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Complete List of Vaccine Names and CPT/CVX CodesA list that matches the vaccine name or codes in Washington State Immunization Information System (WA IIS) with the brand name or other common names of thevaccines you use most often.Vaccine trade name orcommon nameBest facturer/NDC 0907485190636104906441489070228Combination VaccinesPediarixDTAP/HepB/IPV 6 weeks 0.5 mlIMPentacelDTaP/HIB/IPV 6 weeks - 5yrs0.5 mlIMProQuadMMR/V 1 yr 0.5 mlSQKinrixDTaP/IPV 4 - 6 yrs0.5 mlIMComvaxHEPB/HIB 6 weeks 0.5 mlIMTwinrixHepA/HepB18 yrs1.0 mlIMMenHibrixMeningococcal C/Y-HIBPRP0.5mlIM6weeks –18 monthsGlaxoSmithKline –SKBNDC: 58160-0811-52Sanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0510-05Merck- MSDNDC: 00006-4999-00GlaxoSmithKline –SKBNDC: 58160-0812-11Merck- MSDNDC: 00006-4898-00GlaxoSmithKline –SKBGlaxoSmithKline –SKBDiphtheria, Tetanus and PertussisDiphtheria and tetanus toxoidsadsorbedDT (Pediatric) 6 weeks 0.5 mlIMSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0225-10Daptacel*DTaP orDTaP, 5 PertussisAntigen 6 weeks 0.5 mlIMSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0286-10Infanrix*DTaP 6 weeks 0.5 mlIMGlaxoSmithKline –SKBNDC:58160-0810-11DecavacTetanus and diphtheria toxoidsadsorbed Note: To be discontinuedafter supply runs outTd Adult, Preserv free 7 yrs0.5 mlIMSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0291-83106907002090718113* DTAP: Either CVX code (20 or 106) is acceptable in data exchange. In regards to inventory reporting, DTaP (CVX-20) is the default vaccine type that will be shown, inthe event no lot number is not linked to the vaccine type, it will show as DTaP, 5 Pertussis Antigen (CVXC-106).
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameDiphtheria, Tetanus and Pertussis(conti.)TenivacTetanus and diphtheria toxoidsadsorbed Note: New after Decavac isused upBoostrixTetanus Diphtheria & Acellular PertsussisAdacelBest facturer/NDC NumberCPTcodeCVXcodeSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0215-1090718113GlaxoSmithKline –SKBNDC:58160-0842-11Sanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0400-1090715115Sanofi Pasteur – PMC9070020Td Adult, Preserv free 7 yrs0.5 mlIMTdap 7-65 yrs0.5 mlIMTdap TripediaDTaP DTaP, 5 Pertussis AntigenDTaP, 5 0634849063252Tetanus Diphtheria and Acellular PertussisWhenever DTaP was given, even if thebrand name is unknownTetanus and diphtheria toxoidsadsorbedDiphtheria, tetanus toxoids, & wholecell pertussis vaccine (will be fromhistorical records)Td Adult 7-65 yrs0.5 mlIM6 weeks 0.5 mlIM7 yrs0.5 mlIM 12 months 18 yrs0.5 ml(720 EL.U)IM 12 months 18 yrs12 months 18 yrs0.5 ml(25 U)0.5 ml(360 EL.U)1.0 ml(50u)1.0 ml(1440 EL.U)MercK - MSDDTPHepatitis AHavrix(2 doses for pediatric/adolescent)Vaqta(2 doses for pediatric/adolescents)Havrix(3 doses for pediatric/adolescent)Vaqta(2 doses for adults)Havrix(2 doses for adults)2/8Hep A 2 dose - Ped/AdolHep A 2 dose - Ped/AdolHep A 3 dose - Ped/AdolHep A 2 dose - Adult19 yrsHep A 2 dose - Adult19 