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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
61314-0866-01 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov 4, 2019 Feb 28, 2026 In Use
69097-0880-67 69097-0880 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec 24, 2021 In Use
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
00310-0950-36 00310-0950 Goserelin acetate Zoladex 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 5, 2003 May 31, 2020 No Longer Used
15054-1060-03 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Jun 30, 2022 In Use
50090-3466-00 50090-3466 Goserelin acetate ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 30, 2018 In Use
15054-1120-04 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
50242-0260-86 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
00121-2106-02 00121-2106 Leuprolide acetate Leuprolide acetate 5.0 mg/1ml Hormonal Therapy GnRH Agonist Subcutaneous Feb 1, 2025 In Use
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 In Use
63459-0910-15 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
57894-0449-01 57894-0449 Teclistamab TECVAYLI 10.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use
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
82737-0073-01 82737-0073 Motixafortide Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sep 8, 2023 In Use
47426-0101-01 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug 9, 2016 Aug 9, 2016 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
55513-0730-01 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Nov 18, 2010 In Use
57894-0469-01 57894-0469 Talquetamab TALVEY 3.0 mg/1.5mL Immunotherapy T Cell Receptor (TCR) GPRC5D, CD3 Subcutaneous Aug 9, 2023 In Use
62756-0452-37 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous Feb 24, 2025 In Use
42238-0111-12 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 Jan 17, 2018 No Longer Used
50242-0245-86 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov 12, 2021 In Use
00069-0292-01 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 In Use

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