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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
00480-4320-01 00480-4320 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 28, 2023 In Use
55513-0530-10 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb 20, 2015 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
00944-2656-03 00944-2656 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
54868-5229-00 54868-5229 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Feb 23, 2006 Dec 31, 2011 No Longer Used
55513-0530-01 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
00187-5526-75 00187-5526 Bexarotene Targretin 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec 29, 1999 In Use
61748-0301-01 61748-0301 Isotretinoin Myorisan 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 1, 2012 In Use
61269-0850-10 61269-0850 Tretinoin TRETINOIN 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb 1, 2024 In Use
43602-0176-01 43602-0176 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 6, 2024 In Use
72143-0251-30 72143-0251 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug 1, 2022 In Use
54868-5305-00 54868-5305 Isotretinoin Amnesteem Hormonal Therapy Immunomodulator Retinoic Acid Derivative Jan 6, 2012 Sep 16, 2008 No Longer Used
57664-0023-97 57664-0023 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec 29, 2020 In Use
57664-0025-97 57664-0025 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec 29, 2020 In Use
61269-0750-10 61269-0750 Tretinoin Vesanoid 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb 1, 2024 In Use
00591-2435-15 00591-2435 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Apr 29, 2021 In Use
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Jan 31, 2023 No Longer Used
60505-0501-04 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sep 14, 2012 Mar 31, 2018 No Longer Used
64380-0129-02 64380-0129 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 16, 2022 In Use
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Jan 31, 2023 No Longer Used
00093-5740-19 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Dec 31, 2022 No Longer Used
64380-0127-02 64380-0127 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 16, 2022 In Use
72143-0252-30 72143-0252 ISOTRETINOIN ACCUTANE 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug 1, 2022 In Use
59651-0347-01 59651-0347 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 6, 2023 In Use

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