yrsIMIMGlaxoSmithKline –SKBNDC: 58160-0825-11Merck- MSDNDC: 00006-4831-41GlaxoSmithKline –SKBIMMerck- MSDIMGlaxoSmithKline –SKBUpdated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest rer/NDC NumberCPTcodeCVXcodeGlaxoSmithKline –SKBNDC: 58160-0820-11Merck- MSDNDC: 00006-4981-009074408IMGlaxoSmithKline –SKBNDC: 58160-0820-119074744IMMerck- MSD9074343IMGlaxoSmithKline –SKB9074643IMMerck- MSD9064848906474990648489064547RouteHepatitis BEngerix-B Ped/Adol(3 dose schedule)HepB Ped/Adol Preserv.Free Birth - 19yrs0.5 ml10µgRecombivax HB Ped/AdolHepB Ped/Adol Preserv.Free Birth - 19yrsEngerix-B(4 dose schedule)Hepatitis B - dialysis 0.5 ml5µg2.0 ml40µgRecombivax HB for adultsHep B 2 dose –Adol/AdultTwo X 20 µg in 1 or 2injections11-15 years1.0 ml10µgIMIMHepatitis B (conti.)Engerix-B for adults20 yrsHep B AdultRecombivax HB for adultsVarious dosages depending on specificindividual cases, such as high risk ordialysis.20 yrs1.0 ml20µg1.0 ml10µgNote: there are variouschoices available toreflect the specificsituationHIBActHibHib-PRP-T 2 months 5 yrsPedvaxHibHib-PRP-OMP HiberixHib-PRP-T2 months 5 yrs12 months –4 years0.5 mlIM0.5mlIM0.5mlIMSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0545-05Merck- MSDNDC: 00006-4897-00GlaxoSmithKline -HbocProHIBit (discontinued)Hib-PRP-D3/82 months 5 yrs2 months 5 yrs0.5 mlIMGlaxoSmithKline –SKB0.5mlIMWyeth Ayerst – WALUpdated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest e906496290650118IMTalecrisBiotherapeutics – TALORCangene Corp - CNJ9037130IMTalecrisBiotherapeutics - TAL9028186IVMany Manufacturers9028387IMTalecrisBiotherapeutics - TAL9037534IMMedImmune – MED9037893IMTalecrisBiotherapeutics - TAL9038913See pkg insert fordosage and adminrecommendationsIMCangene Corporation(Canada) – C NumberHuman Papilloma VirusGardasilHPV, quadrivalent 9 - 26 yrs0.5mlIMCervarix HPV, bivalent 10-25 yrs0.5mlIMImmune Globuline Products(This list is not comprehensive by brand name or manufacturer)HyperHEP B S/D orHepaGam B(Hepatitis B Immune Globulin)HBIG (Hepatitis BImmune Globulin)GamaSTAN S/D (Immune Globulin)Note: Used for post-exposure prophylaxisfor Hep A and MMR exposureImmune Globulin, intravenousNote: Rarely used for post-exposureprophylaxisSee pkg insert fordosage and adminrecommendationsSee pkg insert fordosage and adminrecommendationsSee pkg insert fordosage and adminrecommendationsSee pkg insert fordosage and adminrecommendationsSee pkg insert fordosage and adminrecommendationsSee pkg insert fordosage and adminrecommendationsIG (Immune Globulin IM)IGIVHyperRAB S/D (Rabies Immune Globulin)RIGSynagis (Respiratory Syncytial VirusImmune Globulin)RSV-IGIMHyperTET S/D (Tetanus ImmuneGlobulin)TIGVariZIG (Varicella Zoster ImmuneGlobulin)Note: Used for post exposure prophylaxisto ChickenpoxVZIGMerck- MSDNDC: 00006-4045-41GlaxoSmithKline –SKBNDC: 58160-0830-52InfluenzaFluzonePreservative Free (state supplied)Influ Split, 6-35 mos, presfree 6 - 35 mos0.25 mlPFSIMFluzoneContains PreservativeInflu Split, 36 mos 3 -18 