| CPT CODE | CPT Description | CVX Code | Vaccine Name | Comments | Last Updated Date |
|---|
| 90281 | Immune globulin (Ig), human, for intramuscular use | 86 | IG | | 6/13/2024 |
| 90283 | Immune globulin (IgIV), human, for intravenous use | 87 | IGIV | | 6/13/2024 |
| 90287 | Botulinum antitoxin, equine, any route | 27 | botulinum antitoxin | | 6/13/2024 |
| 90291 | Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use | 29 | CMVIG | | 6/13/2024 |
| 90296 | Diphtheria antitoxin, equine, any route | 12 | diphtheria antitoxin | | 6/13/2024 |
| 90371 | Hepatitis B immune globulin (HBIg), human, for intramuscular use | 30 | HBIG | | 6/13/2024 |
| 90375 | Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use | 34 | RIG | | 6/13/2024 |
| 90376 | Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use | 34 | RIG | | 6/13/2024 |
| 90378 | Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each | 93 | RSV-MAb | | 6/13/2024 |
| 90380 | Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use | 306 | RSV, mAb, nirsevimab-alip, 0.5 mL, neonate to 24 months | CPT Code to be used for Beyfortus 0.5 mL | 6/13/2024 |
| 90381 | Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use | 307 | RSV, mAb, nirsevimab-alip, 1 mL, neonate to 24 months | CPT Code to be used for Beyfortus 1.0 mL | 6/13/2024 |
| 90382 | Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 mL, for intramuscular use | 332 | RSV, mAb, clesrovimab-cfor, 0.7 mL, neonate and infant, PF | | 6/26/2025 |
| 90389 | Tetanus immune globulin (TIg), human, for intramuscular use | 13 | TIG | | 6/13/2024 |
| 90393 | Vaccinia immune globulin, human, for intramuscular use | 79 | vaccinia immune globulin | | 6/13/2024 |
| 90396 | Varicella-zoster immune globulin, human, for intramuscular use | 36 | VZIG | | 6/13/2024 |
| 90470 | H1N1 immunization administration (intramuscular, intranasal), including counseling when performed | 128 | Novel Influenza-H1N1-09, all formulations | | 2/28/2017 |
| 90476 | Adenovirus vaccine, type 4, live, for oral use | 54 | adenovirus, type 4 | | 6/13/2024 |
| 90477 | Adenovirus vaccine, type 7, live, for oral use | 55 | adenovirus, type 7 | | 6/13/2024 |
| 90581 | Anthrax vaccine, for subcutaneous or intramuscular use | 318 | Anthrax, post-exposure prophylaxis | | 6/13/2024 |
| 90581 | Anthrax vaccine, for subcutaneous or intramuscular use | 24 | Anthrax, pre-exposure prophylaxis, post-exposure prophylaxis | | 6/13/2024 |
| 90585 | Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use | 19 | BCG | | 6/13/2024 |
| 90587 | Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use | 56 | dengue fever tetravalent | | 6/13/2024 |
| 90589 | Chikungunya virus vaccine, live attenuated, for intramuscular use | 317 | Chikungunya live attenuated vaccine, 0.5 mL, PF | | 6/13/2024 |
| 90593 | Chikungunya virus vaccine, recombinant, for intramuscular use | 329 | Chikungunya, VLP, recombinant, 0.8 mL, PF | | 4/15/2025 |
| 90611 | Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative free, 0.5 mL dosage, suspension, for subcutaneous use | 206 | Vaccinia, smallpox monkeypox vaccine live, PF, SQ or ID injection | CPT Code to be used for JYNNEOS vaccine | 6/13/2024 |
| 90619 | Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use | 203 | meningococcal conjugate quadrivalent, MenACWY-TT (MCV4) | | 6/13/2024 |
| 90620 | Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use | 163 | meningococcal B, OMV | | 4/15/2025 |
| 90621 | Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use | 162 | meningococcal B, recombinant | | 6/13/2024 |
| 90622 | Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use | 75 | Vaccinia (smallpox, monkeypox), live | CPT Code to be used for ACAM2000 vaccine | 6/13/2024 |
| 90623 | Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use | 316 | Meningococcal polysaccharide (MenACWY-TT conjugate), (MenB), PF | | 6/13/2024 |
| 90624 | Meningococcal pentavalent vaccine, Men B-4C recombinant proteins and outer membrane vesicle and conjugated Men A, C, W, Y-diphtheria toxoid carrier, for intramuscular use | 328 | Meningococcal oligosaccharide (MenACWY), (MenB), PF | | 7/9/2024 |
