| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
| 70114-0101-01 | 70114-0101 | pegfilgrastim-cbqv | UDENYCA | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 2, 2018 | In Use | |
| 72205-0249-01 | 72205-0249 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 25, 2023 | 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 | |
| 63459-0912-36 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 2, 2015 | 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 | |
| 55513-0546-01 | 55513-0546 | Filgrastim | Neupogen | 480.0 ug/1.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Apr 7, 1997 | 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 |
| 55513-0924-10 | 55513-0924 | Filgrastim | Neupogen | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Oct 2, 2000 | In Use | |
| 63459-0910-17 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 2, 2015 | In Use | |
| 61314-0312-01 | 61314-0312 | filgrastim-sndz | Zarxio | 480.0 ug/.8mL, 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Sep 3, 2015 | Feb 28, 2021 | No Longer Used |
| 44206-0456-94 | 44206-0456 | HUMAN IMMUNOGLOBULIN G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | In Use | |
| 59651-0342-28 | 59651-0342 | Lenalidomide | Lenalidomide | 2.5 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 70771-1677-07 | 70771-1677 | LENALIDOMIDE | LENALIDOMIDE | 5.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 12, 2022 | In Use | |
| 63850-0132-01 | 63850-0132 | Pomalidomide | Pomalidomide | 2.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Nov 1, 2025 | In Use | |
| 59651-0346-01 | 59651-0346 | Lenalidomide | Lenalidomide | 20.0 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 | |
| 61748-0304-11 | 61748-0304 | Isotretinoin | Myorisan | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | May 1, 2012 | 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 |
| 45802-0368-62 | 45802-0368 | Imiquimod | Imiquimod | 12.5 mg/.25g | Immunotherapy | Immunomodulator | Dermatological Agent | Topical | Nov 9, 2010 | In Use | |
| 59572-0503-21 | 59572-0503 | Pomalidomide | Pomalyst | 3.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Feb 18, 2013 | In Use | |
| 00172-7311-00 | 00172-7311 | Cyclosporine Modified | Cyclosporine Modified | 50.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Apr 28, 2005 | Feb 28, 2017 | No Longer Used |
| 31722-0380-01 | 31722-0380 | Bexarotene | Bexarotene | 75.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | May 21, 2025 | In Use | |
| 54868-6185-00 | 54868-6185 | Isotretinoin | Claravis | 30.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Oct 4, 2013 | In Use | |
| 00004-0156-49 | 00004-0156 | Isotretinoin | Accutane | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | May 7, 1982 | Dec 22, 2010 | No Longer Used |
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