| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 44206-0457-95 | 44206-0457 | Human Immunoglobulin G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | In Use | |
| 63459-0910-11 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 11, 2013 | In Use | |
| 68083-0155-01 | 68083-0155 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | May 3, 2024 | In Use | |
| 82737-0073-01 | 82737-0073 | Motixafortide | Aphexda | 62.0 mg/1.7mL | Ancillary Therapy | Immunostimulant | Stem cell mobilizer | Subcutaneous | Sep 8, 2023 | In Use | |
| 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 | |
| 00069-0293-10 | 00069-0293 | filgrastim-aafi | Nivestym | 300.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Mar 11, 2019 | In Use | |
| 54868-5020-00 | 54868-5020 | Filgrastim | Neupogen | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous | Mar 11, 2004 | In Use | |
| 29336-0610-24 | 29336-0610 | Imiquimod | Aldara | Immunotherapy | Immunomodulator | Dermatological Agent | Topical | Jun 24, 2011 | Jun 24, 2011 | No Longer Used | |
| 57664-0022-97 | 57664-0022 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Dec 29, 2020 | In Use | |
| 68084-0879-25 | 68084-0879 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 30, 2015 | In Use | |
| 00185-0932-30 | 00185-0932 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jan 13, 2000 | Mar 31, 2020 | No Longer Used |
| 59651-0342-07 | 59651-0342 | Lenalidomide | Lenalidomide | 2.5 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 68084-0921-25 | 68084-0921 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Nov 3, 2015 | In Use | |
| 00245-0570-01 | 00245-0570 | Isotretinoin | Isotretinoin | 10.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Sep 21, 2021 | In Use | |
| 00074-3108-32 | 00074-3108 | Cyclosporine | Gengraf | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Nov 1, 2015 | In Use | |
| 00078-0274-22 | 00078-0274 | Cyclosporine | NeOral | 100.0 mg/mL | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jul 14, 1995 | In Use | |
| 10631-0005-31 | 10631-0005 | isotretinoin | Absorica LD | 24.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Nov 20, 2019 | In Use | |
| 00115-1476-23 | 00115-1476 | Imiquimod | Imiquimod | 50.0 mg/g | Immunotherapy | Immunomodulator | Dermatological Agent | Topical | Feb 28, 2011 | Jun 1, 2017 | No Longer Used |
| 61748-0301-01 | 61748-0301 | Isotretinoin | Myorisan | 10.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | May 1, 2012 | In Use | |
| 72143-0234-30 | 72143-0234 | ISOTRETINOIN | ACCUTANE | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jan 11, 2021 | Dec 31, 2023 | No Longer Used |
| 43598-0511-01 | 43598-0511 | Lenalidomide | Lenalidomide | 5.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 70710-1025-08 | 70710-1025 | Isotretinoin | Isotretinoin | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Sep 12, 2023 | In Use | |
| 55154-2396-00 | 55154-2396 | cyclosporine | Gengraf | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 24, 2010 | Mar 31, 2016 | No Longer Used |
| 00074-0541-30 | 00074-0541 | Cyclosporine | Gengraf | 50.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jun 20, 2016 | Apr 27, 2018 | No Longer Used |
| 29336-0610-12 | 29336-0610 | Imiquimod | Aldara | Immunotherapy | Immunomodulator | Dermatological Agent | Topical | Sep 24, 2010 | Jan 31, 2015 | No Longer Used |
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