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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
63459-0910-36 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
47426-0101-01 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug 9, 2016 Aug 9, 2016 In Use
70114-0130-01 70114-0130 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 22, 2023 In Use
70114-0120-01 70114-0120 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 6, 2023 In Use
69097-0908-67 69097-0908 LANREOTIDE ACETATE LANREOTIDE ACETATE 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous May 21, 2024 In Use
62935-0223-05 62935-0223 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 In Use
44206-0457-95 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
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
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
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
70720-0951-30 70720-0951 Goserelin ZOLADEX 10.8 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Jan 26, 2018 In Use
00310-0951-30 00310-0951 Goserelin acetate Zoladex 10.8 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 5, 2003 Mar 31, 2020 No Longer Used
69097-0906-67 69097-0906 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 22, 2024 In Use
50242-0245-01 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Jun 29, 2020 In Use
67457-0833-06 67457-0833 Pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jul 9, 2018 May 31, 2026 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
69097-0890-67 69097-0890 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec 24, 2021 In Use
69097-0880-67 69097-0880 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec 24, 2021 In Use
00703-4014-18 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov 6, 2000 Mar 31, 2011 No Longer Used
69097-0870-67 69097-0870 Lanreotide acetate Lanreotide Acetate 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec 24, 2021 In Use
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
69097-0907-67 69097-0907 LANREOTIDE ACETATE LANREOTIDE ACETATE 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous May 22, 2024 In Use
63459-0912-18 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan 7, 2015 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

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