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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
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
50242-0201-01 50242-0201 Mosunetuzumab Lunsumio Velo 45.0 mg/mL Immunotherapy Bispecific Antibody CD20, CD3 Subcutaneous Dec 19, 2025 In Use
70121-2702-01 70121-2702 Denosumab-mobz Boncresa 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Dec 23, 2025 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
69097-0906-67 69097-0906 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 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
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
47426-0101-06 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug 9, 2016 In Use
72603-0402-01 72603-0402 Pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Dec 29, 2025 In Use
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 Jan 17, 2018 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
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
31722-0373-31 31722-0373 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jun 16, 2025 In Use
69448-0014-63 69448-0014 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous Apr 5, 2022 In Use
61314-0240-63 61314-0240 Denosumab JUBBONTI 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 2, 2025 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
63459-0910-18 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan 7, 2015 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
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
55513-0710-21 55513-0710 Denosumab Prolia 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Mar 5, 2024 In Use
65219-0670-01 65219-0670 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
69448-0023-63 69448-0023 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous May 19, 2025 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
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
63459-0912-15 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use

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