| 90625 | Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use | 174 | cholera, live attenuated | | 6/13/2024 |
| 90626 | Tick-borne encephalitis virus vaccine, inactivated; 0.25 mL dosage, for intramuscular use | 223 | Tick-borne encephalitis, inactivated, PF, 0.25mL | | 6/13/2024 |
| 90627 | Tick-borne encephalitis virus vaccine, inactivated; 0.5 mL dosage, for intramuscular use | 224 | Tick-borne encephalitis, inactivated, PF, 0.5mL | | 6/13/2024 |
| 90630 | Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for intradermal use | 166 | influenza, intradermal, quadrivalent, preservative free | | 9/24/2024 |
| 90632 | Hepatitis A vaccine (HepA), adult dosage, for intramuscular use | 52 | Hep A, adult | | 6/13/2024 |
| 90633 | Hepatitis A vaccine (HepA), pediatric/adolescent dosage-2 dose schedule, for intramuscular use | 83 | Hep A, ped/adol, 2 dose | | 6/13/2024 |
| 90634 | Hepatitis A vaccine (HepA), pediatric/adolescent dosage-3 dose schedule, for intramuscular use | 84 | Hep A, ped/adol, 3 dose | | 6/13/2024 |
| 90636 | Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use | 104 | Hep A-Hep B | | 6/13/2024 |
| 90644 | Meningococcal conjugate vaccine, serogroups C & Y and Haemophilus influenzae type b vaccine (Hib-MenCY), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use | 148 | Meningococcal C/Y-HIB PRP | | 6/13/2024 |
| 90645 | Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use | 47 | Hib (HbOC) | | 2/28/2017 |
| 90646 | Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use | 46 | Hib (PRP-D) | | 2/28/2017 |
| 90647 | Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use | 49 | Hib (PRP-OMP) | | 6/13/2024 |
| 90648 | Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use | 48 | Hib (PRP-T) | | 6/13/2024 |
| 90649 | Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use | 62 | HPV, quadrivalent | | 6/13/2024 |
| 90650 | Human Papillomavirus vaccine, types 16, 18, bivalent (2vHPV), 3 dose schedule, for intramuscular use | 118 | HPV, bivalent | | 6/13/2024 |
| 90651 | Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vHPV), 2 or 3 dose schedule, for intramuscular use | 165 | HPV9 | | 6/13/2024 |
| 90653 | Influenza vaccine, inactivated (IIV), subunit, adjuvanted, for intramuscular use | 168 | Influenza, adjuvanted, trivalent, PF | | 6/13/2024 |
| 90654 | Influenza virus vaccine, trivalent (IIV3), split virus, preservative-free, for intradermal use | 144 | influenza, seasonal, intradermal, preservative free | | 9/24/2024 |
| 90656 | Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use | 140 | Influenza, split virus, trivalent, PF | | 6/13/2024 |
| 90657 | Influenza virus vaccine, trivalent (IIV3), split virus, 0.25 mL dosage, for intramuscular use | 141 | Influenza, split virus, trivalent, preservative | | 6/13/2024 |
| 90658 | Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use | 141 | Influenza, split virus, trivalent, preservative | | 6/13/2024 |
| 90659 | Influenza virus vaccine, whole virus, for intramuscular or jet injection use | 16 | influenza, whole | | 2/28/2017 |
| 90660 | Influenza virus vaccine, trivalent, live (LAIV3), for intranasal use | 111 | Influenza, live, trivalent, intranasal, PF | | 6/13/2024 |
| 90661 | Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use | 320 | Influenza, MDCK, trivalent, preservative | | 9/24/2024 |
| 90661 | Influenza virus vaccine, trivalent (ccIIV3), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use | 153 | Influenza, MDCK, trivalent, PF | | 9/24/2024 |
| 90662 | Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | 197 | Influenza, high-dose, quadrivalent, PF | | 6/13/2024 |
| 90662 | Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | 135 | Influenza, high-dose, trivalent, PF | | 6/13/2024 |
| 90663 | Influenza virus vaccine, pandemic formulation, H1N1 | 128 | Novel Influenza-H1N1-09, all formulations | | 2/28/2017 |
