|
Code
|
Display
|
|
82
|
adenovirus, NOS |
|
54
|
adenovirus, type 4 |
|
55
|
adenovirus, type 7 |
|
24
|
anthrax |
|
19
|
BCG |
|
27
|
botulinum antitoxin |
|
26
|
cholera |
|
29
|
CMVIG |
|
56
|
dengue fever |
|
28
|
DT (pediatric) |
|
12
|
diphtheria antitoxin |
|
20
|
DTaP |
|
106
|
DTaP, 5 pertussis antigens |
|
130
|
DTaP-IPV |
|
120
|
DTaP-Hib-IPV |
|
107
|
DTaP, NOS |
|
01
|
DTP |
|
50
|
DTaP-Hib |
|
110
|
DTaP-Hep B-IPV |
|
102
|
DTP-Hib-Hep B |
|
22
|
DTP-Hib |
|
51
|
Hib-Hep B |
|
17
|
Hib, NOS |
|
47
|
Hib (HbOC) |
|
46
|
Hib (PRP-D) |
|
49
|
Hib (PRP-OMP) |
|
48
|
Hib (PRP-T) |
|
57
|
hantavirus |
|
104
|
Hep A-Hep B |
|
52
|
Hep A, adult |
|
85
|
Hep A, NOS |
|
31
|
Hep A, pediatric, NOS |
|
83
|
Hep A, ped/adol, 2 dose |
|
84
|
Hep A, ped/adol, 3 dose |
|
30
|
HBIG |
|
42
|
Hep B, adolescent/high risk infant |
|
43
|
Hep B, adult |
|
44
|
Hep B, dialysis |
|
45
|
Hep B, NOS |
|
08
|
Hep B, adolescent or pediatric |
|
58
|
Hep C |
|
59
|
Hep E |
|
60
|
herpes simplex 2 |
|
61
|
HIV |
|
118
|
HPV, bivalent |
|
62
|
HPV, quadrivalent |
|
86
|
IG |
|
87
|
IGIV |
|
14
|
IG, NOS |
|
123
|
influenza, H5N1-1203 |
|
111
|
influenza, live, intranasal |
|
88
|
influenza, NOS |
|
15
|
influenza, split (incl. purified surface antigen) |
|
16
|
influenza, whole |
|
39
|
Japanese encephalitis |
|
63
|
Junin virus |
|
64
|
leishmaniasis |
|
65
|
leprosy |
|
66
|
Lyme disease |
|
67
|
malaria |
|
04
|
M/R |
|
05
|
measles |
|
03
|
MMR |
|
94
|
MMRV |
|
68
|
melanoma |
|
103
|
meningococcal C conjugate |
|
114
|
meningococcal A,C,Y,W-135 diphtheria conjugate |
|
32
|
meningococcal |
|
108
|
meningococcal, NOS |
|
07
|
mumps |
|
998
|
no vaccine administered |
|
69
|
parainfluenza-3 |
|
11
|
pertussis |
|
23
|
plague |
|
100
|
pneumococcal conjugate |
|
33
|
pneumococcal |
|
109
|
pneumococcal, NOS |
|
10
|
IPV |
|
02
|
OPV |
|
89
|
polio, NOS |
|
70
|
Q fever |
|
34
|
RIG |
|
40
|
rabies, intradermal injection |
|
18
|
rabies, intramuscular injection |
|
90
|
rabies, NOS |
|
99
|
RESERVED - do not use |
|
71
|
RSV-IGIV |
|
93
|
RSV-MAb |
|
72
|
rheumatic fever |
|
73
|
Rift Valley fever |
|
122
|
rotavirus, NOS |
|
119
|
rotavirus, monovalent |
|
116
|
rotavirus, pentavalent |
|
74
|
rotavirus, tetravalent |
|
38
|
rubella/mumps |
|
06
|
rubella |
|
76
|
Staphylococcus bacterio lysate |
|
09
|
Td (adult) |
|
113
|
Td (adult) |
|
13
|
TIG |
|
35
|
tetanus toxoid |
|
112
|
tetanus toxoid, NOS |
|
115
|
Tdap |
|
77
|
tick-borne encephalitis |
|
98
|
TST, NOS |
|
95
|
TST-OT tine test |
|
96
|
TST-PPD intradermal |
|
97
|
TST-PPD tine test |
|
78
|
tularemia vaccine |
|
25
|
typhoid, oral |
|
91
|
typhoid, NOS |
|
53
|
typhoid, parenteral, AKD (U.S. military) |
|
41
|
typhoid, parenteral |
|
101
|
typhoid, ViCPs |
|
999
|
unknown |
|
75
|
vaccinia (smallpox) |
|
105
|
vaccinia (smallpox) diluted |
|
79
|
vaccinia immune globulin |
|
21
|
varicella |
|
36
|
VZIG |
|
117
|
VZIG (IND) |
|
92
|
VEE, NOS |
|
81
|
VEE, inactivated |
|
80
|
VEE, live |
|
37
|
yellow fever |
|
121
|
zoster |