diff --git a/src/main/java/org/mitre/synthea/modules/CardiovascularDiseaseModule.java b/src/main/java/org/mitre/synthea/modules/CardiovascularDiseaseModule.java
index 4ae6a0663f..a46db83491 100644
--- a/src/main/java/org/mitre/synthea/modules/CardiovascularDiseaseModule.java
+++ b/src/main/java/org/mitre/synthea/modules/CardiovascularDiseaseModule.java
@@ -14,6 +14,7 @@
 import org.mitre.synthea.helpers.Utilities;
 import org.mitre.synthea.world.agents.Person;
 import org.mitre.synthea.world.concepts.ClinicianSpecialty;
+import org.mitre.synthea.world.concepts.HealthRecord;
 import org.mitre.synthea.world.concepts.HealthRecord.Code;
 import org.mitre.synthea.world.concepts.HealthRecord.Encounter;
 import org.mitre.synthea.world.concepts.HealthRecord.EncounterType;
@@ -757,7 +758,11 @@ private static void atrialFibrillationTreatment(Person person, long time) {
 
   private static void prescribeMedication(String med, Person person, long time, boolean chronic) {
     Medication entry = person.record.medicationStart(time, med, chronic);
-    entry.codes.add(LOOKUP.get(med));
+    HealthRecord.Code medicationCode = LOOKUP.get(med);
+    if (! entry.containsCode(medicationCode.code, medicationCode.system)) {
+      entry.codes.add(medicationCode);
+    }
+
     // increment number of prescriptions prescribed
     Encounter encounter = (Encounter) person.attributes.get(CVD_ENCOUNTER);
     if (encounter != null) {
@@ -780,7 +785,9 @@ public static void performEncounter(Person person, long time, Encounter encounte
           && !person.record.present.containsKey(diagnosis)) {
         Code code = LOOKUP.get(diagnosis);
         Entry conditionEntry = person.record.conditionStart(time, code.display);
-        conditionEntry.codes.add(code);
+        if (! conditionEntry.containsCode(code.code, code.system)) {
+          conditionEntry.codes.add(code);
+        }
       }
     }
 
@@ -908,4 +915,4 @@ public static void inventoryAttributes(Map<String,Inventory> attributes) {
     Attributes.inventory(attributes, m, "stroke_points", false, true, "Numeric");
     Attributes.inventory(attributes, m, "stroke_history", false, true, "true");
   }
-}
+}
\ No newline at end of file