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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
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 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
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
65219-0284-12 65219-0284 PLERIXAFOR Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jun 22, 2023 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
00024-5843-05 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 1, 1991 Dec 30, 2021 No Longer Used
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
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
70114-0130-01 70114-0130 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 22, 2023 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
70121-1570-01 70121-1570 Filgrastim RELEUKO 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb 25, 2022 In Use
50419-0050-30 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 5, 1991 Sep 21, 2012 No Longer Used
72143-0231-30 72143-0231 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan 11, 2021 Dec 31, 2023 No Longer Used
42291-0870-01 42291-0870 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb 23, 2022 In Use
54868-5522-00 54868-5522 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb 10, 2006 In Use
47781-0484-28 47781-0484 Lenalidomide LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 3, 2022 In Use
57664-0023-97 57664-0023 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec 29, 2020 In Use
10631-0116-31 10631-0116 Isotretinoin Absorica 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jun 8, 2012 In Use
00078-0110-22 00078-0110 Cyclosporine Sandimmune 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 14, 1983 Dec 31, 2025 No Longer Used
70377-0050-13 70377-0050 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use
00245-0571-01 00245-0571 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 21, 2021 In Use
70377-0053-12 70377-0053 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use
68084-0879-95 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sep 30, 2015 In Use
68001-0653-17 68001-0653 ISOTRETINOIN ZENATANE 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jul 11, 2025 In Use
00378-6614-93 00378-6614 Isotretinoin Amnesteem 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov 11, 2002 In Use

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