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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
70383-0073-01 70383-0073 MOTIXAFORTIDE ACETATE Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sep 8, 2023 In Use
58468-0180-01 58468-0180 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Aug 5, 2013 Jun 30, 2016 No Longer Used
00944-2620-03 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sep 2, 2015 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
50419-0002-33 50419-0002 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Sep 5, 1991 Sep 21, 2012 No Longer Used
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2627-04 00944-2627 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Jun 21, 2014 In Use
59572-0420-00 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Jun 10, 2013 In Use
99207-0260-12 99207-0260 Imiquimod Aldara 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 27, 1997 Jun 30, 2022 No Longer Used
00378-6611-93 00378-6611 Isotretinoin Amnesteem 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov 11, 2002 In Use
61748-0301-13 61748-0301 Isotretinoin Myorisan 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 1, 2012 In Use
00115-1476-59 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb 28, 2011 Jun 1, 2017 No Longer Used
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
70771-1680-08 70771-1680 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 7, 2023 In Use
70771-1679-08 70771-1679 LENALIDOMIDE LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 12, 2022 In Use
57664-0022-97 57664-0022 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec 29, 2020 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
54868-5305-00 54868-5305 Isotretinoin Amnesteem Hormonal Therapy Immunomodulator Retinoic Acid Derivative Jan 6, 2012 Sep 16, 2008 No Longer Used
10631-0004-31 10631-0004 isotretinoin Absorica LD 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov 20, 2019 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
00078-0109-61 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Aug 10, 2012 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
31722-0262-01 31722-0262 LENALIDOMIDE LENALIDOMIDE 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
51862-0458-01 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 In Use
70710-1023-08 70710-1023 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 12, 2023 In Use

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