yrs0.5mlMDVIM4/8Sanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0113-25Sanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0392-15Updated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest facturer/NDC NumberCPTcodeCVXcode9068615090672149Influenza Conti.FLUARIX QuadrivalentFlumist QuadrivalentAfluriaContains PreservativeAfluriPreservative FreeFLUARIXFLUARIX QuadrivalentFlublokInfluenza, inj, quad PF,36 mos 3 yrsInfluenza, live intranasal,quadrivalentInflu Inact 9 yrsw/ThimerosolInflu Inact 9 yrspres free 2 - 18 yrsInflu Split, 36 mos presfreeInfluenza, inj, quad PF,36 mosInf, recomb, inj, 18 yrs,PF9 yrs9 yrs3 yrs3 yrs18-49 yrs0.5mlPFSIMGlaxoSmithKline –SKBNDC: 58160-0900-52MedImmune – MEDNDC: 66019-0300-100.2 mlPIS0.5mlMDV0.5mlPFSIMCSL Biotherapies, INC90658141IMCSL Biotherapies, INC906561400.5mlPFSIMGlaxoSmithKline 2149906561400.5mlPFS0.5mlSDVINIMIMGlaxoSmithKline –SKBProtein Sciences Corp– PSCNovartisPharmaceutical Corp.– NOVGlaxoSmithKline –SKBNDC: N/AFlucelvaxInflu split, 18 yrs, PF18 yrs0.5mlPFSIMFluLavalInflu split, 18 years18 yrs0.5 mlMDVIMFlumist QuadravalentInfluenza, live intranasal,quadrivalent2 - 49 yrs0.2 mlPISINFluvirin PFInflu Inact 48 mos presfree3 - 18 yrs0.5mlPFSIMFluvirinContains preservativeInflu Inact. 48 mos,w/Thimerosol4 yrs0.5mlMDVIMNovartisPharmaceutical Corp.– NOV90658141FluzonePreservative FreeInflu Split, 36 mos, presfree3 yrsIMSanofi Pasteur – PMC(AKA: Aventis)90656140FluzoneContains PreservativeInflu Split, 36 mos3 yrsIMSanofi Pasteur – PMC(AKA: Aventis)906581415/80.5mlSDV;PFS0.5mlMDVMedImmune - MEDNovartisPharmaceutical Corp.– NOVUpdated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest facturer/NDC NumberCPTcodeCVXcodeInfluenza Conti.Fluzone High DoseInfluenza, High Dose65 yrs0.5mlPFSIMSanofi Pasteur – PMC(AKA: Aventis)90662135Fluzone IntradermalInfluenza, Intradermal PF18-64yr0.1mLPFMSIDSanofi Pasteur – PMC(AKA: Aventis)906541449073539 Japanese EncephalitisJE-VAX - Japanese EncephalitisJapanese Encephalitis12- 35 mos,3 yrs 0.5ml1.0 mlSQIXIARO - Japanese EncephalitisJapanese Encephalitis-IM17 yrs 0.5mlIMSanofi Pasteur – PMC(AKA: Aventis)NovartisPharmaceutical Corp.– NOV90738134Measles, Mumps & RubellaMMR 1 yrs0.5mlSQMenactra Meningococcal Conjugatevaccine (Serogroups A, C, Y, W-135)Meningococcal (MCV4P) 9 mos-55 yr0.5 mlIMMenveo Meningococcal Conjugatevaccine (Serogroups A, C, Y, W-135)Meningococcal (MCV4O) 2-55 yr0.5 mlIM3-18 mos(2 doses),19 mos( 1 dose)0.5 mlSQ0.5mlMMRII - Measles, Mumps & RubellaMerck- MSDNDC: 00006-4681-0090707039073411490734136Sanofi Pasteur – PMC(AKA: Aventis)9073332IMWyeth Ayerst – WALNDC: 00005-1971-02906701330.5mlSQ/IMMerck- MSDNDC: 00006-4943-0090732330.5mlSQ/IMGlaxoSmithKline –SKB9073233MeningococcalMenomune A/C/Y/W-135Meningococcal Polysaccharide vaccineMeningococcal (MPSV4)Sanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0589-05NovartisPharmaceutical Corp.