Transcription of Influenza Vaccine Products for the 2021-2022 Influenza …
1 Influenza Vaccine Products for the 2021 2022 Influenza Season Mercury Vaccine product Trade name CVX Billing Code2. Manufacturer ( Vaccine abbreviation)1. How Supplied Content Age Range Code (mcg ) CPT. AstraZeneca FluMist (LAIV4) mL (single-use nasal spray) 0 2 through 49 years 149 90672. Fluarix (IIV4) mL (single-dose syringe) 0 6 months & older 3. 150 90686. GlaxoSmithKline FluLaval (IIV4) mL (single-dose syringe) 0 6 months & older3 150 90686. Flublok (RIV4) mL (single-dose syringe) 0 18 years & older 185 90682. mL (single-dose syringe) 0 6 months & older3 150 90686. mL (single-dose vial) 0 6 months & older3 150 90686. Sanofi Pasteur Fluzone (IIV4)). mL (multi-dose vial) 25 6 through 35 months3 158 90687. mL (multi-dose vial) 25 3 years & older 158 90688.
2 Fluzone High-Dose (IIV4-HD) mL (single-dose syringe) 0 65 years & older 197 90662. mL (single-dose syringe) 0 6 through 35 months3 161 90685. mL (single-dose syringe) 0 3 years & older3 150 90686. Afluria (IIV4). mL (multi-dose vial) 6 through 35 months3 158 90687. Seqirus mL (multi-dose vial) 3 years & older4 158 90688. Fluad (aIIV4) mL (single-dose syringe) 0 65 years & older 205 90694. mL (single-dose syringe) 0 6 months & older3 171 90674. Flucelvax (ccIIV4). mL (multi-dose vial) 25 6 months & older3 186 90756. notes 1. IIV4 = egg-based quadrivalent inactivated 2. An administration code should always be 3. Dosing for infants and children age 6 through 4. Afluria is approved by the Food and Drug Influenza Vaccine (injectable); where reported in addition to the Vaccine product 35 months: Administration for intramuscular administration necessary to refer to cell culture-based code.
3 Note: Third party payers may have Afluria mL with the PharmaJet Stratis Needle-Free Vaccine , the prefix cc is used ( , ccIIV4); specific policies and guidelines that might Fluarix mL Injection System for persons age 18 through RIV4 = quadrivalent recombinant hemag- require providing additional information Flucelvax mL 64 years. glutinin Influenza Vaccine (injectable); on their claim forms. FluLaval mL. aIIV4 = adjuvanted quadrivalent inactivated Fluzone mL or mL. Influenza Vaccine . Immunization Action Coalition Saint Paul, Minnesota 651- 647- 9009 Item #P4072 (11/21).
