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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
63459-0910-11 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
69448-0023-63 69448-0023 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous May 19, 2025 In Use
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
00003-3120-01 00003-3120 Nivolumab and hyaluronidase-nvhy OPDIVO QVANTIG 2000.0 U/mL, 120.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Nov 24, 2025 In Use
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 In Use
62935-0302-30 62935-0302 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb 26, 2003 Apr 26, 2019 In Use
00004-0360-09 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 Feb 8, 2018 No Longer Used
50242-0933-86 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
70121-2701-01 70121-2701 Denosumab-mobz Oziltus 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Dec 23, 2025 In Use
57894-0522-01 57894-0522 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 3520.0 mg/22mL, 44000.0 mg/22mL Immunotherapy Bispecific Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
62756-0452-37 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous Feb 24, 2025 In Use
63459-0910-15 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
50090-3466-00 50090-3466 Goserelin acetate ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 30, 2018 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
71202-0012-11 71202-0012 Denosumab OSPOMYV 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 1, 2025 Oct 31, 2025 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 Sep 30, 2026 In Use
65219-0670-01 65219-0670 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
69097-0908-67 69097-0908 LANREOTIDE ACETATE LANREOTIDE ACETATE 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 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
71288-0569-90 71288-0569 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2024 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
69097-0907-67 69097-0907 LANREOTIDE ACETATE LANREOTIDE ACETATE 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
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
62935-0756-80 62935-0756 Leuprolide acetate Eligard 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 1, 2023 In Use

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