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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
70771-1687-03 70771-1687 LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1.0 mg/0.2ml Hormonal Therapy GnRH Agonist Subcutaneous Jan 8, 2026 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
85043-0075-05 85043-0075 Leuprolide acetate Vabrinty 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Dec 15, 2025 In Use
73441-0062-01 73441-0062 MOTIXAFORTIDE APHEXDA 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Jun 15, 2025 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
00006-5083-01 00006-5083 Pembrolizumab and berahyaluronidase alfa-pmph KEYTRUDA QLEX 2000.0 U/mL, 165.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Sep 19, 2025 In Use
67979-0500-01 67979-0500 Histrelin Acetate Vantas 50.0 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Nov 1, 2004 Mar 31, 2022 No Longer Used
47426-0101-01 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug 9, 2016 Aug 9, 2016 In Use
82497-0132-01 82497-0132 Eflapegrastim-xnst Rolvedon 13.2 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Dec 11, 2025 In Use
61314-0228-94 61314-0228 Denosumab WYOST 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 2, 2025 In Use
55513-0730-21 55513-0730 Denosumab XGEVA 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Apr 15, 2025 In Use
57377-0060-01 57377-0060 Testosterone,USP Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan 1, 2021 In Use
15054-0120-01 15054-0120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb 28, 2019 In Use
00004-0365-09 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
71288-0569-90 71288-0569 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2024 In Use
50242-0245-01 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Jun 29, 2020 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
63539-0252-02 63539-0252 Elranatamab-bcmm Elrexfio 44.0 mg/1.1mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug 15, 2023 In Use
15054-1120-04 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
00069-4494-02 00069-4494 Elranatamab-bcmm Elrexfio 76.0 mg/1.9mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug 15, 2023 In Use
72606-0059-01 72606-0059 Denosumab-bmwo Denosumab-BMWO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Sep 10, 2025 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
57894-0522-01 57894-0522 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 3520.0 mg/22mL, 44000.0 mg/22mL Immunotherapy Monoclonal Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Jan 31, 2019 No Longer Used

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