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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
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
50242-0201-01 50242-0201 Mosunetuzumab Lunsumio Velo 45.0 mg/mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous Dec 19, 2025 In Use
70710-1208-01 70710-1208 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 28, 2023 In Use
57377-0025-01 57377-0025 Estradiol pellet Estra-25 25.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan 1, 2017 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
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
43598-0308-23 43598-0308 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Nov 6, 2023 In Use
41616-0936-40 41616-0936 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Dec 15, 2014 Aug 31, 2015 No Longer Used
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
72606-0059-01 72606-0059 Denosumab-bmwo Denosumab-BMWO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Sep 10, 2025 In Use
83257-0029-41 83257-0029 Denosumab-kyqq BOSAYA 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jan 5, 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
50242-0177-01 50242-0177 Mosunetuzumab Lunsumio Velo 5.0 mg/.5mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous Dec 19, 2025 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 Sep 30, 2026 In Use
63459-0910-01 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
00310-0951-30 00310-0951 Goserelin acetate Zoladex 10.8 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 5, 2003 Mar 31, 2020 No Longer Used
00069-0291-10 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 In Use
00480-4320-01 00480-4320 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 28, 2023 Feb 28, 2026 No Longer Used
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
69448-0027-63 69448-0027 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Oct 27, 2025 In Use
50242-0933-01 50242-0933 Atezolizumab and hyaluronidase-tqjs Tecentriq Hybreza 1875.0 mg/15mL, 30000.0 U/15mL Immunotherapy Checkpoint Inhibitor PD-L1 Subcutaneous Sep 12, 2024 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
00185-7400-14 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Jan 6, 2011 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

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