| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| 76282-0710-67 | 76282-0710 | Lanreotide acetate | Lanreotide Acetate | 90.0 mg/.3mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | Jun 1, 2022 | Aug 18, 2023 | 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 |
| 57894-0449-01 | 57894-0449 | Teclistamab | TECVAYLI | 10.0 mg/mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Oct 25, 2022 | In Use | |
| 50242-0108-01 | 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 22, 2017 | 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 | |
| 43598-0308-23 | 43598-0308 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Nov 6, 2023 | 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 | |
| 16714-0572-01 | 16714-0572 | Leuprolide acetate | Leuprolide acetate | 5.0 mg/ml | Hormonal Therapy | GnRH Agonist | Subcutaneous | Aug 1, 2022 | Sep 30, 2024 | In Use | |
| 00480-4320-01 | 00480-4320 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 28, 2023 | In Use | |
| 57894-0450-01 | 57894-0450 | Teclistamab | TECVAYLI | 90.0 mg/mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Oct 25, 2022 | In Use | |
| 70720-0950-36 | 70720-0950 | Goserelin | ZOLADEX | 3.6 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Mar 31, 2018 | In Use | ||
| 70720-0951-30 | 70720-0951 | Goserelin | ZOLADEX | 10.8 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Jan 26, 2018 | In Use | ||
| 57377-0050-01 | 57377-0050 | Estradiol pellet | Estra-50 | 50.0 mg/1 | Hormonal Therapy | Estrogen | Subcutaneous | Jan 1, 2017 | In Use | ||
| 57377-0025-01 | 57377-0025 | Estradiol pellet | Estra-25 | 25.0 mg/1 | Hormonal Therapy | Estrogen | Subcutaneous | Jan 1, 2017 | In Use | ||
| 82737-0073-01 | 82737-0073 | Motixafortide | Aphexda | 62.0 mg/1.7mL | Ancillary Therapy | Immunostimulant | Stem cell mobilizer | Subcutaneous | Sep 8, 2023 | 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 | |
| 47426-0101-06 | 47426-0101 | Granisetron | Sustol | 10.0 mg/.4mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Subcutaneous | Aug 9, 2016 | In Use | |
| 70114-0120-01 | 70114-0120 | Pegfilgrastim-cbqv | UDENYCA | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 6, 2023 | In Use | |
| 55513-0730-01 | 55513-0730 | Denosumab | XGEVA | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Nov 18, 2010 | In Use | |
| 59572-0711-01 | 59572-0711 | Luspatercept | REBLOZYL | 25.0 mg/1 | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Subcutaneous | Nov 8, 2019 | In Use | ||
| 67457-0833-06 | 67457-0833 | Pegfilgrastim | Fulphila | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Jul 9, 2018 | May 31, 2026 | 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 |
| 42238-0111-12 | 42238-0111 | Interferon gamma-1b | Actimmune | 100.0 ug/.5mL | Immunotherapy | Cytokine | Interferon | Subcutaneous | Dec 1, 2013 | Jan 17, 2018 | No Longer Used |
| 00703-4014-11 | 00703-4014 | Leuprolide Acetate | Leuprolide Acetate | Hormonal Therapy | GnRH Agonist | Subcutaneous | Nov 6, 2000 | Mar 31, 2011 | No Longer Used |
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