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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
73441-0800-04 73441-0800 omidubicel-onlv OMISIRGE Ancillary Therapy Immunostimulant Stem cell mobilizer Intravenous May 1, 2023 In Use
50419-0050-14 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 5, 1991 Sep 21, 2012 No Longer Used
63459-0910-18 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan 7, 2015 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 7, 2018 In Use
58468-0181-01 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 15, 2010 Dec 31, 2013 No Longer Used
58468-0180-02 58468-0180 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Mar 15, 2010 Jun 30, 2016 No Longer Used
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
72374-0102-10 72374-0102 Filgrastim-txid NYPOZI 480.0 ug/480ug Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 16, 2024 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
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
72205-0249-01 72205-0249 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
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
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 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
62584-0827-11 62584-0827 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec 11, 2009 Sep 30, 2011 No Longer Used
31722-0261-21 31722-0261 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
72143-0231-30 72143-0231 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan 11, 2021 Dec 31, 2023 No Longer Used
64380-0128-02 64380-0128 Cyclosporine Cyclosporine 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 16, 2022 In Use
61748-0303-11 61748-0303 Isotretinoin Myorisan 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug 26, 2015 In Use
10631-0002-31 10631-0002 isotretinoin Absorica LD 8.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov 20, 2019 In Use
61748-0302-13 61748-0302 Isotretinoin Myorisan 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 1, 2012 In Use
42291-0843-01 42291-0843 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 2, 2016 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
00185-0933-30 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jan 13, 2000 Feb 28, 2020 No Longer Used
10631-0006-31 10631-0006 isotretinoin Absorica LD 28.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov 20, 2019 In Use

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