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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
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
85043-0030-03 85043-0030 Leuprolide acetate Vabrinty 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 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
25021-0416-01 25021-0416 Plerixafor Plerixafor 20.0 mg/mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Aug 1, 2024 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
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
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
62935-0223-05 62935-0223 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 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
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
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
65219-0668-01 65219-0668 Denosumab CONEXXENCE 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
63459-0910-15 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
50242-0933-01 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
00006-5083-01 00006-5083 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
63459-0910-12 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
72606-0037-01 72606-0037 Denosumab-bmwo Stoboclo 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jul 2, 2025 In Use
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 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
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
83457-0012-10 83457-0012 Denosumab OSPOMYV 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Oct 10, 2025 In Use
71202-0012-11 71202-0012 Denosumab OSPOMYV 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 1, 2025 Oct 31, 2025 In Use
85043-0075-05 85043-0075 Leuprolide acetate Vabrinty 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Dec 15, 2025 In Use
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy Erythropoiesis-Stimulating Agent Subcutaneous Nov 8, 2019 In Use

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