| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 76961-0101-01 | 76961-0101 | Eflapegrastim-xnst | Rolvedon | 13.2 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | Subcutaneous | Oct 18, 2022 | In Use | |
| 44206-0456-21 | 44206-0456 | HUMAN IMMUNOGLOBULIN G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | In Use | |
| 70121-1568-01 | 70121-1568 | Filgrastim | RELEUKO | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Feb 25, 2022 | In Use | |
| 67457-0833-06 | 67457-0833 | Pegfilgrastim | Fulphila | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Jul 9, 2018 | May 31, 2026 | In Use |
| 00024-5843-01 | 00024-5843 | Sargramostim | Leukine | 250.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Nov 5, 2013 | Dec 30, 2021 | No Longer Used |
| 63459-0910-36 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 2, 2015 | In Use | |
| 58468-0180-02 | 58468-0180 | Sargramostim | Leukine | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Mar 15, 2010 | Jun 30, 2016 | No Longer Used | ||
| 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 | |
| 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 | |||
| 00480-4320-01 | 00480-4320 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 28, 2023 | Feb 28, 2026 | In Use |
| 72143-0233-30 | 72143-0233 | ISOTRETINOIN | ACCUTANE | 30.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jan 11, 2021 | Jan 31, 2024 | No Longer Used |
| 00378-1942-01 | 00378-1942 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 7, 2023 | In Use | |
| 54868-4554-01 | 54868-4554 | Imiquimod | Aldara | Immunotherapy | Immunomodulator | Dermatological Agent | Topical | Jun 19, 2003 | Sep 30, 2009 | No Longer Used | |
| 76282-0696-48 | 76282-0696 | LENALIDOMIDE | LENALIDOMIDE | 2.5 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Jun 10, 2024 | In Use | |
| 63850-0131-01 | 63850-0131 | Pomalidomide | Pomalidomide | 1.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Nov 1, 2025 | In Use | |
| 82293-0007-10 | 82293-0007 | Lenalidomide | Lenalidomide | 5.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Jan 6, 2026 | In Use | |
| 57664-0020-97 | 57664-0020 | Isotretinoin | Isotretinoin | 10.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Dec 29, 2020 | In Use | |
| 59651-0347-07 | 59651-0347 | Lenalidomide | Lenalidomide | 25.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 59651-0346-07 | 59651-0346 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 59651-0345-07 | 59651-0345 | Lenalidomide | Lenalidomide | 15.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 69097-0384-81 | 69097-0384 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 7, 2023 | In Use | |
| 82293-0009-10 | 82293-0009 | Lenalidomide | Lenalidomide | 15.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Jan 6, 2026 | In Use | |
| 59572-0215-93 | 59572-0215 | Thalidomide | Thalomid | 150.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 20, 2007 | In Use | |
| 59651-0194-21 | 59651-0194 | Pomalidomide | Pomalidomide | 1.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Oct 30, 2020 | In Use |
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