| 90664 | Influenza virus vaccine, live (LAIV), pandemic formulation, for intranasal use | 125 | Novel Influenza-H1N1-09, nasal | | 6/13/2024 |
| 90665 | Lyme disease vaccine, adult dosage, for intramuscular use | 66 | Lyme disease | | 2/28/2017 |
| 90666 | Influenza virus vaccine (IIV), pandemic formulation, split virus, preservative free, for intramuscular use | 126 | Novel influenza-H1N1-09, preservative-free | | 6/13/2024 |
| 90668 | Influenza virus vaccine (IIV), pandemic formulation, split virus, for intramuscular use | 127 | Novel influenza-H1N1-09 | | 6/13/2024 |
| 90669 | Pneumococcal conjugate vaccine, 7 valent, for intramuscular use | 100 | pneumococcal conjugate PCV 7 | | 2/28/2017 |
| 90670 | Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use | 133 | Pneumococcal conjugate PCV 13 | | 6/13/2024 |
| 90671 | Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use | 215 | Pneumococcal conjugate PCV15, polysaccharide CRM197 conjugate, adjuvant, PF | | 6/13/2024 |
| 90672 | Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use | 149 | Influenza, live, quadrivalent, intranasal | | 6/13/2024 |
| 90673 | Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use | 155 | Influenza, recombinant, trivalent, PF | | 6/13/2024 |
| 90674 | Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use | 171 | Influenza, MDCK, quadrivalent, PF | | 6/13/2024 |
| 90675 | Rabies vaccine, for intramuscular use | 176 | Rabies - IM fibroblast culture | | 6/13/2024 |
| 90675 | Rabies vaccine, for intramuscular use | 175 | Rabies - IM Diploid cell culture | | 6/13/2024 |
| 90676 | Rabies vaccine, for intradermal use | 40 | rabies, intradermal injection | | 6/13/2024 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use | 216 | Pneumococcal conjugate PCV20, polysaccharide CRM197 conjugate, adjuvant, PF | | 6/13/2024 |
| 90678 | Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use | 305 | RSV, bivalent, protein subunit RSVpreF, diluent reconstituted, 0.5 mL, PF | CPT Code to be used for ABRYSVO | 6/13/2024 |
| 90679 | Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use | 303 | RSV, recombinant, protein subunit RSVpreF, adjuvant reconstituted, 0.5 mL, PF | CPT Code to be Used for Arexvy | 6/13/2024 |
| 90680 | Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use | 116 | rotavirus, pentavalent | | 6/13/2024 |
| 90681 | Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use | 119 | rotavirus, monovalent | | 6/13/2024 |
| 90682 | Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use | 185 | Influenza, recombinant, quadrivalent, PF | | 6/13/2024 |
| 90683 | Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use | 326 | RSV, mRNA, injectable, PF | | 6/13/2024 |
| 90684 | Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use | 327 | Pneumococcal conjugate PCV21, polysaccharide CRM197 conjugate, PF | | 7/9/2024 |
| 90685 | Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.25 mL dosage, for intramuscular use | 161 | Influenza, injectable,quadrivalent, preservative free, pediatric | | 6/13/2024 |
| 90686 | Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, 0.5 mL dosage, for intramuscular use | 150 | Influenza, split virus, quadrivalent, PF | | 6/13/2024 |
| 90687 | Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.25 mL dosage, for intramuscular use | 158 | Influenza, split virus, quadrivalent, preservative | | 6/13/2024 |
| 90688 | Influenza virus vaccine, quadrivalent (IIV4), split virus, 0.5 mL dosage, for intramuscular use | 158 | Influenza, split virus, quadrivalent, preservative | | 6/13/2024 |
| 90690 | Typhoid vaccine, live, oral | 25 | typhoid, oral | | 6/13/2024 |
| 90691 | Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use | 101 | typhoid, ViCPs | | 6/13/2024 |
| 90692 | Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use | 41 | typhoid, parenteral | | 2/28/2017 |
| 90693 | Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military) | 53 | typhoid, parenteral, AKD (U.S. military) | | 2/28/2017 |
