| Procedure Code | Description | Setting | Coverage |
|---|---|---|---|
| 90476 | ADENOVIRUS VACCINE, TYPE 4, LIVE, FOR ORAL USE | outpatient | covered |
| 90477 | ADENOVIRUS VACCINE, TYPE 7, LIVE, FOR ORAL USE | outpatient | covered |
| 90581 | ANTHRAX VACCINE, FOR SUBCUTANEOUS OR INTRAMUSCULAR USE | outpatient | covered |
| 90585 | BACILLUS CALMETTE-GUERIN VACCINE (BCG) FOR TUBERCULOSIS, LIVE, FOR PERCUTANEOUS USE | outpatient | covered |
| 90587 | DENGUE VACCINE, QUADRIVALENT, LIVE, 3 DOSE SCHEDULE, FOR SUBCUTANEOUS USE | outpatient | covered |
| 90619 | MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS A, C, W, Y, QUADRIVALENT, TETANUS TOXOID CARRIER (MENACWY-TT), FOR INTRAMUSCULAR USE | outpatient | covered |
| 90620 | MENINGOCOCCAL RECOMBINANT PROTEIN AND OUTER MEMBRANE VESICLE VACCINE, SEROGROUP B (MENB-4C), FOR INTRAMUSCULAR USE | outpatient | covered |
| 90621 | MENINGOCOCCAL RECOMBINANT LIPOPROTEIN VACCINE, SEROGROUP B (MENB-FHBP), 2 OR 3 DOSE SCHEDULE, FOR INTRAMUSCULAR USE | outpatient | covered |
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