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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
83257-0030-11 83257-0030 Denosumab-kyqq AUKELSO 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jan 5, 2026 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
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
00024-0793-75 00024-0793 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 No Longer Used
62935-0753-75 62935-0753 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2002 In Use
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
69448-0027-63 69448-0027 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Oct 27, 2025 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
70383-0073-01 70383-0073 MOTIXAFORTIDE ACETATE Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sep 8, 2023 In Use
61314-0240-63 61314-0240 Denosumab JUBBONTI 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 2, 2025 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
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
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
62935-0223-05 62935-0223 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 In Use
71288-0569-90 71288-0569 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2024 In Use
63459-0910-17 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
00004-0350-39 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct 16, 2002 Sep 1, 2009 No Longer Used
44206-0456-94 44206-0456 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 In Use
55513-0710-01 55513-0710 Denosumab Prolia 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 5, 2010 In Use
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 In Use
65219-0672-01 65219-0672 Denosumab BOMYNTRA 70.0 mg/mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jun 30, 2025 In Use
70771-1687-03 70771-1687 LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1.0 mg/0.2ml Hormonal Therapy GnRH Agonist Subcutaneous Jan 8, 2026 In Use
70710-1769-03 70710-1769 LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1.0 mg/0.2ml Hormonal Therapy GnRH Agonist Subcutaneous Jan 8, 2026 In Use
62935-0222-05 62935-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 Apr 26, 2019 In Use

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