CVX Codeset
|
|
| # |
CodeValue |
Description |
| 1 |
03 |
MMR |
| 2 |
08 |
Hep B, adolescent or pediatric |
| 3 |
09 |
Td (adult), 2 Lf tetanus toxoid, preservative free, adsorbed |
| 4 |
10 |
IPV |
| 5 |
101 |
typhoid, ViCPs |
| 6 |
104 |
Hep A-Hep B |
| 7 |
106 |
DTaP, 5 pertussis antigens |
| 8 |
110 |
DTaP-Hep B-IPV |
| 9 |
111 |
influenza, live, intranasal |
| 10 |
113 |
Td (adult), 5 Lf tetanus toxoid, preservative free, adsorbed |
| 11 |
114 |
meningococcal MCV4P |
| 12 |
115 |
Tdap |
| 13 |
116 |
rotavirus, pentavalent |
| 14 |
118 |
HPV, bivalent |
| 15 |
119 |
rotavirus, monovalent |
| 16 |
12 |
diphtheria antitoxin |
| 17 |
120 |
DTaP-Hib-IPV |
| 18 |
121 |
zoster |
| 19 |
122 |
rotavirus, unspecified formulation |
| 20 |
13 |
TIG |
| 21 |
130 |
DTaP-IPV |
| 22 |
133 |
Pneumococcal conjugate PCV 13 |
| 23 |
134 |
Japanese Encephalitis IM |
| 24 |
135 |
Influenza, high dose seasonal |
| 25 |
136 |
Meningococcal MCV4O |
| 26 |
138 |
Td (adult) |
| 27 |
140 |
Influenza, seasonal, injectable, preservative free |
| 28 |
141 |
Influenza, seasonal, injectable |
| 29 |
142 |
tetanus toxoid, not adsorbed |
| 30 |
143 |
Adenovirus types 4 and 7 |
| 31 |
144 |
influenza, seasonal, intradermal, preservative free |
| 32 |
145 |
RSV-MAb (new) |
| 33 |
146 |
DTaP,IPV,Hib,HepB |
| 34 |
149 |
influenza, live, intranasal, quadrivalent |
| 35 |
150 |
influenza, injectable, quadrivalent, preservative free |
| 36 |
153 |
Influenza, injectable, MDCK, preservative free |
| 37 |
154 |
Hep A, IG |
| 38 |
155 |
influenza, recombinant, injectable, preservative free |
| 39 |
156 |
Rho(D)-IG |
| 40 |
157 |
Rho(D) -IG IM |
| 41 |
158 |
influenza, injectable, quadrivalent |
| 42 |
160 |
Influenza A monovalent (H5N1), ADJUVANTED-2013 |
| 43 |
161 |
Influenza, injectable,quadrivalent, preservative free, pediatric |
| 44 |
162 |
meningococcal B, recombinant |
| 45 |
163 |
meningococcal B, OMV |
| 46 |
165 |
HPV9 |
| 47 |
166 |
influenza, intradermal, quadrivalent, preservative free |
| 48 |
168 |
Influenza Trivalent Adjuv |
| 49 |
169 |
Hep A Live Attenuated |
| 50 |
171 |
Influenza, injectable, MDCK, preservative free, quadrivalent |
| 51 |
174 |
cholera, live attenuated |
| 52 |
175 |
Rabies - IM Diploid cell culture |
| 53 |
176 |
Rabies - IM fibroblast culture |
| 54 |
18 |
rabies, intramuscular injection |
| 55 |
181 |
Anthrax Immune Globulin |
| 56 |
183 |
Yellow Fever, Alternative Formulation |
| 57 |
185 |
Seasonal, quadrivalent, recombinant, injectable influenza vaccine, preservative free |
| 58 |
186 |
Influenza, injectable, MDCK, quadrivalent, preservative |
| 59 |
187 |
zoster recombinant |
| 60 |
189 |
Hepatitis B vaccine (recombinant), CpG adjuvanted |
| 61 |
19 |
Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live |
| 62 |
196 |
Td, adsorbed, preservative free, adult use, Lf unspecified |
| 63 |
197 |
influenza, high-dose, quadrivalent |
| 64 |
198 |
Non UD DTP-hepB-Hib Pentavalent |
| 65 |
20 |
DTaP |
| 66 |
200 |
influenza, Southern Hemisphere, pediatric, preservative free |
| 67 |
201 |
influenza, Southern Hemisphere, preservative free |
| 68 |
202 |
influenza, Southern Hemisphere, quadrivalent, with preservative |
| 69 |
203 |
meningococcal polysaccharide (groups A, C, Y, W-135) TT conjugate |