| 90694 | Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage, for intramuscular use | 205 | Influenza, adjuvanted, quadrivalent, PF | | 6/13/2024 |
| 90696 | Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (DTaP-IPV), when administered to children 4 through 6 years of age, for intramuscular use | 130 | DTaP-IPV | | 6/13/2024 |
| 90697 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenzae type b PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTaP-IPV-Hib-HepB), for intramuscular use | 146 | DTaP,IPV,Hib,HepB | | 6/13/2024 |
| 90698 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use | 120 | DTaP-Hib-IPV | | 6/13/2024 |
| 90700 | Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use | 20 | DTaP | | 6/13/2024 |
| 90700 | Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use | 106 | DTaP, 5 pertussis antigens | | 6/13/2024 |
| 90701 | Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use | 01 | DTP | | 2/28/2017 |
| 90702 | Diphtheria and tetanus toxoids adsorbed (DT) when administered to individuals younger than 7 years, for intramuscular use | 28 | DT (pediatric) | | 6/13/2024 |
| 90703 | Tetanus toxoid adsorbed, for intramuscular use | 35 | tetanus toxoid, adsorbed | | 2/28/2017 |
| 90704 | Mumps virus vaccine, live, for subcutaneous use | 07 | mumps | | 2/28/2017 |
| 90705 | Measles virus vaccine, live, for subcutaneous use | 05 | measles | | 2/28/2017 |
| 90706 | Rubella virus vaccine, live, for subcutaneous use | 06 | rubella | | 2/28/2017 |
| 90707 | Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use | 03 | MMR | | 6/13/2024 |
| 90708 | Measles and rubella virus vaccine, live, for subcutaneous use | 04 | M/R | | 2/28/2017 |
| 90710 | Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use | 94 | MMRV | | 6/13/2024 |
| 90712 | Poliovirus vaccine, (any type[s]) (OPV), live, for oral use | 182 | OPV, Unspecified | | 2/28/2017 |
| 90713 | Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use | 10 | IPV | | 6/13/2024 |
| 90714 | Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | 113 | Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed | Beginning in 2005, this CPT code maps to TD preservative free. Remapped to CVX code 09 10/2021 to support active products mapped to that code. | 6/13/2024 |
| 90714 | Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | 09 | Td (adult), 2 Lf tetanus toxoid, preservative free, adsorbed | Beginning in 2005, this CPT code maps to TD preservative free. Remapped to CVX code 09 10/2021 to support active products mapped to that code. | 6/13/2024 |
| 90715 | Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use | 115 | Tdap | | 6/13/2024 |
| 90716 | Varicella virus vaccine (VAR), live, for subcutaneous use | 21 | varicella | | 6/13/2024 |
| 90717 | Yellow fever vaccine, live, for subcutaneous use | 183 | Yellow fever vaccine live - alt | | 6/13/2024 |
| 90717 | Yellow fever vaccine, live, for subcutaneous use | 37 | yellow fever live | | 6/13/2024 |
| 90720 | Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for intramuscular use | 22 | DTP-Hib | | 2/28/2017 |
| 90721 | Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DTaP/Hib), for intramuscular use | 50 | DTaP-Hib | | 2/28/2017 |
| 90723 | Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use | 110 | DTaP-Hep B-IPV | | 6/13/2024 |
| 90724 | Influenza virus vaccine | 88 | influenza, unspecified formulation | | 3/3/2017 |
| 90725 | Cholera vaccine for injectable use | 26 | cholera, unspecified formulation | | 2/28/2017 |
| 90726 | Rabies vaccine | 90 | rabies, unspecified formulation | | 3/3/2017 |
| 90727 | Plague vaccine, for intramuscular use | 23 | plague | | 2/28/2017 |
| 90728 | BCG vaccine | 19 | BCG | | 3/3/2017 |
| 90730 | Hepatitis A vaccine | 85 | Hep A, unspecified formulation | | 3/3/2017 |
| 90731 | Hepatitis B vaccine | 45 | Hep B, unspecified formulation | | 3/3/2017 |
| 90732 | Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use | 33 | pneumococcal polysaccharide PPV23 | | 6/13/2024 |
