Complete List of Vaccine Names and CPT/CVX Codes

A 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 the
vaccines you use most often.

Vaccine trade name or

common name

Best WAIIS
Selection

State
Supplied

Age
(Range)

Dose

Route

Manufacturer/
NDC Number

CPT
code

CVX
code

90723

110

90698

120

90696

130

90748

51

90710

94

90644

148

90636

104

90702

28

Combination Vaccines
Pediarix

DTAP/HepB/IPV

6 weeks +

0.5 ml

IM

Pentacel

DTaP/HIB/IPV

6 weeks - 5
yrs

0.5 ml

IM

4 - 6 yrs

0.5 ml

IM

Kinrix
DTaP/IPV

Quadracel
Comvax

HEPB/HIB

6 weeks +

0.5 ml

IM

ProQuad

MMR/V

1 yr +

0.5 ml

SQ

Meningococcal C/Y-HIBPRP
HepA/HepB

0.5ml

IM

1.0 ml

IM

Diphtheria and tetanus toxoids

adsorbed

DT (Pediatric)

6 weeks +

0.5 ml

IM

Daptacel

DTaP or
DTaP, 5 Pertussis
Antigen

6 weeks +

0.5 ml

IM

Infanrix

DTaP

6 weeks +

0.5 ml

IM

Tenivac - Tetanus and diphtheria toxoids

adsorbed

Td Adult, Preserv free

7+ yrs

0.5 ml

IM

Boostrix
Tetanus Diphtheria & Acellular Pertsussis

Tdap

7-65+ yrs

0.5 ml

IM

Adacel
Tetanus Diphtheria and Acellular Pertussis

Tdap

7-65+yrs

0.5 ml

IM

Tripedia

DTaP

0.5 ml

IM

Decavac - Tetanus and diphtheria toxoids

adsorbed (Replaced by Tenivac)

Td Adult, Preserv free

MenHibrix
Twinrix

6weeks 18
months
18 + yrs

GlaxoSmithKline SKB
NDC: 58160-0811-52
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0510-05
GlaxoSmithKline SKB
NDC: 58160-0812-11
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0562-10
Merck- MSD
NDC: 00006-4898-00
Merck- MSD
NDC: 00006-4999-00
GlaxoSmithKline SKB
NDC: 58160-0801-11
GlaxoSmithKline SKB

Diphtheria, Tetanus and Pertussis

6 weeks +

Sanofi Pasteur PMC

(AKA: Aventis)
NDC: 49281-0225-10
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0286-10
GlaxoSmithKline SKB
NDC:58160-0810-11

106
90700
20

Sanofi Pasteur PMC

(AKA: Aventis)
NDC: 49281-0215-10

90714

113

GlaxoSmithKline SKB
NDC:58160-0842-11
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0400-10

90715

115

Sanofi Pasteur PMC

90700

20

90714

113

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name
Diphtheria, Tetanus and Pertussis
(conti.)
Whenever DTaP was given, even if the
brand name is unknown
Tetanus and diphtheria toxoids
adsorbed
Diphtheria, tetanus toxoids, & whole
cell pertussis vaccine (will be from
historical records)
Hepatitis A
Havrix
(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)
Hepatitis B
Engerix-B Ped/Adol
(3 dose schedule)

Best WAIIS
Selection

State
Supplied

Age
(Range)

CPT
code

CVX
code

DTaP

90700

20

Td Adult

90718

09

90633

83

90632

52

GlaxoSmithKline SKB
NDC: 58160-0820-11
Merck- MSD
NDC: 00006-4981-00

90744

08

IM

Merck- MSD

90747

44

IM

Merck- MSD

90743

43

90746

43

90746

43

90746

43

Dose

Route

Manufacturer/
NDC Number

DTP

Hep A 2 dose - Ped/Adol

Hep A 2 dose - Ped/Adol

Hep A 3 dose - Ped/Adol

Hep A 2 dose - Adult

Hep A 2 dose - Adult

12 months 18 yrs
12 months 18 yrs

19+ yrs
19+ yrs

0.5 ml
(720 EL.U)
0.5 ml
(25 U)

1.0 ml
(50u)
1.0 ml
(1440 EL.U)

IM

GlaxoSmithKline SKB
NDC: 58160-0825-11
Merck- MSD
NDC: 00006-4831-41

IM

Merck- MSD

IM

GlaxoSmithKline SKB

HepB Ped/Adol Preserv.

