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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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00006-4119-03 | 00006-4119 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 00006-4119-02 | 00006-4119 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | May 22, 2019 | In Use |
| 00006-4121-01 | 00006-4121 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 00006-4121-02 | 00006-4121 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 00006-4119-01 | 00006-4119 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 57894-0503-01 | 57894-0503 | Daratumumab and hyaluronidase-fihj (human recombinant) | Darzalex Faspro | 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL | Immunotherapy | Monoclonal Antibody | CD38 | Subcutaneous | May 1, 2020 | In Use | |
| 00006-4109-06 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | May 6, 2011 | In Use |
| 50090-1523-09 | 50090-1523 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4045-00 | 00006-4045 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 50090-1523-01 | 50090-1523 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4109-02 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4045-01 | 00006-4045 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4109-01 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4045-41 | 00006-4045 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 00006-4109-09 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | In Use | |
| 50242-0245-01 | 50242-0245 | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf | Phesgo | 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL | Immunotherapy | Monoclonal Antibody | HER2 | Subcutaneous | Jun 29, 2020 | In Use | |
| 50242-0245-86 | 50242-0245 | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf | Phesgo | 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL | Immunotherapy | Monoclonal Antibody | HER2 | Subcutaneous | May 3, 2021 | In Use | |
| 50242-0260-01 | 50242-0260 | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf | Phesgo | 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL | Immunotherapy | Monoclonal Antibody | HER2 | Subcutaneous | Jun 29, 2020 | In Use | |
| 50242-0260-86 | 50242-0260 | Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf | Phesgo | 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL | Immunotherapy | Monoclonal Antibody | HER2 | Subcutaneous | May 3, 2021 | In Use | |
| 50242-0108-86 | 50242-0108 | Rituximab and hyaluronidase | Rituxan Hycela | 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL | Immunotherapy | Monoclonal Antibody | CD20 | Subcutaneous | Jun 23, 2017 | In Use | |
| 50242-0108-01 | 50242-0108 | Rituximab and hyaluronidase | Rituxan Hycela | 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL | Immunotherapy | Monoclonal Antibody | CD20 | Subcutaneous | Jun 22, 2017 | In Use | |
| 50242-0109-01 | 50242-0109 | Rituximab and hyaluronidase | Rituxan Hycela | 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL | Immunotherapy | Monoclonal Antibody | CD20 | Subcutaneous | Jun 22, 2017 | In Use | |
| 50242-0077-01 | 50242-0077 | Trastuzumab and Hyaluronidase-oysk | Herceptin Hylecta | 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL | Immunotherapy | Monoclonal Antibody | HER2 | Subcutaneous | Feb 28, 2019 | In Use | |
| 00069-9142-11 | 00069-9142 | Docetaxel | Docetaxel | 80.0 mg/8mL, 80.0 mg/8mL | Chemotherapy | Antimitotic Agent | Taxane | Intravenous | Jun 23, 2014 | Aug 31, 2017 | No Longer Used |
| 00069-9142-22 | 00069-9142 | Docetaxel | Docetaxel | 80.0 mg/8mL, 80.0 mg/8mL | Chemotherapy | Antimitotic Agent | Taxane | Intravenous | Jun 23, 2014 | May 31, 2016 | No Longer Used |
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