Complete List of Vaccine Names and CPT/CVX Codes

A list that matches the vaccine name or codes in VacTrAK with the brand name or other common names of the vaccines you use most often.
Vaccine trade name or common name Combination Vaccines
Pediarix ProQuad Pentacel Kinrix Comvax Twinrix DTaP/HepB/IPV MMR/Varicella DTaP/HIB/IPV DTaP/IPV Hep B/HIB HepA/HepB Adult 6 weeks + 1 yr + 6 weeks - 5 yrs 4 - 6 yrs 6 weeks + 18 + yrs 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml 1.0 ml IM SQ IM IM IM IM GlaxoSmithKline - SKB Merck- MSD Sanofi Pasteur - PMC GlaxoSmithKline - SKB Merck- MSD GlaxoSmithKline - SKB 90723 90710 90698 90696 90748 90636 110 94 120 130 51 104

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State Supplied

Age (Range)

Dose

Route

Manufacturer

CPT code

CVX code

Diphtheria, Tetanus and Pertussis

Daptacel Tripedia Infanrix Decavac Tetanus and Diphtheria Toxoids Adsorbed Preservative Free Adacel Tetanus Diphtheria and Acellular Pertussis Diphtheria and tetanus toxoids adsorbed Tetanus and diphtheria toxoids adsorbed Boostrix Tetanus Diphtheria & Acellular Pertsussis If DTaP was given and the brand name is unknown Diphtheria, tetanus toxoids, & whole cell pertussis vaccine (will be from historical records) DTaP 6 weeks + 6 weeks + 6 weeks + 7+ yrs 11-64 yr 6 weeks + 7+ yrs 10-18 yrs 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml 0.5 ml IM IM IM IM IM IM IM IM Sanofi Pasteur - PMC Sanofi Pasteur - PMC GlaxoSmithKline - SKB Sanofi Pasteur - PMC Sanofi Pasteur - PMC Sanofi Pasteur - PMC Sanofi Pasteur - PMC GlaxoSmithKline - SKB 90700 20

Td Adult, Preserv Free Tdap DT (Pediatric) Td - Adult Tdap DTaP DTP

90714 90715 90702 90718 90715 90700 90701

113 115 28 09 115 20 01

Questions? Contact VacTrAK Support: 866-702-8725 or 907-269-0312 or email: vactrak@alaska.gov - https://vactrak.alaska.gov Rev 8 April 2010

Complete List of Vaccine Names and CPT/CVX Codes Vaccine trade name or common name Hepatitis A
Vaqta (2 doses for pediatric/adolescents) Havrix (2 doses for pediatric/adolescent) Vaqta (2 doses for adults) Havrix (2 doses for adults) Havrix (3 doses for pediatric/adolescent) Hep A 2 dose Adult Hep A 2 dose Ped/Adol 12 months - 18 yrs 12 months - 18 yrs 19+ yrs 19+ yrs 12 months - 18 yrs 0.5 ml (25 U) 0.5 ml (720 EL.U) 1.0 ml (50u) 1.0 ml (1440 EL.U) 0.5 ml (360 EL.U) 0.5 ml 10g 0.5 ml 5g 1.0 ml 20g 1.0 ml 10g IM IM IM IM Merck- MSD 90633 GlaxoSmithKline - SKB Merck- MSD 90632 GlaxoSmithKline - SKB 52 83

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State Supplied

Age (Range)

Dose

Route

Manufacturer

CPT code

CVX code

Hep A 3 dose Ped/Adol

IM

GlaxoSmithKline - SKB

90634

84

Hepatitis B
Engerix-B Ped/Adol Recombivax HB (state supplied ped/adol formulation) Engerix-B for adults Recombivax HB for adults Various dosages depending on specific individual cases, such as high risk or dialysis. HepB Ped/Adol Preserv. Free Birth - 19 yrs Birth - 19 yrs 20 + yrs 20 + yrs IM IM IM IM GlaxoSmithKline - SKB 90744 Merck- MSD GlaxoSmithKline - SKB 90746 Merck- MSD 43 08

Hepatitis B Adult Note: there are various choices available to reflect the specific situation Hib-PRP-T Hib-PRP-T Hib-PRP-OMP Hib-Hboc Hib-PRP-D

HIB
ActHib OmniHib PedvaxHib HibTITER ProHIBit (discontinued) 0.5 ml 0.5 ml 0.5ml 0.5ml IM IM IM IM Sanofi Pasteur - PMC GlaxoSmithKline - SKB Merck- MSD Wyeth Ayerst - WAL 90648 90647 90645 48 49 47

2 months - 5 yrs

Questions? Contact VacTrAK Support: 866-702-8725 or 907-269-0312 or email: vactrak@alaska.gov - https://vactrak.alaska.gov Rev 8 April 2010

Complete List of Vaccine Names and CPT/CVX Codes Vaccine trade name or common name Human Papilloma Virus
Gardasil Cervarix
HPV, quadrivalent

Best VacTrAK Selection

State Supplied

Age (Range)

Dose

Route

Manufacturer

CPT code
90649 90650

CVX code
62 118

9 - 26 yrs

0.5ml

HPV, bivalent Influenza split 635 mos pres free Influenza Split 3+ yrs Influenza Nasal Spray Influenza split 36+ mos pres free Influenza Split (Best choice) Influenza split 18+ yrs pres free 2-49 yrs 3+ yrs 4+ yrs 0.25 ml PFS 0.25 ml MDV 0.5ml MDV 0.2 ml total 0.5ml SDV; PFS 0.5ml PFS 0.5ml PFS 0.5ml PFS 0.5ml MDV 0.5 ml MDV 0.5ml 1.0 ml 0.5ml