Free
HepB Ped/Adol Preserv.
Free

Birth - 19 yrs

Birth - 19 yrs

Recombivax - Dialysis
(3 dose schedule)

Hepatitis B - dialysis

Recombivax HB for adults

Hep B 2 dose
Adol/Adult

11-15 years

Engerix-B for adults

Hep B Adult

20 + yrs

1.0 ml
20g

IM

GlaxoSmithKline SKB

Recombivax HB for adults

Hep B Adult

20 + yrs

1.0 ml
10g

IM

Merck- MSD

Various dosages depending on specific

individual cases, such as high risk or
dialysis.

Note: there are various

choices available to
reflect the specific
situation

Recombivax HB Ped/Adol

2/8

0.5 ml
10g
0.5 ml
5g
1.0 ml
40g
1.0 ml
10g

IM

IM
IM

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name

Best WAIIS
Selection

State
Supplied

Age
(Range)

Dose

Route

Manufacturer/
NDC Number

CPT
code

CVX
code

90648

48

90647

49

90648

48

90649

62

90651

165

90650

118

HIB
ActHib

Hib-PRP-T

2 months - 5
yrs

PedvaxHib

Hib-PRP-OMP

Hiberix

Hib-PRP-T

2 months - 5
yrs
12 months
4 years

OmniHib

Hib-PRP-T

HibTITER

Hib-HBOC

ProHIBit (discontinued)

Hib-PRP-D

0.5 ml

IM

0.5ml

IM

0.5ml

IM

Sanofi Pasteur PMC

(AKA: Aventis)
NDC: 49281-0545-05
Merck- MSD
NDC: 00006-4897-00
GlaxoSmithKline SKB

Human Papilloma Virus

Gardasil

HPV, quadrivalent

9 - 26 yrs

0.5ml

IM

Gardasil 9

HPV, 9

9 26 yrs

0.5 ml

IM

Cervarix

HPV, bivalent

10-25 yrs

0.5ml

IM

Immune Globulin Products

HyperHEP B S/D or
HepaGam B
(Hepatitis B Immune Globulin)

(This list is not comprehensive by brand name or manufacturer)

GamaSTAN S/D (Immune Globulin)

Note: Used for post-exposure prophylaxis
for Hep A and MMR exposure
Immune Globulin, intravenous
Note: Rarely used for post-exposure
prophylaxis

HBIG (Hepatitis B
Immune Globulin)

IG (Immune Globulin IM)

IGIV

Synagis (Respiratory Syncytial Virus

Immune Globulin)

RSV-IGIM

HyperTET S/D (Tetanus Immune

Globulin)

TIG

3/8

See pkg insert for

dosage and admin
recommendations
See pkg insert for
dosage and admin
recommendations
See pkg insert for
dosage and admin
recommendations
See pkg insert for
dosage and admin
recommendations
See pkg insert for
dosage and admin
recommendations

Merck- MSD
NDC: 00006-4045-41
Merck- MSD
NDC: 0006-4119-03
GlaxoSmithKline SKB
NDC: 58160-0830-52

IM

Talecris Biotherapeutics
TAL OR
Cangene Corp - CNJ

90371

30

IM

Talecris Biotherapeutics
TAL or Grifols GFR

90281

86

IV

Many Manufacturers

90283

87

IM

MedImmune MED

90378

93

IM

Talecris Biotherapeutics TAL

90389

13

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name

Best WAIIS
Selection

Immune Globulin Products cont.:

