Code | Display | Definition | version introduced |
01 |
diphtheria, tetanus toxoids and pertussis vaccine |
diphtheria, tetanus toxoids and pertussis vaccine |
2.3 |
02 |
poliovirus vaccine, live, oral |
poliovirus vaccine, live, oral |
2.3 |
03 |
measles, mumps and rubella virus vaccine |
measles, mumps and rubella virus vaccine |
2.3 |
04 |
measles and rubella virus vaccine |
measles and rubella virus vaccine |
2.3 |
05 |
measles virus vaccine |
measles virus vaccine |
2.3 |
06 |
rubella virus vaccine |
rubella virus vaccine |
2.3 |
07 |
mumps virus vaccine |
mumps virus vaccine |
2.3 |
08 |
hepatitis B vaccine, pediatric or pediatric/adolescent dosage |
hepatitis B vaccine, pediatric or pediatric/adolescent dosage |
2.3 |
09 |
tetanus and diphtheria toxoids, adsorbed for adult use |
tetanus and diphtheria toxoids, adsorbed for adult use |
2.3 |
10 |
poliovirus vaccine, inactivated |
poliovirus vaccine, inactivated |
2.3 |
100 |
pneumococcal conjugate vaccine, polyvalent |
pneumococcal conjugate vaccine, polyvalent |
2.4 |
101 |
Typhoid Vi capsular polysaccharide vaccine |
Typhoid Vi capsular polysaccharide vaccine |
2.4 |
11 |
pertussis vaccine |
pertussis vaccine |
2.3 |
12 |
diphtheria antitoxin |
diphtheria antitoxin |
2.3 |
13 |
tetanus immune globulin |
tetanus immune globulin |
2.3 |
14 |
immune globulin, NOS |
immune globulin, NOS |
2.3 |
15 |
influenza virus vaccine, split virus (incl. purified surface antigen) |
influenza virus vaccine, split virus (incl. purified surface antigen) |
2.3 |
16 |
influenza virus vaccine, whole virus |
influenza virus vaccine, whole virus |
2.3 |
17 |
Haemophilus influenzae type b vaccine, conjugate NOS |
Haemophilus influenzae type b vaccine, conjugate NOS |
2.3 |
18 |
rabies vaccine, for intramuscular injection |
rabies vaccine, for intramuscular injection |
2.3 |
19 |
Bacillus Calmette-Guerin vaccine |
Bacillus Calmette-Guerin vaccine |
2.3 |
20 |
diphtheria, tetanus toxoids and acellular pertussis vaccine |
diphtheria, tetanus toxoids and acellular pertussis vaccine |
2.3 |
21 |
varicella virus vaccine |
varicella virus vaccine |
2.3 |
22 |
DTP-Haemophilus influenzae type b conjugate vaccine |
DTP-Haemophilus influenzae type b conjugate vaccine |
2.3 |
23 |
plague vaccine |
plague vaccine |
2.3 |
24 |
anthrax vaccine |
anthrax vaccine |
2.3 |
25 |
typhoid vaccine, live, oral |
typhoid vaccine, live, oral |
2.3 |
26 |
cholera vaccine |
cholera vaccine |
2.3 |
27 |
botulinum antitoxin |
botulinum antitoxin |
2.3 |
28 |
diphtheria and tetanus toxoids, adsorbed for pediatric use |
diphtheria and tetanus toxoids, adsorbed for pediatric use |
2.3 |
29 |
cytomegalovirus immune globulin, intravenous |
cytomegalovirus immune globulin, intravenous |
2.3 |
30 |
hepatitis B immune globulin |
hepatitis B immune globulin |
2.3 |
31 |
hepatitis A vaccine, pediatric dosage, NOS |
hepatitis A vaccine, pediatric dosage, NOS |
2.3 |
32 |
meningococcal polysaccharide vaccine |
meningococcal polysaccharide vaccine |
2.3 |
33 |
