 559-561 | ||
| S72091N | 08 | 521-522 | S72116J | 08 | 521-522 | S72135E | 08 | 559-561 | ||
| S72091N | 08 | 564-566 | S72116J | 08 | 559-561 | S72135F | 08 | 559-561 | ||
| S72091P | 08 | 521-522 | S72116K | 08 | 521-522 | S72135G | 08 | 521-522 | ||
| S72091P | 08 | 564-566 | S72116K | 08 | 564-566 | S72135G | 08 | 559-561 | ||
| S72091Q | 08 | 521-522 | S72116M | 08 | 521-522 | S72135H | 08 | 521-522 | ||
| S72091Q | 08 | 564-566 | S72116M | 08 | 564-566 | S72135H | 08 | 559-561 | ||
| S72091R | 08 | 521-522 | S72116N | 08 | 521-522 | S72135J | 08 | 521-522 | ||
| S72091R | 08 | 564-566 | S72116N | 08 | 564-566 | S72135J | 08 | 559-561 | ||
| S72091S | 08 | 559-561 | S72116P | 08 | 521-522 | S72135K | 08 | 521-522 | ||
| S72092A | 08 | 521-522 | S72116P | 08 | 564-566 | S72135K | 08 | 564-566 | ||
| S72092A | 08 | 535-536 | S72116Q | 08 | 521-522 | S72135M | 08 | 521-522 | ||
| S72092A | 15 | 791 | S72116Q | 08 | 564-566 | S72135M | 08 | 564-566 | ||
| S72092A | 15 | 793 | S72116R | 08 | 521-522 | S72135N | 08 | 521-522 | ||
| S72092A | 24 | 963-965 | S72116R | 08 | 564-566 | S72135N | 08 | 564-566 | ||
| S72092B | 08 | 521-522 | S72116S | 08 | 559-561 | S72135P | 08 | 521-522 | ||
| S72092B | 08 | 535-536 | S72121A | 08 | 521-522 | S72135P | 08 | 564-566 | ||
| S72092B | 15 | 791 | S72121A | 08 | 535-536 | S72135Q | 08 | 521-522 | ||
| S72092B | 15 | 793 | S72121A | 15 | 791 | S72135Q | 08 | 564-566 | ||
| S72092B | 24 | 963-965 | S72121A | 15 | 793 | S72135R | 08 | 521-522 | ||
| S72092C | 08 | 521-522 | S72121A | 24 | 963-965 | S72135R | 08 | 564-566 | ||
| S72092C | 08 | 535-536 | S72121B | 08 | 521-522 | S72135S | 08 | 559-561 | ||
| S72092C | 15 | 791 | S72121B | 08 | 535-536 | S72136A | 08 | 521-522 | ||
| S72092C | 15 | 793 | S72121B | 15 | 791 | S72136A | 08 | 535-536 | ||
| S72092C | 24 | 963-965 | S72121B | 15 | 793 | S72136A | 15 | 791 | ||
| S72092D | 08 | 559-561 | S72121B | 24 | 963-965 | S72136A | 15 | 793 | ||
| S72092E | 08 | 559-561 | S72121C | 08 | 521-522 | S72136A | 24 | 963-965 | ||
| S72092F | 08 | 559-561 | S72121C | 08 | 535-536 | S72136B | 08 | 521-522 | ||
| S72092G | 08 | 521-522 | S72121C | 15 | 791 | S72136B | 08 | 535-536 | ||
| S72092G | 08 | 559-561 | S72121C | 15 | 793 | S72136B | 15 | 791 | ||
| S72092H | 08 | 521-522 | S72121C | 24 | 963-965 | S72136B | 15 | 793 | ||
| S72092H | 08 | 559-561 | S72121D | 08 | 559-561 | S72136B | 24 | 963-965 | ||
| S72092J | 08 | 521-522 | S72121E | 08 | 559-561 | S72136C | 08 | 521-522 | ||
| S72092J | 08 | 559-561 | S72121F | 08 | 559-561 | S72136C | 08 | 535-536 | ||
| S72092K | 08 | 521-522 | S72121G | 08 | 521-522 | S72136C | 15 | 791 | ||
| S72092K | 08 | 564-566 | S72121G | 08 | 559-561 | S72136C | 15 | 793 | ||
| S72092M | 08 | 521-522 | S72121H | 08 | 521-522 | S72136C | 24 | 963-965 | ||
| S72092M | 08 | 564-566 | S72121H | 08 | 559-561 | S72136D | 08 | 559-561 | ||
| S72092N | 08 | 521-522 | S72121J | 08 | 521-522 | S72136E | 08 | 559-561 | ||
| S72092N | 08 | 564-566 | S72121J | 08 | 559-561 | S72136F | 08 | 559-561 | ||
| S72092P | 08 | 521-522 | S72121K | 08 | 521-522 | S72136G | 08 | 521-522 | ||