| 70 |
204 |
Ebola Zaire vaccine, live |
| 71 |
205 |
Influenza vaccine, quadrivalent, adjuvanted |
| 72 |
206 |
Smallpox monkeypox vaccine (National Stockpile) |
| 73 |
207 |
COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5 mL dose |
| 74 |
208 |
COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose |
| 75 |
21 |
varicella |
| 76 |
210 |
COVID-19 vaccine, vector-nr, rS-ChAdOx1, PF, 0.5 mL |
| 77 |
211 |
NOVAVAX COVID-19 Vaccine, Adjuvanted |
| 78 |
212 |
COVID-19 vaccine, vector-nr, rS-Ad26, PF, 0.5 mL |
| 79 |
215 |
Pneumococcal conjugate PCV15, polysaccharide CRM197 conjugate, adjuvant, PF |
| 80 |
216 |
Pneumococcal conjugate vaccine, 20 valent (PCV20) |
| 81 |
217 |
COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose |
| 82 |
218 |
COVID-19, mRNA, LNP-S, PF, 10 mcg/0.2 mL dose, tris-sucrose |
| 83 |
219 |
COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose |
| 84 |
220 |
HepB recombinant, 3-antigen, Al(OH)3 |
| 85 |
221 |
COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose |
| 86 |
223 |
Tick-borne encephalitis, inactivated, PF |
| 87 |
224 |
Tick-borne encephalitis, inactivated, PF |
| 88 |
225 |
COVID-19, D614, recomb, preS dTM, AS03 adjuvant add, PF, 5mcg/0.5mL |
| 89 |
227 |
Moderna COVID-19 Vaccine |
| 90 |
228 |
COVID-19, mRNA, LNP-S, PF, pediatric 25 mcg/0.25 mL dose |
| 91 |
229 |
Moderna COVID-19 Vaccine, Bivalent |
| 92 |
230 |
Moderna COVID-19 Vaccine, Bivalent |
| 93 |
231 |
FLUZONE High-Dose Quadrivalent Southern Hemisphere |
| 94 |
24 |
anthrax |
| 95 |
25 |
typhoid, oral |
| 96 |
27 |
botulinum antitoxin |
| 97 |
28 |
DT (pediatric) |
| 98 |
29 |
CMVIG |
| 99 |
30 |
HBIG |
| 100 |
300 |
Pfizer-BioNTech Covid-19 Vaccine, Bivalent |
| 101 |
301 |
Pfizer-BioNTech Covid-19 Vaccine, Bivalent |
| 102 |
302 |
Pfizer-BioNTech Covid-19 Vaccine, Bivalent |
| 103 |
309 |
COVID-19, mRNA, LNP-S, PF, tris-sucrose, 30 mcg/0.3 mL |
| 104 |
314 |
RSV Vaccine unspecified |
| 105 |
33 |
pneumococcal polysaccharide PPV23 |
| 106 |
34 |
RIG |
| 107 |
35 |
tetanus toxoid, adsorbed |
| 108 |
36 |
VZIG |
| 109 |
37 |
yellow fever |
| 110 |
39 |
Japanese encephalitis SC |
| 111 |
41 |
typhoid, parenteral |
| 112 |
43 |
Hep B, adult |
| 113 |
44 |
Hep B, dialysis |
| 114 |
48 |
Hib (PRP-T) |
| 115 |
49 |
Hib (PRP-OMP) |
| 116 |
502 |
COVID-19 IV Non-US Vaccine (COVAXIN) |
| 117 |
51 |
Hib-Hep B |
| 118 |
510 |
COVID-19 IV Non-US Vaccine (BIBP, Sinopharm) |
| 119 |
511 |
COVID-19 IV Non-US Vaccine (CoronaVac, Sinovac) |
| 120 |
52 |
Hep A, adult |
| 121 |
56 |
dengue fever |
| 122 |
57 |
hantavirus |
| 123 |
58 |
Hep C |
| 124 |
59 |
Hep E |
| 125 |
60 |
herpes simplex 2 |
| 126 |
61 |
HIV |
| 127 |
62 |
HPV, quadrivalent |
| 128 |
67 |
malaria |
| 129 |
68 |
melanoma |
| 130 |
70 |
Q fever |
| 131 |
71 |
RSV-IGIV |
| 132 |
72 |
rheumatic fever |
| 133 |
73 |
Rift Valley fever |
| 134 |
75 |
vaccinia (smallpox) |
| 135 |
79 |
vaccinia immune globulin |
| 136 |
8 |
Hep B, adolescent or pediatric |
| 137 |
801 |
AS03 Adjuvant |
| 138 |
83 |
Hep A, ped/adol, 2 dose |
| 139 |
86 |
IG |
| 140 |
87 |
IGIV |
| 141 |
93 |
RSV-MAb |
| 142 |
94 |
MMRV |
| 143 |
95 |
TST-OT tine test |
| 144 |
998 |
no vaccine administered |
|