pneumococcal polysaccharide vaccine |
pneumococcal polysaccharide vaccine |
2.3 |
34 |
rabies immune globulin |
rabies immune globulin |
2.3 |
35 |
tetanus toxoid |
tetanus toxoid |
2.3 |
36 |
varicella zoster immune globulin |
varicella zoster immune globulin |
2.3 |
37 |
yellow fever vaccine |
yellow fever vaccine |
2.3 |
38 |
rubella and mumps virus vaccine |
rubella and mumps virus vaccine |
2.3 |
39 |
Japanese encephalitis vaccine |
Japanese encephalitis vaccine |
2.3 |
40 |
rabies vaccine, for intradermal injection |
rabies vaccine, for intradermal injection |
2.3 |
41 |
typhoid vaccine, parenteral, other than acetone-killed, dried |
typhoid vaccine, parenteral, other than acetone-killed, dried |
2.3 |
42 |
hepatitis B vaccine, adolescent/high risk infant dosage |
hepatitis B vaccine, adolescent/high risk infant dosage |
2.3 |
43 |
hepatitis B vaccine, adult dosage |
hepatitis B vaccine, adult dosage |
2.3 |
44 |
hepatitis B vaccine, dialysis patient dosage |
hepatitis B vaccine, dialysis patient dosage |
2.3 |
45 |
hepatitis B vaccine, NOS |
hepatitis B vaccine, NOS |
2.3 |
46 |
Haemophilus influenzae type b vaccine, PRP-D conjugate |
Haemophilus influenzae type b vaccine, PRP-D conjugate |
2.3 |
47 |
Haemophilus influenzae type b vaccine, HbOC conjugate |
Haemophilus influenzae type b vaccine, HbOC conjugate |
2.3 |
48 |
Haemophilus influenzae type b vaccine, PRP-T conjugate |
Haemophilus influenzae type b vaccine, PRP-T conjugate |
2.3 |
49 |
Haemophilus influenzae type b vaccine, PRP-OMP conjugate |
Haemophilus influenzae type b vaccine, PRP-OMP conjugate |
2.3 |
50 |
DTaP-Haemophilus influenzae type b conjugate vaccine |
DTaP-Haemophilus influenzae type b conjugate vaccine |
2.3 |
51 |
Haemophilus influenzae type b conjugate and Hepatitis B vaccine |
Haemophilus influenzae type b conjugate and Hepatitis B vaccine |
2.3 |
52 |
hepatitis A vaccine, adult dosage |
hepatitis A vaccine, adult dosage |
2.3 |
53 |
typhoid vaccine, parenteral, acetone-killed, dried (U.S. military) |
typhoid vaccine, parenteral, acetone-killed, dried (U.S. military) |
2.3.1 |
54 |
adenovirus vaccine, type 4, live, oral |
adenovirus vaccine, type 4, live, oral |
2.3.1 |
55 |
adenovirus vaccine, type 7, live, oral |
adenovirus vaccine, type 7, live, oral |
2.3.1 |
56 |
dengue fever vaccine |
dengue fever vaccine |
2.3.1 |
57 |
hantavirus vaccine |
hantavirus vaccine |
2.3.1 |
58 |
hepatitis C vaccine |
hepatitis C vaccine |
2.3.1 |
59 |
hepatitis E vaccine |
hepatitis E vaccine |
2.3.1 |
60 |
herpes simplex virus, type 2 vaccine |
herpes simplex virus, type 2 vaccine |
2.3.1 |
61 |
human immunodeficiency virus vaccine |
human immunodeficiency virus vaccine |
2.3.1 |
62 |
human papilloma virus vaccine |
human papilloma virus vaccine |
2.3.1 |
63 |
Junin virus vaccine |
Junin virus vaccine |
2.3.1 |
64 |
leishmaniasis vaccine |
leishmaniasis vaccine |
2.3.1 |
65 |
leprosy vaccine |
leprosy vaccine |
2.3.1 |
66 |
Lyme disease vaccine |
Lyme disease vaccine |
2.3.1 |
67 |
malaria vaccine |
malaria vaccine |