| 90733 | Meningococcal polysaccharide vaccine, serogroups A, C, Y, W-135, quadrivalent (MPSV4), for subcutaneous use | 32 | meningococcal MPSV4 | | 6/13/2024 |
| 90734 | Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use | 136 | Meningococcal MCV4O | | 6/13/2024 |
| 90734 | Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use | 114 | meningococcal MCV4P | | 6/13/2024 |
| 90735 | Japanese encephalitis virus vaccine, for subcutaneous use | 39 | Japanese encephalitis SC | | 2/28/2017 |
| 90736 | Zoster (shingles) vaccine (HZV), live, for subcutaneous injection | 121 | zoster live | | 6/13/2024 |
| 90737 | Hemophilus influenza B | 17 | Hib, unspecified formulation | | 3/3/2017 |
| 90738 | Japanese encephalitis virus vaccine, inactivated, for intramuscular use | 134 | Japanese Encephalitis IM | | 6/13/2024 |
| 90739 | Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use | 189 | HepB-CpG | | 6/13/2024 |
| 90740 | Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use | 44 | Hep B, high-dosage, dialysis or IC | | 6/13/2024 |
| 90741 | Immunization, passive; immune serum globulin, human (ISG) | 14 | IG, unspecified formulation | | 3/3/2017 |
| 90743 | Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use | 43 | Hep B, adult | | 6/13/2024 |
| 90743 | Hepatitis B vaccine (HepB), adolescent, 2 dose schedule, for intramuscular use | 08 | Hep B, adolescent or pediatric | | 6/13/2024 |
| 90744 | Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use | 08 | Hep B, adolescent or pediatric | | 6/13/2024 |
| 90745 | Hepatitis B vaccine, adolescent/high risk infant dosage, for intramuscular use | 42 | Hep B, adolescent/high risk infant | | 3/3/2017 |
| 90746 | Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use | 43 | Hep B, adult | | 6/13/2024 |
| 90747 | Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use | 44 | Hep B, high-dosage, dialysis or IC | | 12/11/2024 |
| 90748 | Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use | 51 | Hib-Hep B | | 6/13/2024 |
| 90750 | Zoster (shingles) vaccine (HZV), recombinant, subunit, adjuvanted, for intramuscular use | 187 | zoster recombinant | | 6/13/2024 |
| 90756 | Influenza virus vaccine, quadrivalent (ccIIV4), derived from cell cultures, subunit, antibiotic free, 0.5 mL dosage, for intramuscular use | 186 | Influenza, MDCK, quadrivalent, preservative | Effective 1/1/2018 | 6/13/2024 |
| 90758 | Zaire ebolavirus vaccine, live, for intramuscular use | 204 | Ebola Zaire vaccine, live, recombinant, 1mL dose | | 6/13/2024 |
| 90759 | Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramuscular use | 220 | HepB recombinant, 3-antigen, Al(OH)3 | | 6/13/2024 |
| 91300 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted, for intramuscular use | 208 | COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose | COVID-19 Vaccine - EUA authorized 12/11/2020 | 6/13/2024 |
| 91301 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, for intramuscular use | 207 | COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose | COVID-19 Vaccine - BLA Licensed and EUA authorized | 6/13/2024 |
| 91302 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5 mL dosage, for intramuscular use | 210 | COVID-19 vaccine, vector-nr, rS-ChAdOx1, PF, 0.5 mL | COVID-19 Vaccine - EUA submission withdrawn | 6/13/2024 |
| 91303 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage, for intramuscular use | 212 | COVID-19 vaccine, vector-nr, rS-Ad26, PF, 0.5 mL | COVID-19 Vaccine - EUA authorized 2/27/2021 | 6/13/2024 |
| 91304 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use | 313 | COVID-19, subunit, rS-nanoparticle, adjuvanted, PF, 5 mcg/0.5 mL | Original and Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91304 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use | 211 | COVID-19, subunit, rS-nanoparticle+Matrix-M1 Adjuvant, PF, 0.5 mL | Original and Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91305 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use | 217 | COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose | COVID-19 Vaccine - EUA authorized for primary series and IC, EUA rescinded 8/31/202 for monovalent boosters | 6/13/2024 |
