Influenza Vaccines 2023-2024 Season Last Updated: October 3, 2023

CPT Code

90686 90688 90687 90694 90686

90682

90756 90674 90686 90672 90662

CVX

150 150 158 205 150

185

186 171 150 149 197

90686

150

90687

158

90688

158

NDC

33332-322-03 33332-422-10 33332-422-10 70461-122-03 58160-909-52

49281-722-10

70461-422-10 70461-322-03 19515-814-52 66019-310-10 49281-123-65 49281-423-50 49281-423-10 49281-639-15 49281-639-15

Influenza Vaccines 2023-2024 Season Last Updated: October 3, 2023

PRESENTATION

0.5 mL 10 pre-filled syringes

DESCRIPTION

seasonal influenza, quadrivalent, preservative free

BRAND NAME

multi-dose vial, 5 mL (0.5 mL dose)

seasonal influenza, quadrivalent, with preservative

AFLURIA Quadrivalent

multi-dose vial, 5 mL (0.25 mL dose) 10 pre-filled syringes 10 pre-filled syringes

seasonal influenza, quadrivalent, with preservative

seasonal influenza, adjuvanted, preservative free

seasonal influenza, quadrivalent, preservative free

FLUAD Quadrivalent Fluarix Quadrivalent

10 pre-filled syringes

seasonal influenza, quadrivalent, derived from recombinant DNA,

preservative free

Flublok Quadrivalent

multi-dose vial, 5 mL

seasonal influenza, quadrivalent, MDCK, contains preservative

Flucelvax Quadrivalent

10 pre-filled syringes

seasonal influenza, quadrivalent, MDCK, preservative free

Flucelvax Quadrivalent

10 pre-filled syringes 10 single dose sprayers 10 pre-filled syringes 0.5 mL 10 pre-filled syringes 0.5 mL 10 single dose vials

seasonal influenza, quadrivalent, preservative free

seasonal influenza, liveattenuated, intranasal,

quadrivalent seasonal influenza, trivalent, high-

dose

seasonal influenza, quadrivalent, preservative free

seasonal influenza, quadrivalent, preservative free

FluLaval Quadrivalent FluMist Quadrivalent

Fluzone High Dose

Fluzone Quadrivalent

multi-dose vial, 5 mL

seasonal influenza, quadrivalent, Fluzone Quadrivalent Multidose

with preservative

Vials (0.25 mL dose)

multi-dose vial, 5 mL

seasonal influenza, quadrivalent, Fluzone Quadrivalent Multidose

with preservative

Vials (0.5 mL dose)

VFC COVERED?

Yes

No Yes No Yes Yes Yes Yes No Yes Yes Yes Yes

317 Adults Covered?

No

No Special Project Only (with advance approval)

No

No No Special Project Only (with advance approval) No No No No No Special Project Only (with advance approval)

Public Clinic "Billables"?

No

No No No No No No No No No No No No

CPT Code

90686 90688 90687 90694 90686 90682 90756 90674 90686 90672 90662

90686

90687 90688

CVX

150 158 158 205 150 185 186 171 150 149 197

150

158 158

NDC

33332-0322-03 33332-0422-10 33332-0422-10 70461-0122-03 58160-0890-52 49281-0722-10 70461-0422-10 70461-0322-03 19515-0808-52 66019-0309-10 49281-0122-65 49281-0422-50 49281-0422-10 49281- 0637-15 49281-0637-15

Historical Influenza Vaccines 2022-2023 Season Last Updated:

10/04/2023

PRESENTATION

0.5 mL 10 pre-filled syringes multi-dose vial, 5 mL (0.5 mL dose) multi-dose vial, 5 mL (0.25 mL dose)

DESCRIPTION

seasonal influenza, quadrivalent, preservative

free

seasonal influenza, quadrivalent, with

preservative

seasonal influenza, quadrivalent, with

preservative

10 pre-filled syringes

seasonal influenza, adjuvanted, preservative free

10 pre-filled syringes 10 pre-filled syringes

seasonal influenza, quadrivalent, preservative

free

seasonal influenza, quadrivalent, derived from

recombinant DNA, preservative free

multi-dose vial, 5 mL

seasonal influenza, quadrivalent, MDCK, contains

preservative

10 pre-filled syringes 10 pre-filled syringes 10 single dose sprayers

seasonal influenza, quadrivalent, MDCK,

preservative free

seasonal influenza, quadrivalent, preservative

free

seasonal influenza, liveattenuated, intranasal,

quadrivalent

BRAND NAME

AFLURIA Quadrivalent

FLUAD Quadrivalent Fluarix Quadrivalent Flublok Quadrivalent Flucelvax Quadrivalent Flucelvax Quadrivalent FluLaval Quadrivalent FluMist Quadrivalent

10 pre-filled syringes

seasonal influenza, trivalent, high-dose

Fluzone High Dose

VFC COVERED?

Yes

No Yes No Yes Yes Yes Yes No

seasonal influenza,

0.5 mL 10 pre-filled syringes

quadrivalent, preservative

Yes

free

Fluzone Quadrivalent

seasonal influenza,

0.5 mL 10 single dose vials

quadrivalent, preservative

Yes

free

multi-dose vial, 5 mL

seasonal influenza,

quadrivalent, with

Fluzone Quadrivalent Multidose

Yes

preservative

Vials (0.25 mL dose)

multi-dose vial, 5 mL

seasonal influenza,

quadrivalent, with

Fluzone Quadrivalent Multidose

Yes

preservative

Vials (0.5 mL dose)

317 Adults Covered?

No

No Special Project Only (with advance approval)

No

No

No Special Project Only (with advance approval)

No No

No No No Special Project Only (with advance approval)

Public Clinic "Billables"?

No

No No No No No No No No No No No No

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