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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
58468-0180-01 58468-0180 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Aug 5, 2013 Jun 30, 2016 No Longer Used
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 7, 2018 In Use
00024-5844-05 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
67457-0833-06 67457-0833 Pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jul 9, 2018 May 31, 2026 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Mar 11, 2019 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
63459-0910-36 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
55513-0209-10 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
55513-0546-01 55513-0546 Filgrastim Neupogen 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Apr 7, 1997 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
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb 20, 2015 In Use
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 In Use
54868-3188-00 54868-3188 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Dec 1, 1996 Jun 30, 2012 No Longer Used
54868-3050-00 54868-3050 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous Aug 14, 2006 In Use
63459-0912-01 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 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
00024-5843-05 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 1, 1991 Dec 30, 2021 No Longer Used
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
00078-0652-06 00078-0652 Panobinostat Farydak 20.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb 23, 2015 Dec 31, 2022 No Longer Used
68152-0108-09 68152-0108 Belinostat Beleodaq 500.0 mg/10mL Chemotherapy Enzyme Inhibitor HDAC Intravenous Jul 21, 2014 Nov 30, 2022 In Use
00703-4004-01 00703-4004 Romidepsin Romidepsin 5.0 mg/mL Chemotherapy Enzyme Inhibitor HDAC Intravenous Apr 14, 2020 In Use
46026-0983-01 46026-0983 Romidepsin Istodax Chemotherapy Enzyme Inhibitor HDAC Intravenous Nov 5, 2009 May 28, 2010 No Longer Used
00703-3125-08 00703-3125 Romidepsin Romidepsin Chemotherapy Enzyme Inhibitor HDAC Intravenous Aug 1, 2018 Oct 31, 2021 No Longer Used

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