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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
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
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 7, 2018 Sep 30, 2026 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
78206-0195-01 78206-0195 Denosumab Bilprevda 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Sep 11, 2025 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
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
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 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
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
76961-0101-01 76961-0101 Eflapegrastim-xnst Rolvedon 13.2 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct 18, 2022 In Use
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use
43817-0906-01 43817-0906 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous May 6, 2019 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
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
63459-0910-36 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
57377-0060-01 57377-0060 Testosterone,USP Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan 1, 2021 In Use
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous Jun 23, 2017 In Use
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
85043-0075-50 85043-0075 Leuprolide acetate Vabrinty 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Feb 2, 2026 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
55513-0730-01 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Nov 18, 2010 In Use
15054-1060-04 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
00004-0357-99 00004-0357 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Aug 22, 2011 Sep 19, 2014 No Longer Used
85043-0025-02 85043-0025 Leuprolide acetate Vabrinty 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 In Use
70771-1687-03 70771-1687 LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1.0 mg/0.2ml Hormonal Therapy GnRH Agonist Subcutaneous Jan 8, 2026 In Use

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