| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00004-0365-09 | 00004-0365 | Peginterferon alfa-2a | Pegasys | 180.0 ug/.5mL | Immunotherapy | Cytokine | Interferon | Subcutaneous | Nov 1, 2011 | In Use | |
| 57894-0514-01 | 57894-0514 | AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) | RYBREVANT FASPRO | 2240.0 mg/14mL, 28000.0 mg/14mL | Immunotherapy | Bispecific Antibody | EGFR, MET | Subcutaneous | Dec 17, 2025 | In Use | |
| 55513-0730-01 | 55513-0730 | Denosumab | XGEVA | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Nov 18, 2010 | 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 | |
| 57894-0510-01 | 57894-0510 | AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) | RYBREVANT FASPRO | 1600.0 mg/10mL, 20000.0 mg/10mL | Immunotherapy | Bispecific Antibody | EGFR, MET | Subcutaneous | Dec 17, 2025 | In Use | |
| 55513-0192-01 | 55513-0192 | Pegfilgrastim | Neulasta | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Feb 20, 2015 | In Use | ||
| 43817-0906-01 | 43817-0906 | Azacitidine | Azacitidine | 100.0 mg/50mL | Chemotherapy | Antimetabolite | Pyrimidine Analog | Subcutaneous | May 6, 2019 | In Use | |
| 50090-3466-00 | 50090-3466 | Goserelin acetate | ZOLADEX | 3.6 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | May 30, 2018 | In Use | ||
| 15054-1060-04 | 15054-1060 | Lanreotide acetate | Somatuline Depot | 60.0 mg/.2mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | Sep 1, 2019 | 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 | |
| 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 | |
| 00006-3083-01 | 00006-3083 | 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 | |
| 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 | |
| 50242-0201-01 | 50242-0201 | Mosunetuzumab | Lunsumio Velo | 45.0 mg/mL | Immunotherapy | Bispecific Antibody | CD20, CD3 | Subcutaneous | Dec 19, 2025 | In Use | |
| 69097-0870-67 | 69097-0870 | Lanreotide acetate | Lanreotide Acetate | 120.0 mg/.5mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | Dec 24, 2021 | In Use | ||
| 50242-0933-01 | 50242-0933 | Atezolizumab and hyaluronidase-tqjs | Tecentriq Hybreza | 1875.0 mg/15mL, 30000.0 U/15mL | Immunotherapy | Checkpoint Inhibitor | PD-L1 | Subcutaneous | Sep 12, 2024 | 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 |
| 72606-0037-01 | 72606-0037 | Denosumab-bmwo | Stoboclo | 60.0 mg/mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Jul 2, 2025 | In Use | |
| 41616-0936-40 | 41616-0936 | Leuprolide Acetate | Leuprolide Acetate | Hormonal Therapy | GnRH Agonist | Subcutaneous | Dec 15, 2014 | Aug 31, 2015 | No Longer Used | ||
| 76282-0710-67 | 76282-0710 | Lanreotide acetate | Lanreotide Acetate | 90.0 mg/.3mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | Jun 1, 2022 | Aug 18, 2023 | In Use | |
| 62935-0227-10 | 62935-0227 | Leuprolide acetate | Eligard | 22.5 mg/.375mL | Hormonal Therapy | GnRH Agonist | Subcutaneous | Nov 27, 2023 | In Use | ||
| 69097-0890-67 | 69097-0890 | Lanreotide acetate | Lanreotide Acetate | 90.0 mg/.3mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | Dec 24, 2021 | In Use | ||
| 00143-9166-01 | 00143-9166 | Denosumab-qbde | XTRENBO | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Jan 8, 2026 | In Use | |
| 62935-0756-80 | 62935-0756 | Leuprolide acetate | Eligard | 7.5 mg/.25mL | Hormonal Therapy | GnRH Agonist | Subcutaneous | Nov 1, 2023 | In Use | ||
| 61314-0228-94 | 61314-0228 | Denosumab | WYOST | 120.0 mg/1.7mL | Immunotherapy | Monoclonal Antibody | RANKL | Subcutaneous | Jun 2, 2025 | In Use |
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