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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
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
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
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb 26, 2003 In Use
44206-0457-22 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
70121-2702-01 70121-2702 Denosumab-mobz Boncresa 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Dec 23, 2025 In Use
00185-7400-14 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Jan 6, 2011 In Use
57377-0060-01 57377-0060 Testosterone,USP Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan 1, 2021 In Use
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Jan 31, 2019 No Longer Used
76282-0710-67 76282-0710 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Jun 1, 2022 Aug 18, 2023 In Use
00703-4014-18 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov 6, 2000 Mar 31, 2011 No Longer Used
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
72843-0591-99 72843-0591 Leuprolide acetate Leuprolide acetate 5.0 mg/ml Hormonal Therapy GnRH Agonist Subcutaneous Oct 25, 2024 In Use
00024-0605-45 00024-0605 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 No Longer Used
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
15054-1090-04 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
69097-0907-67 69097-0907 LANREOTIDE ACETATE LANREOTIDE ACETATE 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 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
76961-0101-01 76961-0101 Eflapegrastim-xnst Rolvedon 13.2 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct 18, 2022 Aug 31, 2027 In Use
83634-0454-61 83634-0454 Leuprolide acetate Leuprolide Acetate 5.0 mg/mL Hormonal Therapy GnRH Agonist Subcutaneous Oct 15, 2025 Jun 30, 2026 In Use
57894-0510-01 57894-0510 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) RYBREVANT FASPRO 1600.0 mg/10mL, 20000.0 mg/10mL Immunotherapy Monoclonal Antibody EGFR, MET Subcutaneous Dec 19, 2025 In Use
57894-0522-01 57894-0522 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 3520.0 mg/22mL, 44000.0 mg/22mL Immunotherapy Monoclonal Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
57894-0514-01 57894-0514 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) RYBREVANT FASPRO 2240.0 mg/14mL, 28000.0 mg/14mL Immunotherapy Monoclonal Antibody EGFR, MET Subcutaneous Dec 19, 2025 In Use
57894-0515-01 57894-0515 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 2400.0 mg/15mL, 30000.0 mg/15mL Immunotherapy Monoclonal Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
57894-0449-01 57894-0449 Teclistamab-cqyv TECVAYLI 10.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use

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