NDC 0069-0297OTC monographFDA BLA · BLA125740

TicoVac

Active substance: Tick-Borne Encephalitis Vaccine

FDA labeler: Pfizer Laboratories Div Pfizer Inc

2 formulations • 6 package configurations
All 8 registered NDCs — click to copy
In one line

TicoVac (Tick-Borne Encephalitis Vaccine) NDC 0069-0297 converts to 00069-0297-02 for billing and bills under J3590 at Per Administration.

openFDA Live Registry SyncHIPAA 5-4-2 StandardCMS Level II Crosswalk
Listing: 0069-0297
Billing & reimbursement crosswalk

NDC • HCPCS Level II • CPT administration

HCPCS Level II J-Code
J3590
Unclassified biologics (requires invoice & NDC on claim)
Billable unit: Per Administration
11-digit HIPAA NDC
00069-0297-02
Zero-padded 5-4-2 format
Standard conversion
CPT administration code
96401
Chemotherapy / Complex Biologic administration, subcutaneous or intramuscular
UB-04 revenue code
Rev 0636
0636 (Pharmacy - Extension of 0250 Drugs Requiring Detail)
Qualifier: UN

Interactive Unit Multiplier Calculator

J3590

Calculate the exact number of billable HCPCS units to report on CMS-1500 / 837P claims based on the patient dose and single-dose vial waste.

MG
Units to report on claim:
100 Units
Based on 1 mg = 1 billable unit (100.0 exact)
Box 24 / HCPCS Quantity Formatted Line:J3590 UN100 (N40069029702)
Complete drug registry

All registered strengths & packaging

Every registered strength and package for TicoVac, with 10-digit and 11-digit NDC formats
Formulation / rolePackage NDCProduct NDC11-digit HIPAAPackaging detailCopy
1.2 ug/.25mL0069-0297-020069-029700069-0297-021 SYRINGE in 1 CARTON (0069-0297-02) / .25 mL in 1 SYRINGE (0069-0297-01)
Prefilled syringe0069-0297-010069-029700069-0297-01Inner component of kit (0069-0297-02)
1.2 ug/.25mL0069-0297-100069-029700069-0297-1010 SYRINGE in 1 CARTON (0069-0297-10) / .25 mL in 1 SYRINGE (0069-0297-01)
2.4 ug/.5mL0069-0411-020069-041100069-0411-021 SYRINGE in 1 CARTON (0069-0411-02) / .5 mL in 1 SYRINGE (0069-0411-01)
Prefilled syringe0069-0411-010069-041100069-0411-01Inner component of kit (0069-0411-02)
2.4 ug/.5mL0069-0411-100069-041100069-0411-1010 SYRINGE in 1 CARTON (0069-0411-10) / .5 mL in 1 SYRINGE (0069-0411-01)
FDA drug label

Prescribing information

No Structured Product Labeling submission was returned for this listing, so the sections below are derived from its FDA registration record rather than the manufacturer's label.

6 Label Sections
TicoVac is indicated for clinical therapeutic management as active pharmaceutical therapy containing TICK-BORNE ENCEPHALITIS PURIFIED ANTIGEN (FORMALDEHYDE INACTIVATED) (1.2 ug/.25mL).
Dosage must be individualized based on clinical therapeutic goals, route of administration (INTRAMUSCULAR), and patient response. Refer to licensed physician prescribing guidelines.
Supplied as INJECTION. Active ingredients: TICK-BORNE ENCEPHALITIS PURIFIED ANTIGEN (FORMALDEHYDE INACTIVATED) (1.2 ug/.25mL).
Contraindicated in patients with severe hypersensitivity to Tick-Borne Encephalitis Vaccine or formulation components.
Review complete patient medical history, potential contraindications, and drug-drug interactions prior to initiation.
Supplied under FDA Labeler: Pfizer Laboratories Div Pfizer Inc. Store according to manufacturer packaging specifications at controlled room temperature or refrigerated conditions as marked on commercial carton.
Labeler

Pfizer Inc.

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