– NOVNDC: 46028-0208-01PneumoniaPrevnar 13(Pneumococcal Conjugate, 13 valent)Pneumococcal, PCV-13 Pneumovax 23(Pneumococcal, polyvalent)Pneumococcal, (PPSV) Pnu-Imune 23Pneumococcal, (PPSV)6/8 2 - 59months 2 yrsw/healthrisks65 yrs,Updated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest facturer/NDC NumberCPTcodeCVXcodePneumonia Conti.Prevnar(Pneumococcal Conjugate, 7 valent)(Note: to be documented for vaccinegiven before 04/2010)PolioPneumococcal, (PCV)IPOL Poliovirus vaccine, inactivatedIPVPoliovirus vaccine, live oralOPV 2 - 59months0.5mlIMWyeth Ayerst – WAL906691006 weeks 0.5 mlSQSanofi Pasteur – PMC(AKA: Aventis)NDC: 49281-0860-1090713101.0 mlIM90675181.0 biesRabies, IDRabies, Intradermal Sanofi Pasteur – PMC(AKA: Aventis)NovartisPharmaceutical Corp.– NOV RotavirusRotateqRotavirus, pentavalentRV5 2-32months2.0 mlORALRotarixRotavirus, monovalentRV1 6-24 weeks1.0 mlORALMerck- MSDNDC: 00006-4047-41GlaxoSmithKline –SKBNDC: 58160-0845-52TB testPurified Protein Derivative (PPD)PPD Test0.1 mlQuantiFERON – TBGold Test (QGT-G)TyphoidQuantiFERON – TB GoldTest (QGT-G)N/ATyphoid ViCPsTyphoid, ViCPs2 yr 0.5 mlIMTyphoid, Oral (Vivotif Berna)Typhoid, Oral6 yr 4 tabsORAL7/8IDBloodDrawParkdalePharmaceuticals – PDN/ASanofi Pasteur – PMC(AKA: Aventis)Berna Products Corp.BPCUpdated: 09/11/2013 V5.13.8
Complete List of Vaccine Names and CPT/CVX CodesVaccine trade name orcommon nameBest facturer/NDC NumberCPTcodeCVXcodeTyphoid Conti.Typhoid, parenteralTyphoid, parenteral VaricellaVarivaxChicken Pox VaccineYellow FeverVaricellaYellow FeverYellow FeverZoster ("Shingles")ZostavaxZoster 1 yrs9 months50 yrs0.5 mlSQMerck- MSDNDC: 00006-4827-0090716210.5mlSQSanofi Pasteur – PMC(AKA: Aventis)90717370.65 mlSQMerck- MSD90736121NotesOn the Vaccination View/Add Screen: there are two places to look for the appropriate vaccine choice when entering a vaccination date. Always look FIRST at the vaccine names that appear on thescreen. ALL routine vaccines will appear. For less common vaccines that you can’t find on this list, go to the “select” box at the bottom of the vaccine list, and choose your vaccine from the drop-downlist and enter the date administered. "Unspecified" vaccines should only be used for entering historical vaccines when the specific vaccine type is unknown. If your practice manages vaccine inventory in WA IIS: make sure the vaccine types you enter match the vaccine types your lot number manager has entered. If you don’t see the correct lot number onyour Vaccination Detail screen, you and your lot number manager may be entering different vaccines (i.e., DTaP vs. DTaP-5 pertussis antigen.) Be sure to speak with the person entering your lotnumbers if you notice any issues/problems.FLU Notes to consider PFS Prefilled Syringe; MDV Multidose vial; SDV - Single Dose vial; PFMS – Prefilled micro syringe WA IIS staff discourage the use of the vaccine type "Influenza Whole". This vaccines type has not been used in the U.S. for some time8/8Updated: 09/11/2013 V5.13.8
Sep 11, 2013 · Complete List of Vaccine Names and CPT/CVX Codes on * DTAP: Either CVX code (20 or 106) is acceptable in data exchange. In regards to inventory reporting, DTaP (C
