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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
65219-0670-01 65219-0670 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 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
57894-0515-01 57894-0515 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 2400.0 mg/15mL, 30000.0 mg/15mL Immunotherapy Bispecific Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
00703-4014-11 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov 6, 2000 Mar 31, 2011 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
00004-0350-39 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct 16, 2002 Sep 1, 2009 No Longer Used
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
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
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
00143-9166-01 00143-9166 Denosumab-qbde XTRENBO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jan 8, 2026 In Use
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
00024-0222-05 00024-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 No Longer Used
76282-0709-67 76282-0709 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Jun 1, 2022 Aug 18, 2023 In Use
25021-0416-01 25021-0416 Plerixafor Plerixafor 20.0 mg/mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Aug 1, 2024 In Use
62935-0223-05 62935-0223 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 In Use
00185-7400-14 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Jan 6, 2011 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
85043-0030-03 85043-0030 Leuprolide acetate Vabrinty 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 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
50242-0933-86 50242-0933 Atezolizumab and hyaluronidase-tqjs Tecentriq Hybreza 1875.0 mg/15mL, 30000.0 U/15mL Immunotherapy Checkpoint Inhibitor PD-L1 Subcutaneous Sep 12, 2024 In Use
51991-0797-98 51991-0797 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous Aug 7, 2017 Jan 31, 2024 No Longer Used
69097-0870-67 69097-0870 Lanreotide acetate Lanreotide Acetate 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec 24, 2021 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov 8, 2019 In Use
15054-0120-01 15054-0120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used

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