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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
70114-0101-01 70114-0101 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 2, 2018 In Use
57962-0560-28 57962-0560 Ibrutinib IMBRUVICA 560.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb 16, 2018 Feb 28, 2025 In Use
57962-0560-71 57962-0560 Ibrutinib IMBRUVICA 560.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb 6, 2019 Dec 31, 2020 In Use
71997-0100-01 71997-0100 DEXAMETHASONE Dexycu 517.0 ug/.005mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid INTRAOCULAR Oct 1, 2018 Oct 1, 2018 No Longer Used
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous Apr 29, 2010 In Use
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov 12, 2021 In Use
25021-0465-01 25021-0465 Octreotide acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Jun 15, 2023 In Use
67457-0246-01 67457-0246 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Apr 1, 2011 In Use
25021-0453-01 25021-0453 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec 15, 2013 Feb 28, 2023 In Use
63323-0377-01 63323-0377 OCTREOTIDE ACETATE Octreotide 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Mar 14, 2006 In Use
71837-5844-01 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
23155-0689-41 23155-0689 OCTREOTIDE ACETATE OCTREOTIDE ACETATE 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Sep 3, 2019 In Use
00703-3321-01 00703-3321 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Nov 14, 2005 In Use
00078-0182-61 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug 13, 2012 In Use
00024-5844-05 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec 1, 1996 Dec 30, 2021 No Longer Used
00024-5844-01 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec 1, 1996 Dec 30, 2021 No Longer Used
64679-0635-02 64679-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0635-01 64679-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
62756-0351-44 62756-0351 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug 14, 2007 Nov 30, 2016 No Longer Used
00703-3321-91 00703-3321 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Jan 28, 2008 Oct 31, 2011 In Use
00078-0182-01 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct 21, 1988 In Use
00781-3168-71 00781-3168 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 4, 2014 Feb 4, 2014 In Use
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
00781-3168-95 00781-3168 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 4, 2014 Feb 14, 2014 In Use

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