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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
52125-0833-01 52125-0833 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Feb 13, 2014 Feb 11, 2015 No Longer Used
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
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
00006-4119-03 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
00006-4121-02 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
00944-2625-03 00944-2625 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Jun 21, 2014 In Use
00944-2627-04 00944-2627 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Jun 21, 2014 In Use
00944-2620-04 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sep 2, 2015 In Use
00944-2620-02 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Jul 18, 2015 In Use
00944-2620-01 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 1, 1998 May 1, 1998 In Use
00944-2623-02 00944-2623 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Jun 21, 2014 In Use
00944-2620-03 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sep 2, 2015 In Use
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2655-04 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G Jan 3, 2011 Aug 26, 2015 In Use
00944-2656-03 00944-2656 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2655-03 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 May 10, 1994 In Use
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
68152-0102-01 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 15, 2011 Feb 28, 2019 No Longer Used
68152-0102-02 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 15, 2011 Feb 28, 2019 No Longer Used
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 15, 2008 Feb 28, 2019 No Longer Used
53270-0101-01 53270-0101 Levoleucovorin Fusilev Ancillary Therapy Chemoprotective Antidote Aug 15, 2008 Feb 24, 2010 No Longer Used
68842-0301-12 68842-0301 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular May 29, 2019 In Use
43598-0262-23 43598-0262 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Sep 5, 2024 In Use
00310-7720-10 00310-7720 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct 8, 2019 Mar 31, 2023 No Longer Used

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