Complete list of vaccine names 01252012 NDC public only

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Complete list of vaccine names 01252012 NDC public only Powered By Docstoc
					Complete List of Vaccine Names and CPT/CVX Codes
A list that matches the vaccine name or codes in CHILD Profile with the brand name or other common names of the vaccines you use
most often.

       Vaccine trade name or                  Best CHILD Profile  State       Age                                   Manufacturer/       CPT     CVX
                                                                                               Dose       Route
          common name                             Selection      Supplied   (Range)                                 NDC Number          code    code
  Combination Vaccines
                                                                                                                   GlaxoSmithKline –
  Pediarix®                                   DTAP/HepB/IPV                6 weeks +     0.5 ml            IM     SKB                  90723   110
                                                                                                                   NDC: 58160-0811-52
                                                                                                                   Sanofi Pasteur –
                                                                            6 weeks - 5
  Pentacel®                                   DTaP/HIB/IPV                               0.5 ml            IM     PMC (AKA: Aventis)   90698   120
                                                                            yrs
                                                                                                                   NDC: 49281-0510-05
                                                                                                                   Merck- MSD
  ProQuad®                                    MMR/V                        1 yr +        0.5 ml            SQ                          90710    94
                                                                                                                   NDC: 00006-4999-00
                                                                                                                   GlaxoSmithKline –
  Kinrix®                                     DTaP/IPV                     4 - 6 yrs     0.5 ml            IM     SKB                  90696   130
                                                                                                                   NDC: 58160-0812-11
                                                                                                                   Merck- MSD
  Comvax®                                     HEPB/HIB                     6 weeks +     0.5 ml            IM                          90748    51
                                                                                                                   NDC: 00006-4898-00
                                                                                                                   GlaxoSmithKline –
  Twinrix®                                    HepA/HepB                     18 + yrs      1.0 ml            IM                          90636   104
                                                                                                                   SKB
  Diphtheria, Tetanus and Pertussis
                                                                                                                   Sanofi Pasteur –
  Diphtheria and tetanus toxoids
                                              DT (Pediatric)               6 weeks +     0.5 ml            IM     PMC (AKA: Aventis)   90702    28
  adsorbed
                                                                                                                   NDC: 49281-0278-10
                                                                                                                   Sanofi Pasteur –
  Daptacel®                                   DTaP                         6 weeks +     0.5 ml            IM     PMC (AKA: Aventis)
                                                                                                                   NDC: 49281-0286-10
                                                                                                                                        90700    20
                                                                                                                   GlaxoSmithKline –
  Infanrix®                                   DTaP                         6 weeks +     0.5 ml            IM     SKB
                                                                                                                   NDC:58160-0810-11
                                                                                                                   Massachusetts
  Tetanus and diphtheria toxoids                                                          0.5 ml                   Biological Labs –
                                              Td Adult, Preserv free       7+ yrs                          IM                          90714   113
  adsorbed                                                                                PFS                      MBL
                                                                                                                   NDC: 14362-0111-03
  Decavac®                                                                                                         Sanofi Pasteur –
  Tetanus and diphtheria toxoids              Td Adult, Preserv free       7+ yrs        0.5 ml            IM     PMC (AKA: Aventis)   90718    09
  adsorbed                                                                                                         NDC: 49281-0291-83
                                                                                                                   GlaxoSmithKline –
  Boostrix®                                                            
                                              Tdap                          7-65+ yrs     0.5 ml            IM     SKB
  Tetanus Diphtheria & Acellular Pertsussis
                                                                                                                   NDC:58160-0842-11
                                                                                                                                        90715   115
  Adacel®                                                                                                          Sanofi Pasteur –
  Tetanus Diphtheria and Acellular            Tdap                         7-65+yrs      0.5 ml            IM     PMC (AKA: Aventis)
  Pertussis                                                                                                        NDC: 49281-0400-10
Complete List of Vaccine Names and CPT/CVX Codes

