| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 57377-0050-01 | 57377-0050 | Estradiol pellet | Estra-50 | 50.0 mg/1 | Hormonal Therapy | Estrogen | Subcutaneous | Jan 1, 2017 | In Use | ||
| 00004-0360-09 | 00004-0360 | Peginterferon alfa-2a | Pegasys | 135.0 ug/.5mL | Immunotherapy | Cytokine | Interferon | Subcutaneous | Nov 1, 2011 | Feb 8, 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 | ||
| 70121-1627-01 | 70121-1627 | Pegfilgrastim | FYLNETRA | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | May 31, 2022 | 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 | |
| 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 | |
| 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 | |
| 76282-0719-67 | 76282-0719 | LANREOTIDE ACETATE | LANREOTIDE ACETATE | 90.0 mg/.3mL | Hormonal Therapy | Somatostatin Analog | Subcutaneous | May 21, 2024 | 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 | |
| 82705-0010-01 | 82705-0010 | Epcoritamab-bysp | EPKINLY | 48.0 mg/.8mL | Immunotherapy | Monoclonal Antibody | CD20, CD3 | Subcutaneous | May 19, 2023 | In Use | |
| 55150-0356-01 | 55150-0356 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 24, 2023 | 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 | |
| 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 | |
| 63539-0252-02 | 63539-0252 | Elranatamab-bcmm | Elrexfio | 44.0 mg/1.1mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Aug 15, 2023 | In Use | |
| 57894-0450-01 | 57894-0450 | Teclistamab | TECVAYLI | 90.0 mg/mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Oct 25, 2022 | In Use | |
| 00069-2522-02 | 00069-2522 | Elranatamab-bcmm | Elrexfio | 44.0 mg/1.1mL | Immunotherapy | Monoclonal Antibody | BCMA, CD3 | Subcutaneous | Aug 15, 2023 | In Use | |
| 50090-2027-00 | 50090-2027 | Goserelin acetate | Zoladex | 3.6 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Sep 23, 2015 | In Use | ||
| 75987-0111-11 | 75987-0111 | Interferon gamma-1b | Actimmune | 100.0 ug/.5mL | Immunotherapy | Cytokine | Interferon | Subcutaneous | Dec 1, 2013 | 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 | |
| 59572-0711-01 | 59572-0711 | Luspatercept | REBLOZYL | 25.0 mg/1 | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Subcutaneous | Nov 8, 2019 | In Use | ||
| 70720-0950-36 | 70720-0950 | Goserelin | ZOLADEX | 3.6 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Mar 31, 2018 | 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 | |
| 62935-0461-50 | 62935-0461 | Leuprolide acetate | Eligard | 45.0 mg/.375mL | Hormonal Therapy | GnRH Agonist | Subcutaneous | Mar 6, 2023 | In Use | ||
| 44206-0456-21 | 44206-0456 | HUMAN IMMUNOGLOBULIN G | Hizentra | 0.2 g/mL | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | Subcutaneous | Jan 1, 2020 | In Use | |
| 70720-0951-30 | 70720-0951 | Goserelin | ZOLADEX | 10.8 mg/1 | Hormonal Therapy | GnRH Agonist | Subcutaneous | Jan 26, 2018 | In Use |
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