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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
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 Jan 17, 2018 No Longer Used
16714-0572-01 16714-0572 Leuprolide acetate Leuprolide acetate 5.0 mg/ml Hormonal Therapy GnRH Agonist Subcutaneous Aug 1, 2022 Sep 30, 2024 No Longer Used
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
50242-0260-01 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Jun 29, 2020 In Use
00121-2106-02 00121-2106 Leuprolide acetate Leuprolide acetate 5.0 mg/1ml Hormonal Therapy GnRH Agonist Subcutaneous Feb 1, 2025 In Use
63459-0912-11 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
50090-2027-00 50090-2027 Goserelin acetate Zoladex 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Sep 23, 2015 In Use
00024-0610-30 00024-0610 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 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
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
00004-0365-30 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
62935-0222-05 62935-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 Apr 26, 2019 In Use
68083-0155-01 68083-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous May 3, 2024 In Use
65219-0284-12 65219-0284 PLERIXAFOR Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jun 22, 2023 In Use
62935-0453-45 62935-0453 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 7, 2005 In Use
83257-0005-41 83257-0005 Pegfilgrastim-jmdb Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Oct 1, 2023 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
00004-0365-09 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
72205-0249-01 72205-0249 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov 8, 2019 In Use
76282-0719-67 76282-0719 LANREOTIDE ACETATE LANREOTIDE ACETATE 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous May 21, 2024 In Use
15054-1090-04 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Sep 1, 2019 In Use
50242-0260-86 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 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
72851-0042-01 72851-0042 Leuprolide CAMCEVI 42.0 mg/mL Hormonal Therapy GnRH Agonist Subcutaneous Dec 30, 2022 In Use

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