      Vaccine trade name or            Best CHILD Profile  State       Age                                       Manufacturer/           CPT        CVX
                                                                                        Dose            Route
         common name                       Selection      Supplied   (Range)                                     NDC Number              code       code
Diphtheria, Tetanus and Pertussis
(conti.)
                                                                                                                Sanofi Pasteur –
Tripedia®                              DTaP                          6 weeks +    0.5 ml                 IM                              90700       20
                                                                                                                PMC (AKA: Aventis)
Whenever DTaP was given, even if
                                       DTaP                                                                                              90700       20
the brand name is unknown
Diphtheria, tetanus toxoids, & whole
cell pertussis vaccine (will be from   DTP
historical records)
Hepatitis A
                                                                                                                GlaxoSmithKline –
Havrix® (2 doses for                   Hep A 2 dose -                12 months    0.5 ml
                                                                                                        IM     SKB
pediatric/adolescent)                  Ped/Adol                      - 18 yrs     (720 EL.U)
                                                                                                                NDC: 58160-0825-11       90633       83
Vaqta® (2 doses for                    Hep A 2 dose -                12 months    0.5 ml                        Merck- MSD
                                                                                                        IM
pediatric/adolescents)                 Ped/Adol                      - 18 yrs     (25 U)                        NDC: 00006-4831-41
Havrix® (3 doses for                   Hep A 3 dose -                12 months    0.5 ml                        GlaxoSmithKline –
                                                                                                         IM                              90634       84
pediatric/adolescent)                  Ped/Adol                      - 18 yrs     (360 EL.U)                    SKB
                                                                                  1.0 ml
Vaqta® (2 doses for adults)            Hep A 2 dose - Adult          19+ yrs                             IM     Merck- MSD
                                                                                  (50u)
                                                                                                                                         90632       52
                                                                                  1.0 ml                        GlaxoSmithKline –
Havrix® (2 doses for adults)           Hep A 2 dose - Adult          19+ yrs                             IM
                                                                                  (1440 EL.U)                   SKB
Hepatitis B
                                                                                                                GlaxoSmithKline –
Engerix-B® Ped/Adol                    HepB Ped/Adol Preserv.        Birth - 19   0.5 ml
                                                                                                        IM     SKB
(3 dose schedule)                      Free                          yrs          10µg
                                                                                                                NDC: 58160-0820-11
                                                                                                                                         90744       08
                                                                                                                Merck- MSD
                                       HepB Ped/Adol Preserv.        Birth - 19   0.5 ml
Recombivax HB® Ped/Adol                                                                                 IM     NDC: 00006-4981-00
                                       Free                          yrs          5µg
                                                                                  2.0 ml                        GlaxoSmithKline –
Engerix-B®                                                                        40µg
                                       Hepatitis B - dialysis                                           IM     SKB                      90747       44
(4 dose schedule)                                                                 Two X 20 µg in 1 or
                                                                                  2 injections
                                                                                                                NDC: 58160-0820-11
                                       Hep B 2 dose –                11-15        1.0 ml
Recombivax HB® for adults                                                                                IM     Merck- MSD               90743       43
                                       Adol/Adult                    years        10µg
                                                                                  1.0 ml                        GlaxoSmithKline –
Engerix-B® for adults                                                20 + yrs                            IM
                                                                                  20µg                          SKB
                                       Hep B Adult                                                                                       90746       43
                                                                                  1.0 ml
Recombivax HB® for adults                                            20 + yrs                            IM     Merck- MSD
                                                                                  10µg




2/7                                                                                                                 Updated: 11/01/2011 V4.11.5.3
Complete List of Vaccine Names and CPT/CVX Codes

      Vaccine trade name or          Best CHILD Profile  State               Age                                  Manufacturer/           CPT        CVX
                                                                                               Dose      Route
         common name                     Selection      Supplied           (Range)                                NDC Number              code       code

Hepatitis B (conti.)

                                     Note: there are various
Various dosages depending on
                                     choices available to
specific individual cases, such as
                                     reflect the specific
high risk or dialysis.
                                     situation
HIB
                                                                                                                 Sanofi Pasteur –
                                                                          2 months -
ActHib®                              Hib-PRP-T                                        0.5 ml             IM     PMC (AKA: Aventis)       90648       48
                                                                          5 yrs
                                                                                                                 NDC: 49281-0545-05
                                                                          2 months -                             Merck- MSD
PedvaxHib®                           Hib-PRP-OMP                                      0.5ml              IM                              90647       49
                                                                          5 yrs                                  NDC: 00006-4897-00
                                                                          12 months
                                                                                                                 GlaxoSmithKline –
Hiberix®                             Hib-PRP-T                            – 4 years    0.5ml              IM
                                                                                                                 SKB
                                                                                                                                          90648       48
                                                                          2 months -                             GlaxoSmithKline –
OmniHib®                             Hib-PRP-T                                         0.5 ml             IM
                                                                          5 yrs                                  SKB
                                                                          2 months -
HibTITER®                            Hib-Hboc                                          0.5ml              IM     Wyeth Ayerst – WAL       90645       47
                                                                          5 yrs
ProHIBit® (discontinued)             Hib-PRP-D
Human Papilloma Virus
                                                                                                                 Merck- MSD
Gardasil®                            HPV, quadrivalent                   9 - 26 yrs   0.5ml              IM                              90649       62
                                                                                                                 NDC: 00006-4045-41
                                                                                                                 GlaxoSmithKline –
Cervarix™                            HPV, bivalent                       10-25 yrs    0.5ml              IM     SKB                      90650      118
                                                                                                                 NDC: 58160-0830-46
Immune Globuline Products            (This list is not comprehensive by brand name or manufacturer)
HyperHEP B S/D® or                                                                     See insert for            Talecris
HepaGam B®                           HBIG (Hepatitis B                                 dosage and                Biotherapeutics –
                                                                                                          IM                              90371       30
(Hepatitis B Immune Globulin)        Immune Globulin)                                  admin                     TAL OR
                                                                                       recommendations           Cangene Corp - CNJ
                                                                                       See insert for
                                     IG (Immune Globulin                               dosage and                Talecris
GamaSTAN S/D® (Immune Globulin)                                                                           IM                              90281       86
                                     IM)                                               admin                     Biotherapeutics - TAL
                                                                                       recommendations
                                                                                       See insert for
HyperRAB S/D® (Rabies Immune                                                           dosage and                Talecris
                                     RIG                                                                  IM                              90375       34
Globulin)                                                                              admin                     Biotherapeutics - TAL
                                                                                       recommendations


