| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00093-9019-65 | 00093-9019 | Cyclosporine | Cyclosporine | 50.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jun 8, 2021 | In Use | |
| 69238-1175-03 | 69238-1175 | Isotretinoin | Isotretinoin | 20.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Oct 2, 2017 | In Use | |
| 00378-1941-21 | 00378-1941 | Lenalidomide | Lenalidomide | 15.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 00591-2451-15 | 00591-2451 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Apr 29, 2021 | In Use | |
| 10631-0003-31 | 10631-0003 | isotretinoin | Absorica LD | 16.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Nov 20, 2019 | In Use | |
| 59651-0346-01 | 59651-0346 | Lenalidomide | Lenalidomide | 20.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 6, 2023 | In Use | |
| 70771-1664-08 | 70771-1664 | Isotretinoin | Isotretinoin | 25.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 9, 2025 | In Use | |
| 00245-0575-01 | 00245-0575 | Isotretinoin | Isotretinoin | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Jun 25, 2021 | In Use | |
| 00078-0240-61 | 00078-0240 | Cyclosporine | Sandimmune | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Mar 22, 2010 | In Use | |
| 43975-0315-10 | 43975-0315 | Bexarotene | Bexarotene | 75.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | May 10, 2018 | In Use | |
| 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 | |
| 50419-0050-14 | 50419-0050 | Sargramostim | Leukine | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Mar 5, 1991 | Sep 21, 2012 | No Longer Used | ||
| 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 | |
| 58468-0181-02 | 58468-0181 | Sargramostim | Leukine | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Mar 15, 2010 | Dec 31, 2013 | No Longer Used | ||
| 61314-0304-10 | 61314-0304 | filgrastim-sndz | Zarxio | 300.0 ug/.5mL, 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Sep 3, 2015 | Feb 28, 2021 | No Longer Used |
| 70121-1570-07 | 70121-1570 | Filgrastim | RELEUKO | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Feb 25, 2022 | In Use | |
| 70771-1776-01 | 70771-1776 | Plerixafor | PLERIXAFOR | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 28, 2023 | In Use | |
| 63459-0918-59 | 63459-0918 | tbo-filgrastim | GRANIX | 300.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 7, 2018 | 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 | ||
| 25021-0416-01 | 25021-0416 | Plerixafor | Plerixafor | 20.0 mg/mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Aug 1, 2024 | In Use | |
| 72374-0101-01 | 72374-0101 | Filgrastim-txid | NYPOZI | 300.0 ug/300ug | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Dec 16, 2024 | In Use | |
| 44206-0456-21 | 44206-0456 | HUMAN IMMUNOGLOBULIN G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | 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 | |
| 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 |
| 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 |
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