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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
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
00024-0222-05 00024-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 No Longer Used
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
15054-0060-01 15054-0060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
15054-0090-01 15054-0090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
00069-0291-01 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 In Use
50242-0260-01 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 Jun 29, 2020 In Use
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
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
50090-2027-00 50090-2027 Goserelin acetate Zoladex 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Sep 23, 2015 In Use
55513-0710-01 55513-0710 Denosumab Prolia 60.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 5, 2010 In Use
57377-0050-01 57377-0050 Estradiol pellet Estra-50 50.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan 1, 2017 In Use
57894-0449-01 57894-0449 Teclistamab TECVAYLI 10.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 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
15054-1120-03 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Jun 30, 2022 In Use
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb 26, 2003 In Use
62935-0306-40 62935-0306 Leuprolide acetate Eligard 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Jan 11, 2024 In Use
63459-0177-14 63459-0177 Omacetaxine Mepesuccinate Synribo 3.5 mg/mL Chemotherapy Plant Alkaloid BCR-ABL Subcutaneous Nov 19, 2012 Apr 30, 2024 No Longer Used
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
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
63459-0918-59 63459-0918 tbo-filgrastim GRANIX 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 7, 2018 In Use
00024-5862-01 00024-5862 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Sep 1, 2013 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
68083-0155-01 68083-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous May 3, 2024 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

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