| 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-Hib |
DTaP-Haemophilus influenzae type b conjugate vaccine |
2.3 |
| 51 |
Hib-Hep B |
Haemophilus influenzae type b conjugate and Hepatitis B vaccine |
2.3 |
| 52 |
Hep A, adult |
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 |
Hep E |
hepatitis E vaccine |
2.3.1 |
| 60 |
herpes simplex 2 |
herpes simplex virus, type 2 vaccine |
2.3.1 |
| 61 |
HIV |
human immunodeficiency virus vaccine |
2.3.1 |
| 62 |
human papilloma virus vaccine |
human papilloma virus vaccine |
2.3.1 |
| 63 |
Junin virus |
Junin virus vaccine |
2.3.1 |
| 64 |
leishmaniasis |
leishmaniasis |
2.3.1 |
| 65 |
leprosy |
leprosy |
2.3.1 |
| 66 |
Lyme disease |
Lyme disease |
2.3.1 |
| 67 |
malaria |
malaria |
2.3.1 |
| 68 |
melanoma |
melanoma |
2.3.1 |
| 69 |
parainfluenza-3 |
parainfluenza-3 |
2.3.1 |
| 70 |
Q fever vaccine |
Q fever vaccine |
2.3.1 |
| 71 |
RSV-IGIV |
respiratory syncytial virus immune globulin, intravenous |
2.3.1 |
| 72 |
rheumatic fever |
rheumatic fever |
2.3.1 |
| 73 |
Rift Valley fever |
Rift Valley fever |
2.3.1 |
| 74 |
rotavirus |
rotavirus vaccine, tetravalent, live, oral |
2.3.1 |
| 75 |
smallpox |
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 |
VEE, 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 |
Hep A, ped/adol, 3 dose |
hepatitis A vaccine, pediatric/adolescent dosage, 3 dose schedule |
2.3.1 |
| 85 |
Hep A, NOS |
hepatitis A vaccine, NOS |
2.3.1 |
| 86 |
IG |
immune globulin, intramuscular |
2.3.1 |
| 87 |
IGIV |
immune globulin, intravenous |
2.3.1 |
| 88 |
influenza, NOS |
influenza virus vaccine, NOS |
2.3.1 |
| 89 |
polio, NOS |
poliovirus vaccine, NOS |
2.3.1 |
| 90 |
rabies, NOS |
rabies vaccine, NOS |
2.3.1 |
| 91 |
typhoid, NOS |
typhoid vaccine, NOS |
2.3.1 |
| 92 |
VEE, NOS |
Venezuelan equine encephalitis vaccine, NOS |
2.3.1 |
| 93 |
RSV-Mab |
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 |
TST-OT tine test |
tuberculin skin test; old tuberculin, multipuncture device |
2.4 |
| 96 |
TST-PPD intradermal |
tuberculin skin test; purified protein derivative solution, intradermal |
2.4 |
| 97 |
TST-PPD tine test |
tuberculin skin test; purified protein derivative, multipuncture device |
2.4 |
| 98 |
TST, NOS |
tuberculin skin test; NOS |
2.4 |
| 99 |
RESERVED - do not use |
RESERVED - do not use |
2.4 |
| 999 |
Unknown |
unknown vaccine or immune globulin |
2.4 |