VariZIG (Varicella Zoster Immune
Globulin)
Note: Used for post exposure prophylaxis
to Chickenpox

State
Supplied

Age
(Range)

Dose

Route

Manufacturer/
NDC Number

CPT
code

CVX
code

Cangene Corporation
(Canada) CNJ

90396

36

90685

161

90688

158

90688

158

90672

149

90686

150

(This list is not comprehensive by brand name or manufacturer)

VZIG

See pkg insert for

dosage and admin
recommendations

IM

Influenza
Fluzone, Quadrivalent, 6-35 mos (IIV4)

Influenza inj quad PF,

6-35 mos

6 - 35 mos

0.25 ml
PFS

IM

FluLaval, Quadrivalent (IIV4)

Influenza, inj, quad,

w/preservative 36+ mos

3 - 18 yrs

0.5 ml
MDV

IM

Fluzone, Quad, w/preserv (IIV4)

Influenza, inj, quad, w

Preservative, 3+ yrs

3+ yrs

0.5 ml
MDV

IM

Influenza, live intranasal,

quadrivalent
Influenza, inj, quad PF,
36+ mos

2 - 18 yrs

3+ yrs

Flumist Quadrivalent (LAIV4)

FLUARIX Quadrivalent (IIV4)
Afluria (IIV3)
Contains Preservative
Afluria (IIV3)
Preservative Free
Agriflu (IIV3), preservative free
FLUARIX Quadrivalent (IIV4)
Flublok (RIV3)
Flucelvax (ccIIV3)
FluLaval (IIV3)
FluLaval Quad PF (IIV4)
FluLaval Quad w/presrv (IIV4)

4/8

Influ Inact 9 + yrs

w/Thimerosol

9+ yrs

Influ Inact 9+yrs

pres free

9+ yrs

Influ split, 18+ yrs, PF

Influenza, inj, quad PF,
36+ mos
Inf, recomb, inj, 18+ yrs,
PF
Influ split, MDCK, presv
free, 18+ years
Influ Split, 36+ mos
Influenza, inj. Quad PF,
36+ mos
Influenza, in j quad,
w/preservative, 36+ mos

18+ yrs
3+ yrs
18-49 yrs
18+ yrs
3+ yrs
3+ yrs
3+ yrs

0.2 ml
PIS
0.5ml
PFS
0.5ml
MDV
0.5ml
PFS
0.5ml
PFS
0.5ml
PFS
0.5ml
SDV
0.5ml
PFS
0.5 ml
MDV
0.5ml
PFS
0.5 ml
MDV

IN
IM

Sanofi Pasteur PMC

(AKA: Aventis)
NDC: 49281-0514-25
GlaxoSmithKline SKB
NDC: 19515-0891-11
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0621-15
MedImmune MED
NDC: 66019-0301-10
GlaxoSmithKline SKB
NDC: 58160-0901-52

IM

CSL Biotherapies, INC

90658

141

IM

CSL Biotherapies, INC

90656

140

90656

140

90686

150

90673

155

90661

153

90658

141

90686

150

90688

158

IM
IM
IM
IM
IM
IM
IM

Novartis Pharmaceutical
Corp. NOV
GlaxoSmithKline SKB
NDC: 58160-0901-52
Protein Sciences Corp
PSC
Novartis Pharmaceutical
Corp. NOV
GlaxoSmithKline SKB
GlaxoSmithKline SKB
GlaxoSmithKline SKB

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name

Best WAIIS
Selection

State
Supplied

Age
(Range)

Dose

Route

Manufacturer/
NDC Number

CPT
code

CVX
code

90672

149

90658

141

90656

140

90657

141

90656

140

90658

141

90685

161

90687

158

90686

150

90688

158

Influenza cont.:
Flumist Quadrivalent (LAIV4)
Fluvirin (IIV3)
Fluvirin (PF) (IIV3)
Fluzone (IIV3)
Contains Preservative
Fluzone (IIV3)
Preservative Free
Fluzone (IIV3)
Contains Preservative
Fluzone, Quad, 6-35 mos, PF (IIV4)
Fluzone, Quad, w/preserv (IIV4)
Fluzone, Quad, 3+ yrs, PF (IIV4)
Fluzone, Quad, w/preserv (IIV4)

