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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
25021-0453-01 25021-0453 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec 15, 2013 Feb 28, 2023 In Use
00703-3321-91 00703-3321 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Jan 28, 2008 Oct 31, 2011 In Use
68462-0897-10 68462-0897 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug 9, 2023 In Use
00024-5844-01 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec 1, 1996 Dec 30, 2021 No Longer Used
67457-0246-01 67457-0246 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Apr 1, 2011 In Use
59137-0365-01 59137-0365 Treosulfan GRAFAPEX 5000.0 mg/5g Chemotherapy Alkylating Agent Alkyl Sulfonate Intravenous Jan 28, 2025 In Use
30237-8900-06 30237-8900 Sipuleucel-T Provenge 50000000.0 1/1 Immunotherapy Immunomodulator Prostatic Acid Phosphatase Intravenous Apr 29, 2010 In Use
71997-0100-01 71997-0100 DEXAMETHASONE Dexycu 517.0 ug/.005mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid INTRAOCULAR Oct 1, 2018 Oct 1, 2018 No Longer Used
57962-0560-28 57962-0560 Ibrutinib IMBRUVICA 560.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb 16, 2018 Feb 28, 2025 In Use
57962-0560-71 57962-0560 Ibrutinib IMBRUVICA 560.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb 6, 2019 Dec 31, 2020 In Use
70114-0101-01 70114-0101 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 2, 2018 In Use
55513-0190-01 55513-0190 Pegfilgrastim Neulasta 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Apr 1, 2002 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
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
70114-0130-01 70114-0130 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 22, 2023 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
83257-0005-41 83257-0005 Pegfilgrastim-jmdb Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Oct 1, 2023 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
65219-0371-10 65219-0371 pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct 6, 2022 In Use
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
61314-0866-02 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Mar 3, 2025 In Use
60687-0729-01 60687-0729 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Apr 27, 2023 In Use
68788-8293-05 68788-8293 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
67296-1413-01 67296-1413 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan 1, 2021 In Use
48102-0048-01 48102-0048 dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jun 1, 2018 Dec 31, 2020 In Use

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