2.3.1 |
68 |
melanoma vaccine |
melanoma vaccine |
2.3.1 |
69 |
parainfluenza-3 virus vaccine |
parainfluenza-3 virus vaccine |
2.3.1 |
70 |
Q fever vaccine |
Q fever vaccine |
2.3.1 |
71 |
respiratory syncytial virus immune globulin, intravenous |
respiratory syncytial virus immune globulin, intravenous |
2.3.1 |
72 |
rheumatic fever vaccine |
rheumatic fever vaccine |
2.3.1 |
73 |
Rift Valley fever vaccine |
Rift Valley fever vaccine |
2.3.1 |
74 |
rotavirus vaccine, tetravalent, live, oral |
rotavirus vaccine, tetravalent, live, oral |
2.3.1 |
75 |
smallpox vaccine |
smallpox vaccine |
2.3.1 |
76 |
Staphylococcus bacteriophage lysate |
Staphylococcus bacteriophage lysate |
2.3.1 |
77 |
tick-borne encephalitis vaccine |
tick-borne encephalitis vaccine |
2.3.1 |
78 |
tularemia vaccine |
tularemia vaccine |
2.3.1 |
79 |
vaccinia immune globulin |
vaccinia immune globulin |
2.3.1 |
80 |
Venezuelan equine encephalitis, live, attenuated |
Venezuelan equine encephalitis, live, attenuated |
2.3.1 |
81 |
Venezuelan equine encephalitis, inactivated |
Venezuelan equine encephalitis, inactivated |
2.3.1 |
82 |
adenovirus vaccine, NOS |
adenovirus vaccine, NOS |
2.3.1 |
83 |
hepatitis A vaccine, pediatric/adolescent dosage, 2 dose schedule |
hepatitis A vaccine, pediatric/adolescent dosage, 2 dose schedule |
2.3.1 |
84 |
hepatitis A vaccine, pediatric/adolescent dosage, 3 dose schedule |
hepatitis A vaccine, pediatric/adolescent dosage, 3 dose schedule |
2.3.1 |
85 |
hepatitis A vaccine, NOS |
hepatitis A vaccine, NOS |
2.3.1 |
86 |
immune globulin, intramuscular |
immune globulin, intramuscular |
2.3.1 |
87 |
immune globulin, intravenous |
immune globulin, intravenous |
2.3.1 |
88 |
influenza virus vaccine, NOS |
influenza virus vaccine, NOS |
2.3.1 |
89 |
poliovirus vaccine, NOS |
poliovirus vaccine, NOS |
2.3.1 |
90 |
rabies vaccine, NOS |
rabies vaccine, NOS |
2.3.1 |
91 |
typhoid vaccine, NOS |
typhoid vaccine, NOS |
2.3.1 |
92 |
Venezuelan equine encephalitis vaccine, NOS |
Venezuelan equine encephalitis vaccine, NOS |
2.3.1 |
93 |
respiratory syncytial virus monoclonal antibody (palivizumab), intramuscular |
respiratory syncytial virus monoclonal antibody (palivizumab), intramuscular |
2.4 |
94 |
measles, mumps, rubella, and varicella virus vaccine |
measles, mumps, rubella, and varicella virus vaccine |
2.4 |
95 |
tuberculin skin test; old tuberculin, multipuncture device |
tuberculin skin test; old tuberculin, multipuncture device |
2.4 |
96 |
tuberculin skin test; purified protein derivative solution, intradermal |
tuberculin skin test; purified protein derivative solution, intradermal |
2.4 |
97 |
tuberculin skin test; purified protein derivative, multipuncture device |
tuberculin skin test; purified protein derivative, multipuncture device |
2.4 |
98 |
tuberculin skin test; NOS |
tuberculin skin test; NOS |
2.4 |
99 |
RESERVED - do not use |
RESERVED - do not use |
2.4 |
999 |
unknown vaccine or immune globulin |
unknown vaccine or immune globulin |
2.4 |