Influenza, live intranasal,

quadrivalent
Influ Inact 48+ mos, w
Thimerosol
Influ Inact 48+ mos
presser free

2 - 49 yrs
4+ yrs
4+ yrs

Influenza split, 6-35 mos

6-35 mos

Influ Split, 36+ mos, pres

free

3+ yrs

Influ Split, 36+ mos

3+ yrs

Influenza inj quad PF,

6-35 mos

6 - 35 mos

Influenza, inj, quad

w/presr, 6-35mos
Influenza, inj, quad PF,
3+ yrs
Influenza, inj, quad, w
Preservative, 3+ yrs

6-35 mos

3+ yrs

3+ yrs

0.2 ml
PIS
0.5 ml
MDV
0.5 ml
PFS
0.25ml
MDV
0.5ml
PFS
0.5ml
MDV
0.25 ml
PFS
0.25 ml
MDV
0.5 ml PFS
0.5 ml SDV
0.5ml
MDV

IN
IM
IM
IM
IM
IM
IM
IM
IM
IM

MedImmune MED
NDC: 66019-0301-10
Novartis Pharmaceutical
Corp. NOV
Novartis Pharmaceutical
Corp. NOV
Sanofi Pasteur PMC
(AKA: Aventis)
Sanofi Pasteur PMC
(AKA: Aventis)
Sanofi Pasteur PMC
(AKA: Aventis)
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0514-25
Sanofi Pasteur PMC
(AKA: Aventis)
Sanofi Pasteur PMC
(AKA: Aventis)
Sanofi Pasteur PMC
(AKA: Aventis)

Fluzone High Dose (IIV3)

Influenza, High Dose

65+ yrs

0.5ml
PFS

IM

Sanofi Pasteur PMC

(AKA: Aventis)

90662

135

Fluzone Intradermal (IIV3)

Influenza, Intradermal PF

18-64yr

0.1mL
PFMS

ID

Sanofi Pasteur PMC

(AKA: Aventis)

90654

144

17 yrs +

0.5ml

IM

Intercell Biomedical - INT

90738

134

1+ yrs

0.5ml

SQ

Merck- MSD
NDC: 00006-4681-00

90707

03

Japanese Encephalitis
IXIARO - Japanese Encephalitis

Japanese Encephalitis-IM

JE-VAX - Japanese Encephalitis

Japanese Encephalitis

Measles, Mumps & Rubella

MMRII - Measles, Mumps & Rubella

5/8

MMR

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name

Best WAIIS
Selection

State
Supplied

Age
(Range)

Dose

Route

Manufacturer/
NDC Number

CPT
code

CVX
code

90734

114

90734

136

90620

163

90621

162

Meningococcal
Sanofi Pasteur PMC
(AKA: Aventis)
NDC: 49281-0589-05
Novartis Pharmaceutical
Corp. NOV
NDC: 46028-0208-01
Novartis Pharmaceutical
Corp. NOV
NDC: 46028-0114-02
Pfizer, INC - PFR
NDC: 0005-0100-01

Menactra Meningococcal Conjugate

vaccine (Serogroups A, C, Y, W-135)

Meningococcal (MCV4P)

9mos-55 yrs

0.5 ml

IM

Menveo Meningococcal Conjugate

vaccine (Serogroups A, C, Y, W-135)

Meningococcal (MCV4O)

2-55 yrs

0.5 ml

IM

Bexsero Meningococcal B, OMV

Meningococcal B, OMV

10-25 yrs

0.5 ml

IM

Trumenba Meningococcal B,
recombinant

Meningococcal B,
recombinant

10-25 yrs

0.5 ml

IM

Meningococcal (MPSV4)

