| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 60505-4536-02 | 60505-4536 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 9, 2023 | In Use | |
| 59572-0205-94 | 59572-0205 | Thalidomide | Thalomid | 50.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Jun 20, 2003 | In Use | |
| 54868-6185-00 | 54868-6185 | Isotretinoin | Claravis | 30.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Oct 4, 2013 | In Use | |
| 55111-0136-81 | 55111-0136 | Isotretinoin | ZENATANE | 20.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Mar 26, 2013 | In Use | |
| 00591-2223-15 | 00591-2223 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Dec 1, 2008 | Feb 28, 2018 | In Use |
| 00172-7310-00 | 00172-7310 | Cyclosporine Modified | Cyclosporine Modified | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Mar 29, 2005 | Mar 31, 2017 | No Longer Used |
| 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 |
| 00944-2627-04 | 00944-2627 | Human Immunoglobulin G, Immune Globulin Intravenous (Human) | GAMMAGARD | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | Jun 21, 2014 | In Use | ||
| 50419-0002-33 | 50419-0002 | Sargramostim | Leukine | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Sep 5, 1991 | Sep 21, 2012 | No Longer Used | ||
| 44206-0457-22 | 44206-0457 | Human Immunoglobulin G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | In Use | |
| 54868-3050-00 | 54868-3050 | Filgrastim | Neupogen | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous | Aug 14, 2006 | In Use | |
| 63459-0910-11 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 11, 2013 | In Use | |
| 00024-5862-01 | 00024-5862 | Plerixafor | Mozobil | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Sep 1, 2013 | In Use | |
| 44206-0457-95 | 44206-0457 | Human Immunoglobulin G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | 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 | |
| 70710-1208-01 | 70710-1208 | Plerixafor | PLERIXAFOR | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 28, 2023 | In Use | |
| 00944-2620-02 | 00944-2620 | Human Immunoglobulin G | GAMMAGARD | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | Jul 18, 2015 | In Use | ||
| 63459-0912-18 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Jan 7, 2015 | In Use | |
| 72374-0102-10 | 72374-0102 | Filgrastim-txid | NYPOZI | 480.0 ug/480ug | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Dec 16, 2024 | 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 | |
| 00944-2625-03 | 00944-2625 | Human Immunoglobulin G, Immune Globulin Intravenous (Human) | GAMMAGARD | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | Jun 21, 2014 | In Use | ||
| 58468-0140-01 | 58468-0140 | Plerixafor | Mozobil | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Dec 15, 2008 | Mar 23, 2018 | No Longer Used |
| 54868-5020-00 | 54868-5020 | Filgrastim | Neupogen | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous | Mar 11, 2004 | In Use | |
| 63459-0910-01 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 11, 2013 | 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 |
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