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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
85043-0075-05 85043-0075 Leuprolide acetate Vabrinty 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Dec 15, 2025 In Use
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 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
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
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
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
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
85043-0045-04 85043-0045 Leuprolide acetate Vabrinty 45.0 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 In Use
55513-0710-21 55513-0710 Denosumab Prolia 60.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Mar 5, 2024 In Use
85043-0030-03 85043-0030 Leuprolide acetate Vabrinty 30.0 mg/.5mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 In Use
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy 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
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Jan 31, 2019 No Longer Used
69448-0023-63 69448-0023 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous May 19, 2025 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
50242-0177-01 50242-0177 Mosunetuzumab Lunsumio Velo 5.0 mg/.5mL Immunotherapy Bispecific Antibody CD20, CD3 Subcutaneous Dec 19, 2025 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
00143-9166-01 00143-9166 Denosumab-qbde XTRENBO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jan 8, 2026 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
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 In Use
50242-0245-86 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 May 3, 2021 In Use
55513-0730-21 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Apr 15, 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
76282-0719-67 76282-0719 LANREOTIDE ACETATE LANREOTIDE ACETATE 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
69448-0025-63 69448-0025 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2025 In Use

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