Transcription of Influenza Vaccine Products for the 2017-2018 …
1 ManufacturerTrade Name( Vaccine abbreviation)1 How SuppliedMercuryContent(mcg )Age RangeVaccine Product Billing Code2 CPTM edicareGlaxoSmithKlineFluarix (IIV4) mL (single-dose syringe)06 months & older90686 90686ID Biomedical Corp. of Quebec, a subsidiary of GlaxoSmithKlineFluLaval (IIV4) mL (single-dose syringe)06 months & mL (multi-dose vial)<256 months & older90688 90688 MedImmuneFluMist (LAIV4) mL (single-use nasal spray)02 through 49 years9067290672 Protein Sciences Corporation, a Sanofi companyFlublok (RIV4) mL (single-dose syringe)018 years & older9068290682 Sanofi Pasteur, (IIV4) mL (single-dose syringe)06 through 35 months90685 mL (single-dose syringe)03 years & older90686 mL (single-dose vial)03 years & older90686 mL (multi-dose vial)256 through 35 months90687 mL (multi-dose vial)253 years & older90688 90688 Fluzone High-Dose (IIV3-HD) mL (single-dose syringe)065 years & older90662 90662 SeqirusAfluria (IIV3)
2 ML (single-dose syringe)05 years & mL (multi-dose vial) (IIV4) mL (single-dose syringe)05 years & mL (multi-dose vial) (aIIV3) mL (single-dose syringe)065 years & older9065390653 Flucelvax (ccIIV4) mL (single-dose syringe)04 years & older90674 mL (multi-dose vial)259075690756 Footnotes1. IIV3/IIV4 = egg-based trivalent/quadrivalent inactivated Influenza Vaccine (injectable); where necessary to refer to cell culture-based Vaccine , the prefix cc is used ( , ccIIV4); RIV4 = quadrivalent recombinant hemagglutinin Influenza Vaccine (injectable); aIIV3 = adjuvanted trivalent inactivated Influenza An administration code should always be reported in addition to the Vaccine product code. Note: Third party payers may have specific policies and guidelines that might require providing additional information on their claim Afluria is approved by the Food and Drug Administration for intramuscular administration with the PharmaJet Stratis Needle-Free Injection System for persons age 18 through 64 Vaccine Products for the 2018 2019 Influenza SeasonImmunization Action Coalition Saint Paul, Minnesota 651-6 47-9009 content reviewed by the Centers for Disease Control and Item #P4072 (8/18)
