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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class (Descending) Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 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
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
63459-0918-59 63459-0918 tbo-filgrastim GRANIX 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
76961-0101-01 76961-0101 Eflapegrastim-xnst Rolvedon 13.2 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct. 18, 2022 In Use
70121-1569-07 70121-1569 Filgrastim RELEUKO 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1571-07 70121-1571 Filgrastim RELEUKO 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70114-0120-01 70114-0120 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 6, 2023 In Use
70121-1568-07 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1568-01 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 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
70121-1570-07 70121-1570 Filgrastim RELEUKO 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1570-01 70121-1570 Filgrastim RELEUKO 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
65219-0371-10 65219-0371 pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct. 6, 2022 In Use
00944-2620-01 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 1, 1998 May 1, 1998 In Use
00944-2620-02 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 July 18, 2015 In Use
00944-2620-03 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2620-04 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2623-02 00944-2623 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2625-03 00944-2625 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2627-04 00944-2627 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2655-03 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 May 10, 1994 In Use
00944-2655-04 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G Jan. 3, 2011 Aug. 26, 2015 In Use
58468-0140-01 58468-0140 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Dec. 15, 2008 March 23, 2018 No Longer Used
61314-0304-01 61314-0304 filgrastim-sndz Zarxio 300.0 ug/.5mL, 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
61314-0304-10 61314-0304 filgrastim-sndz Zarxio 300.0 ug/.5mL, 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
61314-0312-01 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
61314-0312-10 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sept. 3, 2015 Feb. 28, 2021 No Longer Used
70383-0073-01 70383-0073 MOTIXAFORTIDE ACETATE Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sept. 8, 2023 In Use
83257-0005-41 83257-0005 Pegfilgrastim-jmdb Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Oct. 1, 2023 In Use
73441-0800-04 73441-0800 omidubicel-onlv OMISIRGE Ancillary Therapy Immunostimulant Stem cell mobilizer Intravenous May 1, 2023 In Use
72205-0249-01 72205-0249 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 25, 2023 In Use
67457-0833-06 67457-0833 Pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous July 9, 2018 May 31, 2026 In Use
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous Sept. 1, 2023 In Use
43598-0308-23 43598-0308 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Nov. 6, 2023 In Use
82737-0073-01 82737-0073 Motixafortide Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sept. 8, 2023 In Use
00480-4320-01 00480-4320 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
55150-0356-01 55150-0356 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 24, 2023 In Use
65219-0284-12 65219-0284 PLERIXAFOR Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous June 22, 2023 In Use
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 25, 2023 In Use
70710-1208-01 70710-1208 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
70771-1776-01 70771-1776 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 24, 2023 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
73491-0627-01 73491-0627 Efbemalenograstim alfa-vuxw RYZNEUTA 20.0 mg/mL Immunotherapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 23, 2023 In Use
00187-5525-60 00187-5525 Bexarotene Targretin 1.0 g/100g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical June 28, 2000 In Use
00187-5526-75 00187-5526 Bexarotene Targretin 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 1999 In Use
00378-6955-01 00378-6955 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 9, 2015 In Use
68682-0003-10 68682-0003 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 17, 2015 In Use
00089-0610-12 00089-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 24, 2011 Jan. 31, 2015 No Longer Used
00093-6126-19 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
00093-6126-64 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
00781-7152-09 00781-7152 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 May 31, 2014 No Longer Used
00781-7152-13 00781-7152 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 May 31, 2014 No Longer Used
54868-4554-01 54868-4554 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 19, 2003 Sept. 30, 2009 No Longer Used
00004-0155-49 00004-0155 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
00004-0156-49 00004-0156 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
00004-0169-49 00004-0169 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
54868-0955-00 54868-0955 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative Aug. 7, 1995 Dec. 29, 2010 No Longer Used
00555-1054-56 00555-1054 Isotretinoin Claravis 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1054-86 00555-1054 Isotretinoin Claravis 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1055-56 00555-1055 Isotretinoin Claravis 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1055-86 00555-1055 Isotretinoin Claravis 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1056-86 00555-1056 Isotretinoin Claravis 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 18, 2006 In Use
00555-1057-56 00555-1057 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1057-86 00555-1057 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
10631-0115-31 10631-0115 Isotretinoin Absorica 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use
10631-0116-31 10631-0116 Isotretinoin Absorica 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use
10631-0117-31 10631-0117 Isotretinoin Absorica 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use
10631-0118-31 10631-0118 Isotretinoin Absorica 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use
54868-5039-00 54868-5039 Isotretinoin Amnesteem 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 2, 2010 In Use
54868-5041-00 54868-5041 Isotretinoin Amnesteem 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 14, 2009 In Use
54868-5043-00 54868-5043 Isotretinoin Amnesteem 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 14, 2009 In Use
54868-5305-00 54868-5305 Isotretinoin Amnesteem Hormonal Therapy Immunomodulator Retinoic Acid Derivative Jan. 6, 2012 Sept. 16, 2008 No Longer Used
54868-6185-00 54868-6185 Isotretinoin Claravis 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 4, 2013 In Use
54868-6307-00 54868-6307 Isotretinoin Claravis 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 14, 2011 In Use
54868-6308-00 54868-6308 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 20, 2011 In Use
54868-6366-00 54868-6366 Isotretinoin Myorisan 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug. 23, 2012 In Use
54868-6378-00 54868-6378 Isotretinoin Myorisan 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 29, 2012 In Use
54868-6425-00 54868-6425 Isotretinoin ZENATANE 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 16, 2014 In Use
54868-6426-00 54868-6426 Isotretinoin ZENATANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 16, 2014 In Use
55111-0113-78 55111-0113 Isotretinoin ZENATANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral March 9, 2015 In Use
55111-0113-81 55111-0113 Isotretinoin ZENATANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral March 9, 2015 In Use
55111-0135-81 55111-0135 Isotretinoin ZENATANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral March 26, 2013 In Use
55111-0136-81 55111-0136 Isotretinoin ZENATANE 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral March 26, 2013 In Use
55111-0137-81 55111-0137 Isotretinoin ZENATANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral March 26, 2013 In Use
69238-1017-03 69238-1017 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1174-03 69238-1174 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1175-03 69238-1175 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1176-03 69238-1176 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
59572-0501-00 59572-0501 Pomalidomide Pomalyst 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0501-21 59572-0501 Pomalidomide Pomalyst 1.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0502-00 59572-0502 Pomalidomide Pomalyst 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0502-21 59572-0502 Pomalidomide Pomalyst 2.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0503-00 59572-0503 Pomalidomide Pomalyst 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0503-21 59572-0503 Pomalidomide Pomalyst 3.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0504-00 59572-0504 Pomalidomide Pomalyst 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
59572-0504-21 59572-0504 Pomalidomide Pomalyst 4.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Feb. 18, 2013 In Use
68084-0075-11 68084-0075 Tretinoin Tretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 18, 2013 In Use

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