3-18 mos
(2 doses),
19+ mos
( 1 dose)

0.5 ml

SQ

Sanofi Pasteur PMC

(AKA: Aventis)

90733

32

0.5ml

IM

Pfizer, INC - PFR

NDC: 00005-1971-02

90670

133

0.5ml

SQ/IM

Merck- MSD
NDC: 00006-4943-00

90732

33

2 - 59
months

0.5ml

IM

Wyeth Ayerst WAL

90669

100

6 weeks +

0.5 ml

SQ

Sanofi Pasteur PMC

(AKA: Aventis)
NDC: 49281-0860-10

90713

10

1.0 ml

IM

Sanofi Pasteur PMC

(AKA: Aventis)

90675

18

Menomune A/C/Y/W-135
Meningococcal Polysaccharide vaccine
Pneumonia
Prevnar 13
(Pneumococcal Conjugate, 13 valent)

Pneumococcal, PCV-13

Pneumovax 23
(Pneumococcal, polyvalent)

Pneumococcal, (PPSV)

Prevnar
(Pneumococcal Conjugate, 7 valent)
(Note: to be documented for vaccine
given before 04/2010)

Pneumococcal, (PCV)

2 - 59
months
2 yrs
w/health
risks

Polio
IPOL Poliovirus vaccine, inactivated

IPV

Poliovirus vaccine, live oral

OPV

Rabies
Imovax

6/8

Rabies

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Vaccine trade name or
common name

Best WAIIS
Selection

State
Supplied

Age
(Range)

Dose

Manufacturer/
NDC Number

Route

CPT
code

CVX
code

90675

18

90676

40

Rabies conti:
Rabavert

Rabies

Rabies, ID
Rotavirus

Rabies, Intradermal

Rotateq

1.0 ml

IM

0.1ml

ID

Novartis Pharmaceutical
Corp. NOV

Rotavirus, pentavalent
RV5

2-32
months

2.0 ml

ORAL

Merck- MSD
NDC: 00006-4047-41

90680

116

Rotavirus, monovalent
RV1

6-24 weeks

1.0 ml

ORAL

GlaxoSmithKline SKB
NDC: 58160-0845-52

90681

119

ID

Parkdale
Pharmaceuticals PD

86580

96

N/A

86480

N/A

Sanofi Pasteur PMC

(AKA: Aventis)

90691

101

Crucell - CRU

90690

25

Rotavirus Cont.:
Rotarix
TB test
Purified Protein Derivative (PPD)

PPD Test

0.1 ml

QuantiFERON TB
Gold Test (QGT-G)

QuantiFERON TB Gold
Test (QGT-G)

N/A

Blood
Draw

Typhoid
Typhoid ViCPs

Typhoid, ViCPs

2 yr +

0.5 ml

IM

Typhoid, Oral (Vivotif Berna)

Typhoid, Oral

6 yr +

4 tabs

ORAL

Typhoid, parenteral

Typhoid, parenteral

1+ yrs

0.5 ml

SQ

Merck- MSD
NDC: 00006-4827-00

90716

21

Yellow Fever

9+ months

0.5ml

SQ

Sanofi Pasteur PMC

(AKA: Aventis)

90717

37

Zoster

50 + yrs

0.65 ml

SQ

Merck- MSD

90736

121

Varicella
Varivax
Chicken Pox Vaccine

Varicella

Yellow Fever
Yellow Fever

Zoster ("Shingles")
Zostavax

7/8

Updated: 05/19/15, V5.14.11.2

Complete List of Vaccine Names and CPT/CVX Codes

Notes
On 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 the
screen. ALL routine vaccines will appear. For less common vaccines that you cant find on this list, go to the select box at the bottom of the vaccine list, and choose your vaccine from the drop-down
list 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 dont see the correct lot number on
your 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 lot
numbers 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 time

8/8

Updated: 05/19/15, V5.14.11.2