| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 55513-0192-01 | 55513-0192 | Pegfilgrastim | Neulasta | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Feb 20, 2015 | In Use | ||
| 63459-0912-18 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Jan 7, 2015 | 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 | |
| 57894-0503-01 | 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 | |
| 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 | |
| 70114-0130-01 | 70114-0130 | pegfilgrastim-cbqv | UDENYCA | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Dec 22, 2023 | In Use | |
| 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 | |
| 70720-0950-36 | 70720-0950 | Goserelin | ZOLADEX | 3.6 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Mar 31, 2018 | In Use | ||
| 85043-0030-03 | 85043-0030 | Leuprolide acetate | Vabrinty | 30.0 mg/.5mL | Hormonal Therapy | GnRH Agonist | Subcutaneous | Aug 4, 2025 | 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 | |
| 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 |
| 69097-0907-67 | 69097-0907 | LANREOTIDE ACETATE | LANREOTIDE ACETATE | 60.0 mg/.2mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | May 30, 2025 | In Use | ||
| 57894-0450-01 | 57894-0450 | Teclistamab-cqyv | TECVAYLI | 90.0 mg/mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Oct 25, 2022 | 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 | ||
| 55513-0730-21 | 55513-0730 | Denosumab | XGEVA | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Apr 15, 2025 | 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 | |
| 72606-0059-01 | 72606-0059 | Denosumab-bmwo | Denosumab-BMWO | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Sep 10, 2025 | In Use | |
| 82497-0132-01 | 82497-0132 | Eflapegrastim-xnst | Rolvedon | 13.2 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | Subcutaneous | Dec 11, 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 | |
| 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 | |
| 71288-0155-01 | 71288-0155 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 24, 2023 | In Use | |
| 00004-0357-30 | 00004-0357 | Peginterferon alfa-2a | Pegasys | 180.0 ug/.5mL | Immunotherapy | Cytokine | Interferon | Subcutaneous | Mar 29, 2011 | Jun 30, 2024 | No Longer Used |
| 76282-0720-67 | 76282-0720 | LANREOTIDE ACETATE | LANREOTIDE ACETATE | 120.0 mg/.5mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | May 30, 2025 | In Use | ||
| 76282-0719-67 | 76282-0719 | LANREOTIDE ACETATE | LANREOTIDE ACETATE | 90.0 mg/.3mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | May 30, 2025 | 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 |
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