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Commonly Administered Pediatric Vaccines

Effective 1/1/2016 Commonly Administered Pediatric Vaccines CPT Separately report the administration with Current Procedural Terminology (CPT ). # of vaccine Product codes 90460-90461 or 90471-90474 [Please see table below] Manufacturer Brand Components Code Meningococcal recombinant protein and outer membrane vesicle vaccine , serogroup B, 2 dose Novartis Bexsero 90620 1. schedule, for IM use 90621 Meningococcal recombinant lipoprotein vaccine , serogroup B, 3 dose schedule, for IM use Pfizer Trumenba 1. Influenza virus vaccine , quadrivalent (IIV4), split virus, preservative free, for intradermal use Sanofi Pasteur Fluzone Intradermal 90630 1. Quadrivalent Hepatitis A vaccine (Hep A), Pediatric /adolescent dosage, 2 dose, for IM use GlaxoSmithKline HAVRIX.

Jan 01, 2016 · 90680 Rotavirus vaccine, pentavalent (RV5), 3 dose schedule, live, for oral use Merck RotaTeq 1 90681 Rotavirus vaccine, human, attenuated (RV1), 2 dose schedule, live, for oral use GlaxoSmithKline ROTARIX 1 90685 Influenza virus vaccine, quadrivalent (IIV4), split virus, preservative free, for children 6-35 months

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