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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
61314-0866-02 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Mar 3, 2025 In Use
43817-0906-01 43817-0906 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous May 6, 2019 In Use
69097-0906-67 69097-0906 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
62756-0452-36 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous Feb 24, 2025 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
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy Erythropoiesis-Stimulating Agent Subcutaneous Nov 8, 2019 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
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
63459-0912-12 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
15054-0090-01 15054-0090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
00703-4014-11 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov 6, 2000 Mar 31, 2011 No Longer Used
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
85043-0025-02 85043-0025 Leuprolide acetate Vabrinty 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Aug 4, 2025 In Use
76282-0718-67 76282-0718 LANREOTIDE ACETATE LANREOTIDE ACETATE 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
15054-0120-01 15054-0120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov 14, 2007 Aug 31, 2016 No Longer Used
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 In Use
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
76282-0709-67 76282-0709 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Jun 1, 2022 Aug 18, 2023 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
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
63459-0177-14 63459-0177 Omacetaxine Mepesuccinate Synribo 3.5 mg/mL Chemotherapy Plant Alkaloid BCR-ABL Subcutaneous Nov 19, 2012 Apr 30, 2024 No Longer Used
72606-0038-01 72606-0038 Denosumab-bmwo Osenvelt 120.0 mg/1.7mL Immunotherapy Monoclonal Antibody RANKL Subcutaneous Jul 2, 2025 In Use
63459-0912-01 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 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

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