| S72092P | 08 | 564-566 | S72121K | 08 | 564-566 | S72136G | 08 | 559-561 | ||
| S72092Q | 08 | 521-522 | S72121M | 08 | 521-522 | S72136H | 08 | 521-522 | ||
| S72092Q | 08 | 564-566 | S72121M | 08 | 564-566 | S72136H | 08 | 559-561 | ||
| S72092R | 08 | 521-522 | S72121N | 08 | 521-522 | S72136J | 08 | 521-522 | ||
| S72092R | 08 | 564-566 | S72121N | 08 | 564-566 | S72136J | 08 | 559-561 | ||
| S72092S | 08 | 559-561 | S72121P | 08 | 521-522 | S72136K | 08 | 521-522 | ||
| S72099A | 08 | 521-522 | S72121P | 08 | 564-566 | S72136K | 08 | 564-566 | ||
| S72099A | 08 | 535-536 | S72121Q | 08 | 521-522 | S72136M | 08 | 521-522 | ||
| S72099A | 15 | 791 | S72121Q | 08 | 564-566 | S72136M | 08 | 564-566 | ||
| S72099A | 15 | 793 | S72121R | 08 | 521-522 | S72136N | 08 | 521-522 | ||
| S72099A | 24 | 963-965 | S72121R | 08 | 564-566 | S72136N | 08 | 564-566 | ||
| S72099B | 08 | 521-522 | S72121S | 08 | 559-561 | S72136P | 08 | 521-522 | ||
| S72099B | 08 | 535-536 | S72122A | 08 | 521-522 | S72136P | 08 | 564-566 | ||
| S72099B | 15 | 791 | S72122A | 08 | 535-536 | S72136Q | 08 | 521-522 | ||
| S72099B | 15 | 793 | S72122A | 15 | 791 | S72136Q | 08 | 564-566 | ||
| S72099B | 24 | 963-965 | S72122A | 15 | 793 | S72136R | 08 | 521-522 | ||
| S72099C | 08 | 521-522 | S72122A | 24 | 963-965 | S72136R | 08 | 564-566 | ||
| S72099C | 08 | 535-536 | S72122B | 08 | 521-522 | S72136S | 08 | 559-561 | ||
| S72099C | 15 | 791 | S72122B | 08 | 535-536 | S72141A | 08 | 521-522 | ||
| S72099C | 15 | 793 | S72122B | 15 | 791 | S72141A | 08 | 535-536 | ||
| S72099C | 24 | 963-965 | S72122B | 15 | 793 | S72141A | 15 | 791 | ||
| S72099D | 08 | 559-561 | S72122B | 24 | 963-965 | S72141A | 15 | 793 | ||
| S72099E | 08 | 559-561 | S72122C | 08 | 521-522 | S72141A | 24 | 963-965 | ||
| S72099F | 08 | 559-561 | S72122C | 08 | 535-536 | S72141B | 08 | 521-522 | ||
| S72099G | 08 | 521-522 | S72122C | 15 | 791 | S72141B | 08 | 535-536 | ||
| S72099G | 08 | 559-561 | S72122C | 15 | 793 | S72141B | 15 | 791 | ||
| S72099H | 08 | 521-522 | S72122C | 24 | 963-965 | S72141B | 15 | 793 | ||
| S72099H | 08 | 559-561 | S72122D | 08 | 559-561 | S72141B | 24 | 963-965 | ||
| S72099J | 08 | 521-522 | S72122E | 08 | 559-561 | S72141C | 08 | 521-522 | ||
| S72099J | 08 | 559-561 | S72122F | 08 | 559-561 | S72141C | 08 | 535-536 | ||
| S72099K | 08 | 521-522 | S72122G | 08 | 521-522 | S72141C | 15 | 791 | ||
| S72099K | 08 | 564-566 | S72122G | 08 | 559-561 | S72141C | 15 | 793 | ||
| S72099M | 08 | 521-522 | S72122H | 08 | 521-522 | S72141C | 24 | 963-965 | ||
| S72099M | 08 | 564-566 | S72122H | 08 | 559-561 | S72141D | 08 | 559-561 | ||
| S72099N | 08 | 521-522 | S72122J | 08 | 521-522 | S72141E | 08 | 559-561 | ||
| S72099N | 08 | 564-566 | S72122J | 08 | 559-561 | S72141F | 08 | 559-561 | ||
| S72099P | 08 | 521-522 | S72122K | 08 | 521-522 | S72141G | 08 | 521-522 | ||
| S72099P | 08 | 564-566 | S72122K | 08 | 564-566 | S72141G | 08 | 559-561 | ||
| S72099Q | 08 | 521-522 | S72122M | 08 | 521-522 | S72141H | 08 | 521-522 | ||
| S72099Q | 08 | 564-566 | S72122M | 08 | 564-566 | S72141H | 08 | 559-561 | ||