3/7                                                                                                                  Updated: 11/01/2011 V4.11.5.3
Complete List of Vaccine Names and CPT/CVX Codes

      Vaccine trade name or             Best CHILD Profile  State               Age                                  Manufacturer/           CPT        CVX
                                                                                                  Dose      Route
         common name                        Selection      Supplied           (Range)                                NDC Number              code       code
Immune Globuline Products (conti.)      (This list is not comprehensive by brand name or manufacturer)

                                                                                          See insert for
Synagis® (Respiratory Syncytial Virus                                                     dosage and
                                        RSV-IGIM                                                             IM     MedImmune – MED          90378       93
Immune Globulin)                                                                          admin
                                                                                          recommendations
                                                                                          See insert for
HyperTET S/D® (Tetanus Immune                                                             dosage and                Talecris
                                        TIG                                                                  IM                              90389       13
Globulin)                                                                                 admin                     Biotherapeutics - TAL
                                                                                          recommendations
Influenza
                                                                                                                    Sanofi Pasteur –
Fluzone®                                Influ Split, 6-35 mos,                            0.25 ml
                                                                            6 - 35 mos                      IM     PMC (AKA: Aventis)       90655      140
Preservative Free (state supplied)      pres free                                         PFS
                                                                                                                    NDC: 49281-0111-25
                                                                                                                    Sanofi Pasteur –
Fluzone®                                                                                  0.5ml
                                        Influ Split, 36+ mos                3 -18 yrs                       IM     PMC (AKA: Aventis)       90658      141
Contains Preservative                                                                     MDV
                                                                                                                    NDC: 49281-0388-15
Flumist® -                                                                                0.2 ml                    MedImmune – MED
                                        Influenza Nasal Spray               2 - 18 yrs                      IN                              90660      111
Live attenuated Influenza Vaccine                                                         PIS                       NDC: 66019-0109-10
                                                                                                                    Novartis
                                        Influ Inact 48+ mos pres                          0.5ml                     Pharmaceutical Corp.
Fluvirin® PF                                                                3 - 18 yrs                      IM                              90656      140
                                        free                                              PFS                       – NOV
                                                                                                                    NDC: 66521-0114-02
Afluria®                                Influ Inact 9 + yrs                               0.5ml                     CSL Biotherapies,
                                                                             9+ yrs                          IM                              90658      141
Contains Preservative                   w/Thimerosol                                      MDV                       INC
                                                                                          0.5ml
Fluzone®                                Influ Split, 36+ mos,                                                       Sanofi Pasteur –
                                                                             3+ yrs       SDV;               IM
Preservative Free                       pres free                                                                   PMC (AKA: Aventis)
                                                                                          PFS                                                90656      140
Afluria®                                Influ Inact 9+yrs                                 0.5ml                     CSL Biotherapies,
                                                                             9+ yrs                          IM
Preservative Free                       pres free                                         PFS                       INC
                                        Influ Split, 36+ mos                              0.5ml                     GlaxoSmithKline –
FLUARIX®                                                                     3+ yrs                          IM
                                        pres free                                         PFS                       SKB
                                                                                                                    Novartis
Fluvirin®                               Influ Inact. 48+ mos,                             0.5ml
                                                                             4+ yrs                          IM     Pharmaceutical Corp.     90658      141
Contains preservative                   w/Thimerosol                                      MDV
                                                                                                                    – NOV
Fluzone®                                                                                  0.5ml                     Sanofi Pasteur –
                                        Influ Split, 36+ mos                 3+ yrs                          IM
Contains Preservative                                                                     MDV                       PMC (AKA: Aventis)
                                                                                                                    Novartis
                                        Influ split, 18+ years,                           0.5ml                                              90656
Agriflu®                                                                     18+ yrs                         IM     Pharmaceutical Corp.                140
                                        pres free                                         PFS
                                                                                                                    – NOV
                                                                                                                    GlaxoSmithKline –
                                                                                          0.5 ml
FluLaval®                               Influ split, 18+ years               18+ yrs                         IM     SKB                      90658      141
                                                                                          MDV
                                                                                                                    NDC: N/A
4/7                                                                                                                     Updated: 11/01/2011 V4.11.5.3
Complete List of Vaccine Names and CPT/CVX Codes

