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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
00006-5083-01 00006-5083 Pembrolizumab and berahyaluronidase alfa-pmph KEYTRUDA QLEX 2000.0 U/mL, 165.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Sep 19, 2025 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
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
70114-0120-01 70114-0120 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 6, 2023 In Use
62935-0222-05 62935-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 Apr 26, 2019 In Use
00006-3083-01 00006-3083 Pembrolizumab and berahyaluronidase alfa-pmph KEYTRUDA QLEX 2000.0 U/mL, 165.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Sep 19, 2025 In Use
65219-0371-10 65219-0371 pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct 6, 2022 In Use
72606-0058-01 72606-0058 Denosumab-bmwo Denosumab-BMWO 60.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Sep 10, 2025 In Use
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
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
69097-0906-67 69097-0906 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
78206-0195-01 78206-0195 Denosumab Bilprevda 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Sep 11, 2025 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
50242-0245-01 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 Jun 29, 2020 In Use
69448-0023-63 69448-0023 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous May 19, 2025 In Use
67457-0833-06 67457-0833 Pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jul 9, 2018 May 31, 2026 In Use
76282-0720-67 76282-0720 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
50419-0392-01 50419-0392 LAROTRECTINIB VITRAKVI 20.0 mg/mL Chemotherapy Tyrosine Kinase Inhibitor TRK OROPHARYNGEAL Jul 26, 2019 In Use
50419-0393-03 50419-0393 LAROTRECTINIB VITRAKVI 20.0 mg/mL Chemotherapy Tyrosine Kinase Inhibitor TRK OROPHARYNGEAL Dec 6, 2022 In Use
54868-0365-01 54868-0365 Estrogens, Conjugated Premarin Hormonal Therapy Estrogen Oral Jul 26, 1995 Jul 6, 2010 No Longer Used
00310-0201-14 00310-0201 Anastrozole Arimidex 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Sep 15, 2011 Jun 30, 2019 No Longer Used
00078-0909-61 00078-0909 letrozole and ribociclib Kisqali Femara Co-pack 2.5 mg/1, 200.0 mg/1 Chemotherapy, Hormonal Therapy Cyclin Dependent Kinase Inhibitor CDK 4/6, Hormonal Oral May 4, 2017 Aug 31, 2026 In Use
83858-0104-30 83858-0104 Dasatinib PHYRAGO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug 1, 2024 In Use
00480-1246-21 00480-1246 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Mar 3, 2022 In Use
00054-0322-03 00054-0322 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Mar 24, 2016 Mar 24, 2016 No Longer Used

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