Vaccines

Divisions

Vaccine Brandname NDC Manufacturer Packaging
DTaP [1] Daptacel® 49281-0286-10 Sanofi Pasteur 10 pack – 1 dose vial
DTaP [1] Infanrix® 58160-0810-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0810-52 10 pack – 1 dose T-L syringe
DTaP-IPV [2] Kinrix® 58160-0812-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0812-52 10 pack – 1 dose syringe
DTaP-Hep B-IPV [4] Pediarix® 58160-0811-52 GlaxoSmithKline 10 pack – 1 dose syringe
DTaP-IP-HI [4] Pentacel® 49281-0510-05 Sanofi Pasteur 5 pack – 1 dose vial
e-IPV [5] IPOL® 49281-0860-10 Sanofi Pasteur 10 dose vial
Hepatitis A Pediatric [5] Vaqta® 00006-4831-41 Merck 10 pack – 1 dose vial
00006-4095-02 10 pack – 1 dose syringe
Hepatitis A Pediatric [5] Havrix® 58160-0825-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0825-52 10 pack – 1 dose syringe
Hepatitis A-Hepatitis B 18 only [3] Twinrix® 58160-0815-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0815-52 10 pack – 1 dose syringe
Hepatitis B [5]Pediatric/Adolescent Engerix B® 58160-0820-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0820-52 10 pack – 1 dose syringe
Hepatitis B [5]Pediatric/Adolescent Recombivax 00006-4981-00 Merck 10 pack – 1 dose vial
HB® 00006-4093-02 10 pack – 1 dose syringe
Hib [5] PedvaxHIB® 00006-4897-00 Merck 10 pack – 1 dose vial
Hib [5] ActHIB® 49281-0545-05 Sanofi Pasteur 5 pack – 1 dose vial
HIBMENCY [3] MENHIBRIX® 58160-0801-11 GlaxoSmithKline 10 pack – 1 dose vial
HPV – Quadrivalent Human Papillomavirus Types 6, 11, 16 and 18 Recombinant [5] Gardasil® 00006-4045-41 Merck 10 pack – 1 dose vial
HPV – Human Papillomavirus 9-valent [5] Gardasil®9 00006-4119-03 Merck 10 pack – 1 dose vial
HPV -Bivalent Human Papillomavirus Types 16 and 18 [5] Cervarix® 58160-0830-52 GlaxoSmithKline 10 pack-1 dose syringe
MENB – Meningococcal Group B [5] Trumenba® 00005-0100-10 Pfizer 10 pack – 1 dose syringe
MENB – Meningococcal Group B [5] Bexsero® 46028-0114-01 GlaxoSmithKline 10 pack – 1 dose syringe
46028-0114-02 GlaxoSmithKline 1 pack – 1 dose syringe
Meningococcal Conjugate (Groups A, C, Y and W-135) [5] Menactra® 49281-0589-05 Sanofi Pasteur 5 pack – 1 dose vial
Meningococcal Conjugate (Groups A, C, Y and W-135) [5] Menveo® 46028-0208-01 GlaxoSmithKline 5 pack – 1 dose vial
Measles, Mumps and Rubella (MMR) [1] M-M-R®II 00006-4681-00 Merck 10 pack – 1 dose vial
MMR/Varicella [2] ProQuad® 00006-4171-00 Merck 10 pack – 1 dose vial
Pneumococcal
13-valent [5] (Pediatric)
Prevnar 13 TM 00005-1971-02 Pfizer 10 pack – 1 dose syringe
Pneumococcal Polysaccharide (23 Valent) Pneumovax®23 00006-4943-00 Merck 10 pack – 1 dose vial
Rotavirus, Live, Oral, Pentavalent [5] RotaTeq® 00006-4047-41 Merck 10 pack – 1 dose tube
00006-4047-20 25 pack – 1 dose tube
Rotavirus, Live, Oral, Oral [5] Rotarix® 58160-0854-52 GlaxoSmithKline 10 pack – 1 dose vial
Tetanus & Diphtheria Toxoids [3] Tenivac® 49281-0215-15 Sanofi Pasteur 10 pack – 1 dose syringe
49281-0215-10 10 pack – 1 dose vial
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis [1] Boostrix® 58160-0842-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0842-52 10 pack – 1 dose syringe
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis [1] Adacel® 49281-0400-10 Sanofi Pasteur 10 pack – 1 dose vial
49281-0400-15 5 pack – 1 dose syringe
Varicella [5] Varivax® 00006-4827-00 Merck 10 pack – 1 dose vial
 