      Vaccine trade name or           Best CHILD Profile  State       Age                                 Manufacturer/            CPT        CVX
                                                                                          Dose   Route
         common name                      Selection      Supplied   (Range)                               NDC Number               code       code
Influenza (conti.)
Flumist® -                                                                        0.2 ml
                                      Influenza Nasal Spray         19 – 49 yrs                   IN     MedImmune – MED           90660      111
Live attenuated Influenza Vaccine                                                 PIS
                                                                                  0.5ml                  Sanofi Pasteur –
Fluzone® High Dose                    Influenza, High Dose          65+ yrs                       IM                               90662      135
                                                                                  PFS                    PMC (AKA: Aventis)
                                      Influenza, Intradermal                      0.1mL                  Sanofi Pasteur –
Fluzone® Intradermal                                                18-64yr                       ID                               90654      144
                                      PF                                          PFMS                   PMC (AKA: Aventis)
Japanese Encephalitis
                                                                    12- 35
                                                                                  0.5ml                  Sanofi Pasteur –
JE-VAX® - Japanese Encephalitis       Japanese Encephalitis         mos, 3 yrs                    SQ                               90735       39
                                                                                  1.0 ml                 PMC (AKA: Aventis)
                                                                    +
                                      Japanese Encephalitis-                                             Intercell Biomedical –
IXIARO® - Japanese Encephalitis                                     17 yrs +      0.5ml           IM                               90738      134
                                      IM                                                                 INT
Measles, Mumps & Rubella
                                                                                                         Merck- MSD
MMR®II - Measles, Mumps & Rubella     MMR                          1+ yrs        0.5ml           SQ                               90707       03
                                                                                                         NDC: 00006-4681-00
Meningococcal
                                                                                                         Sanofi Pasteur –
Menactra® Meningococcal Conjugate     Meningococcal
                                                                   2-55 yr       0.5 ml          IM     PMC (AKA: Aventis)        90734      114
vaccine (Serogroups A, C, Y, W-135)   (MCV4P)
                                                                                                         NDC: 49281-0589-05
                                                                                                         Novartis
Menveo® Meningococcal Conjugate       Meningococcal                                                      Pharmaceutical Corp.
                                                                   11-55 yr      0.5 ml          IM                               90734      136
vaccine (Serogroups A, C, Y, W-135)   (MCV4O)                                                            – NOV
                                                                                                         NDC: 46028-0208-01
                                                                    3-18
                                                                    months
Menomune® A/C/Y/W-135
                                      Meningococcal                 (2 doses),                           Sanofi Pasteur –
Meningococcal Polysaccharide                                                      0.5 ml          SQ                               90733       32
                                      (MPSV4)                       19+                                  PMC (AKA: Aventis)
vaccine
                                                                    months
                                                                    ( 1 dose)
Pneumonia

Prevnar 13®                                                         2 - 59                               Wyeth Ayerst – WAL
                                      Pneumococcal, PCV-13                       0.5ml           IM                               90670      133
(Pneumococcal Conjugate, 13 valent)                                 months                               NDC: 00005-1971-02
                                                                    ≥2 yrs
Pneumovax® 23                                                                                            Merck- MSD
                                      Pneumococcal, (PPSV)         w/health      0.5ml          SQ/IM                             90732       33
(Pneumococcal, polyvalent)                                                                               NDC: 00006-4943-00
                                                                    risks



5/7                                                                                                           Updated: 11/01/2011 V4.11.5.3
Complete List of Vaccine Names and CPT/CVX Codes

      Vaccine trade name or             Best CHILD Profile  State       Age                                  Manufacturer/           CPT        CVX
                                                                                           Dose     Route
         common name                        Selection      Supplied   (Range)                                NDC Number              code       code
Pneumonia (conti.)

