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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
57894-0522-01 57894-0522 AMIVANTAMAB and HYALURONIDASE-lpuj (HUMAN RECOMBINANT) Rybrevant Faspro 3520.0 mg/22mL, 44000.0 mg/22mL Immunotherapy Bispecific Antibody EGFR, MET Subcutaneous Feb 13, 2026 In Use
62935-0222-05 62935-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug 26, 2002 Apr 26, 2019 In Use
00024-0610-30 00024-0610 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 May 31, 2016 No Longer Used
62935-0227-10 62935-0227 Leuprolide acetate Eligard 22.5 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 27, 2023 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
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
73441-0062-01 73441-0062 MOTIXAFORTIDE APHEXDA 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Jun 15, 2025 In Use
50242-0245-86 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 May 3, 2021 In Use
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct 25, 2022 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
70771-1687-03 70771-1687 LEUPROLIDE ACETATE LEUPROLIDE ACETATE 1.0 mg/0.2ml Hormonal Therapy GnRH Agonist Subcutaneous Jan 8, 2026 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
69097-0906-67 69097-0906 LANREOTIDE ACETATE LANREOTIDE ACETATE 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous May 30, 2025 In Use
83457-0012-10 83457-0012 Denosumab OSPOMYV 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Oct 10, 2025 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb 28, 2019 In Use
50090-3466-00 50090-3466 Goserelin acetate ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 30, 2018 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov 8, 2019 In Use
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb 20, 2015 In Use
61314-0240-63 61314-0240 Denosumab JUBBONTI 60.0 mg/mL Ancillary Therapy Monoclonal Antibody RANKL Subcutaneous Jun 2, 2025 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
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
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb 26, 2003 In Use
62935-0756-80 62935-0756 Leuprolide acetate Eligard 7.5 mg/.25mL Hormonal Therapy GnRH Agonist Subcutaneous Nov 1, 2023 In Use
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 25, 2023 In Use
62935-0452-45 62935-0452 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan 23, 2002 Apr 26, 2019 No Longer Used

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