Adult Vaccine Price List
Vaccine Brandname/ Tradename NDC Manufacturer Packaging
Hepatitis A-Adult [5] Vaqta® 00006-4096-02 Merck 10 pack – 1 dose syringe
00006-4841-41 10 pack – 1 dose vial
Hepatitis A Adult [5] Havrix® 58160-0826-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0826-52 10 pack – 1 dose syringe
Hepatitis A-Hepatitis B Adult [3] Twinrix® 58160-0815-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0815-52 10 pack – 1 dose syringe
Hepatitis B-Adult [5] Recombivax HB® 00006-4995-41 Merck 10 pack – 1 dose vial
00006-4094-02 10 pack- 1 dose syringe
Hepatitis B-Adult [5] Engerix-B® 58160-0821-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0821-52 10 pack – 1 dose syringe
HPV -Quadrivalent Human Papillomavirus Types 6, 11, 16 and 18 Recombinant Adult [5] Gardasil® 00006-4045-41 Merck 10 pack – 1 dose vial
HPV-Human Papillomavirus 9 Valent [5] Gardasil®9 00006-4119-03 Merck 10 pack – 1 dose vial
HPV-Human Papillomavirus Bivalent Types 16 and 18 [5] Cervarix® 58160-0830-52 GlaxoSmithKline 10 pack – 1 dose syringe
Measles, Mumps, & Rubella-Adult [1] M-M-R®II 00006-4681-00 Merck 10 pack – 1 dose vials
Meningococcal Conjugate [5] Menveo® 46028-0208-01 GlaxoSmithKline 5 pack – 1 dose vial
Meningococcal Conjugate [5] Menactra 49281-0589-05 Sanofi 5 pack – 1 dose vial
MENB – Meningococcal Group B [5] Trumenba® 00005-0100-10 Pfizer 10 pack – 1 dose syringe
MENB – Meningococcal Group B [5] Bexsero® 46028-0114-01 GlaxoSmithKline 10 pack – 1 dose syringe
46028-0114-02 1 pack – 1 dose syringe
Pneumococcal
13-valent [5] (Adult)
Prevnar 13™ 00005-1971-02 Pfizer 10 pack – 1 dose syringes
Pneumococcal Polysaccharide (23 Valent) Pneumovax®23 00006-4837-03 Merck 10 pack – 1 dose syringes
00006-4943-00 10 pack – single dose vial
Tetanus and Diphtheria Toxoids[3] Tenivac 49281-0215-10 Sanofi 10 pack – 1 dose vial
49281-0215-15 10 pack – 1 dose syringe
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis [1] Adacel 49281-0400-10 Sanofi 10 pack – 1 dose vial
49281-0400-15 5 pack – 1 dose syringe
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis [1] Boostrix® 58160-0842-11 GlaxoSmithKline 10 pack – 1 dose vial
58160-0842-52 10 pack – 1 dose syringe
Varicella-Adult [5] Varivax® 00006-4827-00 Merck 10 pack – 1 dose vial
Zoster Vaccine Live Zostavax® 00006-4963-41 Merck 10 pack – 1 dose vial
 
Pediatric Influenza Vaccine Price List
Vaccine Brandname/ Tradename NDC Manufacturer Packaging
Influenza [5] (Age 6 months and older) Fluzone® 49281-0396-15 Sanofi Pasteur 10 dose vial
Fluzone® 49281-0623-15 10 dose vial
Quadrivalent
Influenza [5]
(Age 6-35 months)
Fluzone® 49281-0515-25 Sanofi Pasteur 10 pack – 1 dose syringe
Quadrivalent
Pediatric dose
No Preservative
Influenza [5]
(Age 36 months and older)
Fluzone® 49281-0415-50 Sanofi Pasteur 10 pack – 1 dose syringe
Quadrivalent
No-Preservative 49281-0415-10 10 pack – 1 dose vial
Influenza [5]
(Age 36 months and older)
Fluarix® 58160-0903-52 GlaxoSmithKline 10 pack- 1 dose
Quadrivalent TipLok syringe
Preservative Free  
Influenza [5]
(Age 36 months and older)
FluLaval 19515-0898-11 GlaxoSmithKline 10 dose vial
Quadrivalent
Influenza [5]
(Age 4 years and older)
Fluvirin® 66521-0118-10 Novartis 10 dose vial
Influenza [5]
(Age 4 years and older)
Fluvirin® 66521-0118-02 Novartis 10 pack -1 dose syringe
Preservative Free
Influenza [5] Live, Intranasal
(Age 2-49 years)
FluMist® 66019-0302-10 MedImmune 10 pack- 1 dose sprayer (Intranasal)
Quadrivalent
No Preservative
Influenza [5]
(Age 9 years and older)
Afluria® 33332-0015-01 bioCSL 10 pack-1 dosesy ringe
No Preservative
Influenza [5] Afluria® 33332-0115-10 bioCSL 10 dose vial
(Age 9 years and older)
 
Adult Influenza Vaccine Price List
Vaccine Brandname/ Tradename NDC Manufacturer Packaging
Influenza [5]
(Age 6 months and older)
Fluzone® 49281-0396-15 Sanofi Pasteur 10 dose vial
Influenza [5] (Age 6 months and older) Fluzone® 49281-0623-15 Sanofi Pasteur 10 dose vial
Quadrivalent
Influenza [5]
(Age 36 months and older)
Fluzone® 49281-0415-10 Sanofi Pasteur 10 pack – 1 dose vial
Quadrivalent
No Preservative 49281-0415-50 10 pack – 1 dose syringe
Influenza [5] (Age 18 years and older) Flucelvax® 62577-0614-01 Novartis 10 pack – 1 dose syringe
Preservative Free
Antibiotic free
Influenza [5]
(Age 4 years and older)
Fluvirin® 66521-0118-10 Novartis 10 dose vial
Influenza [5] (Age 4 years and older) Fluvirin® 66521-0118-02 Novartis 10 pack -1 dose syringe
Preservative Free
Influenza [5] (Age 36 months and older) Fluarix® 58160-0903-52 GlaxoSmithKline 10 pack- 1 dose
Quadrivalent TipLok syringe
Preservative Free
Influenza [5] (Age 36 months and older) FluLaval Quadrivalent 19515-0898-11 GlaxoSmithKline 10 dose vial
Influenza [5] (Age 9 years and older) Afluria® 33332-0015-01 bioCSL 10 pack-1 dose
No Preservative syringe
Influenza [5]
(Age 9 years and older)
Afluria® 33332-0115-10 bioCSL 10 dose vials-1 pack
Influenza [5] (Age 18 years and older) Flublok® No Preservative 42874-0015-10 Protein Sciences 10 pack – 1 dose vial