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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
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 In Use
62935-0306-40 62935-0306 Leuprolide acetate Eligard 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Jan 11, 2024 In Use
85043-0045-04 85043-0045 Leuprolide acetate Vabrinty 45.0 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 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
00003-3120-01 00003-3120 Nivolumab and hyaluronidase-nvhy OPDIVO QVANTIG 2000.0 U/mL, 120.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Nov 24, 2025 In Use
63459-0912-12 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
69448-0023-63 69448-0023 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous May 19, 2025 In Use
50242-0177-01 50242-0177 Mosunetuzumab Lunsumio Velo 5.0 mg/.5mL Immunotherapy Bispecific Antibody CD20, CD3 Subcutaneous Dec 19, 2025 In Use
65219-0670-01 65219-0670 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
61314-0866-01 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov 4, 2019 Feb 28, 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 Bispecific Antibody EGFR, MET Subcutaneous Dec 17, 2025 In Use
85043-0030-03 85043-0030 Leuprolide acetate Vabrinty 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 In Use
76282-0718-67 76282-0718 LANREOTIDE ACETATE LANREOTIDE ACETATE 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
15054-1060-03 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Jun 30, 2022 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
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
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
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
00143-9166-01 00143-9166 Denosumab-qbde XTRENBO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jan 8, 2026 In Use
00004-0360-09 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Feb 8, 2018 No Longer Used
15054-1060-04 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
57894-0469-01 57894-0469 Talquetamab TALVEY 3.0 mg/1.5mL Immunotherapy T Cell Receptor (TCR) GPRC5D, CD3 Subcutaneous Aug 9, 2023 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous Jun 22, 2017 In Use
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 In Use
47426-0101-06 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug 9, 2016 In Use

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