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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
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
61314-0866-02 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Mar 3, 2025 In Use
58468-0181-02 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 15, 2010 Dec 31, 2013 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
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous Sep 1, 2023 In Use
00555-1057-86 00555-1057 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
99207-0260-01 99207-0260 Imiquimod Aldara 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 27, 1997 Dec 31, 2015 No Longer Used
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jul 7, 2006 In Use
47781-0485-28 47781-0485 Lenalidomide LENALIDOMIDE 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 3, 2022 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
00480-1241-28 00480-1241 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 8, 2023 In Use
00078-0241-61 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Mar 22, 2010 In Use
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Jul 12, 2012 In Use
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous Apr 29, 2010 In Use
60505-0133-02 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec 31, 2022 In Use
60505-0501-05 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sep 14, 2012 Mar 31, 2018 No Longer Used
70710-1031-01 70710-1031 LENALIDOMIDE LENALIDOMIDE 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 12, 2022 In Use
69189-0464-01 69189-0464 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan 8, 2016 May 24, 2017 No Longer Used
59572-0205-14 59572-0205 Thalidomide Thalomid 50.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 20, 2003 In Use
00074-6463-32 00074-6463 Cyclosporine Modified Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Aug 31, 2017 No Longer Used
59651-0635-03 59651-0635 ISOTRETINOIN ISOTRETINOIN 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan 29, 2024 In Use
68308-0573-30 68308-0573 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 21, 2021 In Use
70377-0050-13 70377-0050 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2025 In Use

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