Violations Screen

Ref ID

The Ref ID assigned to the client via ImmTrac2 for PreCertification.  This is not the same as the Client ID.  

First Name

The client’s first name.

Last Name

The client’s last name.

DOB

Client’s date of birth..

Immunization Admin Date

The date the immunization in violation was administered.

NDC Code

The NDC Code submitted for the immunization in violation.

CVX Code

The CVX Code submitted for the immunization in violation.

CPT Code

The CPT Code submitted for the immunization in violation.

Trade Name

The Trade Name submitted for the immunization in violation.

Vaccine Group

The Vaccine Group submitted for the immunization in violation.

Manufacturer

The Manufacturer submitted for the immunization in violation.

Returns the user to the previous screen.