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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
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
63459-0910-18 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan 7, 2015 In Use
71202-0012-10 71202-0012 Denosumab OSPOMYV 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 1, 2025 Oct 31, 2025 In Use
00003-6120-01 00003-6120 Nivolumab and hyaluronidase-nvhy OPDIVO QVANTIG 2000.0 U/mL, 120.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Jan 2, 2025 In Use
62935-0756-80 62935-0756 Leuprolide acetate Eligard 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 1, 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
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
69448-0025-63 69448-0025 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2025 In Use
00024-0605-45 00024-0605 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 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
62756-0452-37 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous Feb 24, 2025 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
57894-0469-01 57894-0469 Talquetamab TALVEY 3.0 mg/1.5mL Immunotherapy T Cell Receptor (TCR) GPRC5D, CD3 Subcutaneous Aug 9, 2023 In Use
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov 12, 2021 In Use
00004-0357-99 00004-0357 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Aug 22, 2011 Sep 19, 2014 No Longer Used
00004-0365-30 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov 1, 2011 In Use
82705-0002-01 82705-0002 Epcoritamab-bysp EPKINLY 4.0 mg/.8mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous May 19, 2023 In Use
44206-0458-24 44206-0458 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
15054-0060-01 15054-0060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb 26, 2003 In Use
62935-0461-50 62935-0461 Leuprolide acetate Eligard 45.0 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Mar 6, 2023 In Use
70710-1208-01 70710-1208 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 28, 2023 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
50090-3466-00 50090-3466 Goserelin acetate ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 30, 2018 In Use

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