Code | Display |
01 | DTP |
02 | OPV |
03 | MMR |
04 | M/R |
05 | measles |
06 | rubella |
07 | mumps |
08 | Hep B, adolescent or pediatric |
09 | Td (adult), adsorbed |
10 | IPV |
100 | pneumococcal conjugate PCV 7 |
101 | typhoid, ViCPs |
102 | DTaP/DTP-Hib-Hep B |
103 | meningococcal C conjugate |
104 | Hep A-Hep B |
105 | vaccinia (smallpox) diluted |
106 | DTaP, 5 pertussis antigens |
107 | DTaP, unspecified formulation |
108 | meningococcal, unspecified formulation |
109 | pneumococcal, unspecified formulation |
11 | pertussis |
110 | DTaP-Hep B-IPV |
111 | influenza, live, intranasal |
112 | tetanus toxoid, unspecified formulation |
113 | Td (adult) preservative free |
114 | meningococcal MCV4P |
115 | Tdap |
116 | rotavirus, pentavalent |
117 | VZIG (IND) |
118 | HPV, bivalent |
119 | rotavirus, monovalent |
12 | diphtheria antitoxin |
120 | DTaP-Hib-IPV |
121 | zoster |
122 | rotavirus, unspecified formulation |
123 | influenza, H5N1-1203 |
125 | Novel Influenza-H1N1-09, nasal |
126 | Novel influenza-H1N1-09, preservative-free |
127 | Novel influenza-H1N1-09 |
128 | Novel Influenza-H1N1-09, all formulations |
129 | Japanese Encephalitis, unspecified formulation |
13 | TIG |
130 | DTaP-IPV |
131 | typhus, historical |
132 | DTaP-IPV-HIB-HEP B, historical |
133 | Pneumococcal conjugate PCV 13 |
134 | Japanese Encephalitis IM |
135 | Influenza, high dose seasonal |
136 | Meningococcal MCV4O |
137 | HPV, unspecified formulation |
138 | Td (adult) |
139 | Td(adult) unspecified formulation |
14 | IG, unspecified formulation |
140 | Influenza, seasonal, injectable, preservative free |
141 | Influenza, seasonal, injectable |
142 | tetanus toxoid, not adsorbed |
143 | Adenovirus types 4 and 7 |
144 | influenza, seasonal, intradermal, preservative free |
145 | RSV-MAb (new) |
146 | DTaP,IPV,Hib,HepB |
147 | meningococcal MCV4, unspecified formulation |
148 | Meningococcal C/Y-HIB PRP |
149 | influenza, live, intranasal, quadrivalent |
15 | influenza, split (incl. purified surface antigen) |
150 | influenza, injectable, quadrivalent, preservative free |
151 | influenza nasal, unspecified formulation |
152 | Pneumococcal Conjugate, unspecified formulation |
153 | Influenza, injectable, MDCK, preservative free |
154 | Hep A, IG |
155 | influenza, recombinant, injectable, preservative free |
156 | Rho(D)-IG |
157 | Rho(D) -IG IM |
158 | influenza, injectable, quadrivalent |
159 | Rho(D) - Unspecified formulation |
16 | influenza, whole |
160 | Influenza A monovalent (H5N1), ADJUVANTED-2013 |
161 | Influenza, injectable,quadrivalent, preservative free, pediatric |
162 | meningococcal B, recombinant |
163 | meningococcal B, OMV |
164 | meningococcal B, unspecified |
17 | Hib, unspecified formulation |
18 | rabies, intramuscular injection |
19 | BCG |
20 | DTaP |
21 | varicella |
22 | DTP-Hib |
23 | plague |
24 | anthrax |
25 | typhoid, oral |
26 | cholera |
27 | botulinum antitoxin |
28 | DT (pediatric) |
29 | CMVIG |
30 | HBIG |
31 | Hep A, pediatric, unspecified formulation |
32 | meningococcal MPSV4 |
33 | pneumococcal polysaccharide PPV23 |
34 | RIG |
35 | tetanus toxoid, adsorbed |
36 | VZIG |
37 | yellow fever |
38 | rubella/mumps |
39 | Japanese encephalitis SC |
40 | rabies, intradermal injection |
41 | typhoid, parenteral |
42 | Hep B, adolescent/high risk infant |
43 | Hep B, adult |
44 | Hep B, dialysis |
45 | Hep B, unspecified formulation |
46 | Hib (PRP-D) |
47 | Hib (HbOC) |
48 | Hib (PRP-T) |
49 | Hib (PRP-OMP) |
50 | DTaP-Hib |
51 | Hib-Hep B |
52 | Hep A, adult |
53 | typhoid, parenteral, AKD (U.S. military) |
54 | adenovirus, type 4 |
55 | adenovirus, type 7 |
56 | dengue fever |
57 | hantavirus |
58 | Hep C |
59 | Hep E |
60 | herpes simplex 2 |
61 | HIV |
62 | HPV, quadrivalent |
63 | Junin virus |
64 | leishmaniasis |
65 | leprosy |
66 | Lyme disease |
67 | malaria |
68 | melanoma |
69 | parainfluenza-3 |
70 | Q fever |
71 | RSV-IGIV |
72 | rheumatic fever |
73 | Rift Valley fever |
74 | rotavirus, tetravalent |
75 | vaccinia (smallpox) |
76 | Staphylococcus bacterio lysate |
77 | tick-borne encephalitis |
78 | tularemia vaccine |
79 | vaccinia immune globulin |
80 | VEE, live |
801 | AS03 Adjuvant |
81 | VEE, inactivated |
82 | adenovirus, unspecified formulation |
83 | Hep A, ped/adol, 2 dose |
84 | Hep A, ped/adol, 3 dose |
85 | Hep A, unspecified formulation |
86 | IG |
87 | IGIV |
88 | influenza, unspecified formulation |
89 | polio, unspecified formulation |
90 | rabies, unspecified formulation |
91 | typhoid, unspecified formulation |
92 | VEE, unspecified formulation |
93 | RSV-MAb |
94 | MMRV |
95 | TST-OT tine test |
96 | TST-PPD intradermal |
97 | TST-PPD tine test |
98 | TST, unspecified formulation |
99 | RESERVED - do not use |
998 | no vaccine administered |
999 | unknown |