| S72099R | 08 | 521-522 | S72122N | 08 | 521-522 | S72141J | 08 | 521-522 | ||
| S72099R | 08 | 564-566 | S72122N | 08 | 564-566 | S72141J | 08 | 559-561 | ||
| S72099S | 08 | 559-561 | S72122P | 08 | 521-522 | S72141K | 08 | 521-522 | ||
| S72101A | 08 | 521-522 | S72122P | 08 | 564-566 | S72141K | 08 | 564-566 | ||
| S72101A | 08 | 535-536 | S72122Q | 08 | 521-522 | S72141M | 08 | 521-522 | ||
| S72101A | 15 | 791 | S72122Q | 08 | 564-566 | S72141M | 08 | 564-566 | ||
| S72101A | 15 | 793 | S72122R | 08 | 521-522 | S72141N | 08 | 521-522 | ||
| S72101A | 24 | 963-965 | S72122R | 08 | 564-566 | S72141N | 08 | 564-566 | ||
| S72101B | 08 | 521-522 | S72122S | 08 | 559-561 | S72141P | 08 | 521-522 | ||
| S72101B | 08 | 535-536 | S72123A | 08 | 521-522 | S72141P | 08 | 564-566 | ||
| S72101B | 15 | 791 | S72123A | 08 | 535-536 | S72141Q | 08 | 521-522 | ||
| S72101B | 15 | 793 | S72123A | 15 | 791 | S72141Q | 08 | 564-566 | ||
| S72101B | 24 | 963-965 | S72123A | 15 | 793 | S72141R | 08 | 521-522 | ||
| S72101C | 08 | 521-522 | S72123A | 24 | 963-965 | S72141R | 08 | 564-566 | ||
| S72101C | 08 | 535-536 | S72123B | 08 | 521-522 | S72141S | 08 | 559-561 | ||
| S72101C | 15 | 791 | S72123B | 08 | 535-536 | S72142A | 08 | 521-522 | ||
| S72101C | 15 | 793 | S72123B | 15 | 791 | S72142A | 08 | 535-536 | ||
| S72101C | 24 | 963-965 | S72123B | 15 | 793 | S72142A | 15 | 791 | ||
| S72101D | 08 | 559-561 | S72123B | 24 | 963-965 | S72142A | 15 | 793 | ||
| S72101E | 08 | 559-561 | S72123C | 08 | 521-522 | S72142A | 24 | 963-965 | ||
| S72101F | 08 | 559-561 | S72123C | 08 | 535-536 | S72142B | 08 | 521-522 | ||
| S72101G | 08 | 521-522 | S72123C | 15 | 791 | S72142B | 08 | 535-536 | ||
| S72101G | 08 | 559-561 | S72123C | 15 | 793 | S72142B | 15 | 791 | ||
| S72101H | 08 | 521-522 | S72123C | 24 | 963-965 | S72142B | 15 | 793 | ||
| S72101H | 08 | 559-561 | S72123D | 08 | 559-561 | S72142B | 24 | 963-965 | ||
| S72101J | 08 | 521-522 | S72123E | 08 | 559-561 | S72142C | 08 | 521-522 | ||
| S72101J | 08 | 559-561 | S72123F | 08 | 559-561 | S72142C | 08 | 535-536 | ||
| S72101K | 08 | 521-522 | S72123G | 08 | 521-522 | S72142C | 15 | 791 | ||
| S72101K | 08 | 564-566 | S72123G | 08 | 559-561 | S72142C | 15 | 793 | ||
| S72101M | 08 | 521-522 | S72123H | 08 | 521-522 | S72142C | 24 | 963-965 | ||
| S72101M | 08 | 564-566 | S72123H | 08 | 559-561 | S72142D | 08 | 559-561 | ||
| S72101N | 08 | 521-522 | S72123J | 08 | 521-522 | S72142E | 08 | 559-561 | ||
| S72101N | 08 | 564-566 | S72123J | 08 | 559-561 | S72142F | 08 | 559-561 | ||
| S72101P | 08 | 521-522 | S72123K | 08 | 521-522 | S72142G | 08 | 521-522 | ||
| S72101P | 08 | 564-566 | S72123K | 08 | 564-566 | S72142G | 08 | 559-561 | ||
| S72101Q | 08 | 521-522 | S72123M | 08 | 521-522 | S72142H | 08 | 521-522 | ||
| S72101Q | 08 | 564-566 | S72123M | 08 | 564-566 | S72142H | 08 | 559-561 | ||
| S72101R | 08 | 521-522 | S72123N | 08 | 521-522 | S72142J | 08 | 521-522 | ||
| S72101R | 08 | 564-566 | S72123N | 08 | 564-566 | S72142J | 08 | 559-561 |
| | |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 25 Mar 2026 13:16:25 CMS, code-revision=381, description-revision=1473 |