| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00378-6614-88 | 00378-6614 | Isotretinoin | Amnesteem | 40.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Nov 11, 2002 | Jul 24, 2013 | In Use |
| 64380-0129-02 | 64380-0129 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 16, 2022 | In Use | |
| 59572-0504-00 | 59572-0504 | Pomalidomide | Pomalyst | 4.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Feb 18, 2013 | In Use | |
| 10631-0002-31 | 10631-0002 | isotretinoin | Absorica LD | 8.0 mg/1 | Hormonal Therapy | Immunomodulator | Retinoic Acid Derivative | Oral | Nov 20, 2019 | In Use | |
| 63304-0044-01 | 63304-0044 | Lenalidomide | Lenalidomide | 15.0 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Mar 4, 2023 | In Use | |
| 43598-0516-63 | 43598-0516 | Lenalidomide | Lenalidomide | 2.5 mg/1 | Immunotherapy | Immunomodulator | Thalidomide Analog | Oral | Sep 6, 2022 | In Use | |
| 63459-0912-12 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 11, 2013 | In Use | |
| 00944-2656-03 | 00944-2656 | Human Immunoglobulin G | Gammagard S/D | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | In Use | |||
| 00024-5843-01 | 00024-5843 | Sargramostim | Leukine | 250.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Nov 5, 2013 | Dec 30, 2021 | No Longer Used |
| 70121-1694-02 | 70121-1694 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 25, 2023 | In Use | |
| 00069-0291-10 | 00069-0291 | filgrastim-aafi | Nivestym | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Sep 24, 2018 | In Use | |
| 63459-0912-15 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 11, 2013 | In Use | |
| 63459-0910-18 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Jan 7, 2015 | In Use | |
| 71837-5844-05 | 71837-5844 | SARGRAMOSTIM | Leukine | 500.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte colony stimulating factor | Intravenous, Subcutaneous | May 30, 2018 | May 8, 2012 | No Longer Used |
| 00944-2655-04 | 00944-2655 | Human Immunoglobulin G | Gammagard S/D | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Jan 3, 2011 | Aug 26, 2015 | In Use | ||
| 00480-4320-01 | 00480-4320 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 28, 2023 | Feb 28, 2026 | 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 | |
| 00944-2658-04 | 00944-2658 | Human Immunoglobulin G | Gammagard S/D | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | In Use | |||
| 70121-1571-07 | 70121-1571 | Filgrastim | RELEUKO | 480.0 ug/1.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Feb 25, 2022 | In Use | |
| 61314-0312-10 | 61314-0312 | filgrastim-sndz | Zarxio | 480.0 ug/.8mL, 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Sep 3, 2015 | Feb 28, 2021 | No Longer Used |
| 63459-0912-36 | 63459-0912 | tbo-filgrastim | Granix | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 2, 2015 | In Use | |
| 00069-0291-01 | 00069-0291 | filgrastim-aafi | Nivestym | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Sep 24, 2018 | In Use | |
| 00069-0293-10 | 00069-0293 | filgrastim-aafi | Nivestym | 300.0 ug/mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Mar 11, 2019 | In Use | |
| 25021-0416-01 | 25021-0416 | Plerixafor | Plerixafor | 20.0 mg/mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Aug 1, 2024 | 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 |
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