IM IM

Merck- MSD GlaxoSmithKline - SKB

Influenza
Fluzone PF Preservative Free (state supplied) Fluzone (contains preservative) Fluzone (contains preservative) Flumist - Live Attenuated Influenza Vaccine FluzonePF Preservative Free Fluvirin (contains preservative) Afluria Preservative Free FLUARIX Afluria (contains preservative) Influenza Split FluLaval 6-35 mos 6-35 mos IM IM IM IM IM IM IM IM IM IM Sanofi Pasteur - PMC Sanofi Pasteur - PMC Sanofi Pasteur - PMC MedImmune - MED Sanofi Pasteur - PMC Novartis - NOV (formerly Chiron) CSL Biotherapies, INC - CSL 90656 GlaxoSmithKline - SKB CSL Biotherapies, INC - CSL 90658 GlaxoSmithKline - SKB 90655 90657 90658 90660 90656 90658 15 111 15

18+ yrs

Japanese Encephalitis
Japanese Encephalitis Japanese Encephalitis MMR 12- 35 mos 3 yrs+ 1+ yrs SQ Sanofi Pasteur - PMC 90735 39

Measles, Mumps & Rubella

Measles, Mumps & Rubella SQ Merck- MSD 90707 03

Questions? Contact VacTrAK Support: 866-702-8725 or 907-269-0312 or email: vactrak@alaska.gov - https://vactrak.alaska.gov Rev 8 April 2010

Complete List of Vaccine Names and CPT/CVX Codes Vaccine trade name or common name Meningococcal
Menactra Meningococcal Conjugate vaccine (Serogroups A, C, Y, W-135) Menomune A/C/Y/W-135 Meningococcal Polysaccharide vaccine Meningococcal (MCV) Meningococcal (MPSV) 2-55 yr 19+ mo ( 1 dose) 3-18 mo (2 doses) 0.5 ml IM Sanofi Pasteur - PMC 90734 114

Best VacTrAK Selection

State Supplied

Age (Range)

Dose

Route

Manufacturer

CPT code

CVX code

0.5 ml

SQ

Sanofi Pasteur - PMC

90733

32

Pneumonia
Prevnar Pneumococcal Conjugate, 7 valent Prevnar Pneumococcal Conjugate, 13 valent Pneumovax 23 Pneumococcal, polyvalent Pnu-Imune 23 Pneumococcal (PCV) Pneumococcal, PCV-13 Pneumococcal (PPSV) Pneumococcal (PPSV) 2 - 59 months 2 - 59 months 65+ yrs, 2 yrs w/health risks 65+ yrs, 2 yrs w/health risks 0.5ml 0.5ml 0.5ml 0.5ml IM IM SQ/IM SQ/IM Wyeth Ayerst - WAL Wyeth Ayerst - WAL Merck- MSD 90732 GlaxoSmithKline - SKB 33 90669 90670 100 133

Polio
IPOL Polioviurs vaccine, inactivated Poliovirus vaccine, live oral IPV OPV Rabies Rabies
Rabies Intradermal

6 weeks +

0.5 ml

SQ

Sanofi Pasteur - PMC

90713

10 02

Rabies
Imovax Rabavert Rabies, ID 1.0 ml 1.0 ml IM IM Sanofi Pasteur - PMC Novartis - NOV 90675 18

Rotavirus
Rotateq Rotarix Rotavirus, pentavalent RV5 Rotavirus, monovalent RV1 2-32 months 6-24 weeks 2.0 ml 1.0 ml ORAL ORAL Merck- MSD GlaxoSmithKline - SKB 90680 90681 116 119

Questions? Contact VacTrAK Support: 866-702-8725 or 907-269-0312 or email: vactrak@alaska.gov - https://vactrak.alaska.gov Rev 8 April 2010

Complete List of Vaccine Names and CPT/CVX Codes Vaccine trade name or common name TB test
Purified Protein Derivative (PPD) PPD Test 0.1 ml ID Parkdale Pharmaceuticals - PD Sanofi Pasteur - PMC Berna Products Corp.BPC 86580 96

Best VacTrAK Selection

State Supplied

Age (Range)

Dose

Route

Manufacturer

CPT code

CVX code

Typhoid
Typhoid ViCPs Typhoid, Oral Typhoid, parenteral Typhoid, ViCPs Typhoid, oral Typhoid, parenteral Varicella Yellow Fever Zoster, Live 1+ yrs 9+ months 60 + yrs 0.5 ml 0.5ml 0.65 ml SQ SQ SQ Merck- MSD Sanofi Pasteur - PMC Merck- MSD 90716 90717 90736 21 37 121 2 yr + 6 yr + 0.5 ml 4 tabs IM ORAL 90691 90690 101 25

Varicella
Varivax Chicken Pox Vaccine

Yellow Fever
Yellow Fever

Zoster ("Shingles")
Zostavax

Notes
On the Vaccination View/Add screen, there are two places to look for the appropriate vaccine choice when entering a vaccination date. Look FIRST at the vaccine names that appear on the screen. ALL routine vaccines will appear. For less common vaccines not 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. Note: Unspecified vaccines should only be used for entering historical vaccines when the specific vaccine type is unknown. If your practice manages vaccine inventory in VacTrAK, 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 VacTrAK staff discourage the use of the vaccine type "Influenza Whole". This vaccines type has not been used in the U.S. for some time

Questions? Contact VacTrAK Support: 866-702-8725 or 907-269-0312 or email: vactrak@alaska.gov - https://vactrak.alaska.gov Rev 8 April 2010