                                                                                                            GlaxoSmithKline –
Pnu-Imune® 23                           Pneumococcal, (PPSV)          65+ yrs,     0.5ml            SQ/IM                            90732       33
                                                                                                            SKB
Prevnar®
(Pneumococcal Conjugate, 7 valent)                                    2 - 59
                                        Pneumococcal, (PCV)                        0.5ml             IM     Wyeth Ayerst – WAL       90669      100
(Note: to be documented for vaccine                                   months
given before 04/2010)
Polio
                                                                                                            Sanofi Pasteur –
IPOL® Poliovirus vaccine, inactivated   IPV                          6 weeks +    0.5 ml            SQ     PMC (AKA: Aventis)       90713       10
                                                                                                            NDC: 49281-0860-10
Poliovirus vaccine, live oral           OPV

Rabies
                                                                                                            Sanofi Pasteur –
Imovax®                                 Rabies                                     1.0 ml            IM
                                                                                                            PMC (AKA: Aventis)
                                                                                                            Novartis                 90675       18
Rabavert®                               Rabies                                     1.0 ml            IM     Pharmaceutical Corp.
                                                                                                            – NOV
                                                                                                                                     90676       40
Rabies, ID                              Rabies, Intradermal                        0.1ml             ID

Rotavirus
                                                                                                            Merck- MSD
                                        Rotavirus, pentavalent        2-32
Rotateq®                                                                          2.0 ml           ORAL    NDC: 000006-4047-        90680      116
                                        RV5                           months
                                                                                                            41
                                                                                                            GlaxoSmithKline –
                                        Rotavirus, monovalent
Rotarix®                                                             6-24 weeks   1.0 ml           ORAL    SKB                      90681      119
                                        RV1
                                                                                                            NDC: 58160-0845-52
Respiratory Syncytial Virus

Synagis®                                RSV-IGIM

TB test
                                                                                                                 Parkdale
Purified Protein Derivative (PPD)                PPD Test                                  0.1 ml    ID      Pharmaceuticals –       86580       96
                                                                                                                   PD
Typhoid

                                                                                                            Sanofi Pasteur –
Typhoid ViCPs                           Typhoid, ViCPs                2 yr +       0.5 ml            IM                              90691      101
                                                                                                            PMC (AKA: Aventis)

6/7                                                                                                             Updated: 11/01/2011 V4.11.5.3
  Complete List of Vaccine Names and CPT/CVX Codes

        Vaccine trade name or                     Best CHILD Profile  State                          Age                                                Manufacturer/              CPT       CVX
                                                                                                                           Dose           Route
           common name                                Selection      Supplied                      (Range)                                              NDC Number                 code      code
  Typhoid (conti.)
                                                                                                                                                      Berna Products
  Typhoid, Oral                                   Typhoid, Oral                                   6 yr +           4 tabs                  ORAL                                    90690           25
                                                                                                                                                      Corp.- BPC
  Typhoid, parenteral                             Typhoid, parenteral
  Varicella
                                                                                                                                                      Merck- MSD
  Varivax® Chicken Pox Vaccine                    Varicella                                      1+ yrs           0.5 ml                    SQ                                    90716           21
                                                                                                                                                      NDC: 00006-4827-00
  Yellow Fever
                                                                                                                                                      Sanofi Pasteur –
  Yellow Fever                                    Yellow Fever                                    9+ months        0.5ml                     SQ                                    90717           37
                                                                                                                                                      PMC (AKA: Aventis)
  Zoster ("Shingles")

  Zostavax®                                       Zoster                                          50 + yrs         0.65 ml                   SQ       Merck- MSD                   90736       121


Notes
    On the Vaccination View/Add Screen: there are two places to look for the appropriate vaccine choice when entering a vaccination date. Always look FIRST at the vaccine names that
    appear on the screen. ALL routine vaccines will appear. For less common vaccines that you can’t find 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.
          "Unspecified" vaccines should only be used for entering historical vaccines when the
             specific vaccine type is unknown.

    If your practice manages vaccine inventory in CHILD Profile: make sure the vaccine types you enter match the vaccine types your lot number manager has entered. If you don’t 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
       CHILD Profile staff discourage the use of the vaccine type "Influenza Whole". This vaccines type has not been used in the U.S. for some time

    Pfizer purchased Wyeth Ayerst in 2010 but they are continuing to use the Wyeth Ayerst branding for a period of time. Pfizer will be added as a manufacture when the
    packaging changes.




  7/7                                                                                                                                                       Updated: 11/01/2011 V4.11.5.3

				
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