| 91306 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use | 207 | COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose | COVID-19 Vaccine - EUA authorization rescinded 8/31/2022 for adult monovalent booster dose | 6/13/2024 |
| 91307 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use | 218 | COVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 mL dose, tris-sucrose | COVID-19 Vaccine - EUA authorized, pediatric 5 yrs through 11 yrs dose requires dilution | 6/13/2024 |
| 91308 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use | 219 | COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose | COVID-19 Vaccine - EUA authorized for children under 5 yrs | 6/13/2024 |
| 91309 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use | 221 | COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose | COVID-19 Vaccine - EUA authorized for pediatric, EUA rescinded 8/31/2022 for adult monovalent booster dose | 6/13/2024 |
| 91310 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, for intramuscular use | 225 | COVID-19, D614, recomb, preS dTM, AS03 adjuvant add, PF, 5mcg/0.5mL | COVID-19 Vaccine - Potential EUA authorization booster dose | 6/13/2024 |
| 91311 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use | 228 | COVID-19, mRNA, LNP-S, PF, pediatric 25 mcg/0.25 mL dose | COVID-19 Vaccine - EUA authorized for ages 6 mo through 5 yrs | 6/13/2024 |
| 91312 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use | 300 | COVID-19, mRNA, LNP-S, bivalent, PF, 30 mcg/0.3 mL dose | COVID-19 Vaccine - EUA authorized 8/31/2022 bivalent booster ages 12+ yrs | 6/13/2024 |
| 91313 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use | 229 | COVID-19, mRNA, LNP-S, bivalent, PF, 50 mcg/0.5 mL or 25mcg/0.25 mL dose | COVID-19 Vaccine - EUA authorized 8/31/2022 bivalent booster for ages 18+ yrs, potential EUA ages 6 yrs through 17 yrs | 6/13/2024 |
| 91314 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use | 229 | COVID-19, mRNA, LNP-S, bivalent, PF, 50 mcg/0.5 mL or 25mcg/0.25 mL dose | COVID-19 Vaccine - EUA authorized 8/31/2022 bivalent booster for ages 6 yrs through 11 yrs | 6/13/2024 |
| 91315 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use | 301 | COVID-19, mRNA, LNP-S, bivalent, PF, 10 mcg/0.2 mL dose | COVID-19 Vaccine - Potential EUA authorization bivalent booster for ages 5 yrs through 11 yrs | 6/13/2024 |
| 91316 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use | 230 | COVID-19, mRNA, LNP-S, bivalent, PF, 10 mcg/0.2 mL | COVID-19 Vaccine - EUA authorized 12/8/2022 bivalent booster (Moderna) for ages 6 mo through 5 yrs | 6/13/2024 |
| 91317 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use | 302 | COVID-19, mRNA, LNP-S, bivalent, PF, 3 mcg/0.2 mL dose | COVID-19 Vaccine - EUA authorized 12/8/2022 bivalent vaccine (Pfizer) for ages 6 mo through 4 yrs | 6/13/2024 |
| 91318 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use | 308 | COVID-19, mRNA, LNP-S, PF, tris-sucrose, 3 mcg/0.3 mL | Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91319 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use | 310 | COVID-19, mRNA, LNP-S, PF, tris-sucrose, 10 mcg/0.3 mL | Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91320 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use | 309 | COVID-19, mRNA, LNP-S, PF, tris-sucrose, 30 mcg/0.3 mL | Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91321 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use | 311 | COVID-19, mRNA, LNP-S, PF, 25 mcg/0.25 mL | Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91322 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use | 312 | COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL | Fall COVID-19 vaccine starting 2023 | 9/24/2024 |
| 91323 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular use | 334 | COVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 mL | | 4/15/2025 |