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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
55513-0028-01 55513-0028 Darbepoetin alfa Aranesp 200.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0032-01 55513-0032 Darbepoetin alfa Aranesp 500.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 7, 2006 In Use
55513-0053-01 55513-0053 Darbepoetin alfa Aranesp 150.0 ug/.75mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0053-04 55513-0053 Darbepoetin alfa Aranesp 150.0 ug/.75mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0110-01 55513-0110 Darbepoetin alfa Aranesp 300.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0111-01 55513-0111 Darbepoetin alfa Aranesp 300.0 ug/.6mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
54868-5802-00 54868-5802 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 13, 2007 In Use
00024-0222-05 00024-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 May 31, 2016 No Longer Used
00024-0605-45 00024-0605 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 May 31, 2016 No Longer Used
00024-0610-30 00024-0610 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 May 31, 2016 No Longer Used
00024-0793-75 00024-0793 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 May 31, 2016 No Longer Used
62935-0223-05 62935-0223 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug. 26, 2002 In Use
62935-0453-45 62935-0453 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 7, 2005 In Use
62935-0753-75 62935-0753 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2002 In Use
63323-0376-01 63323-0376 OCTREOTIDE ACETATE Octreotide 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
63323-0376-04 63323-0376 OCTREOTIDE ACETATE Octreotide 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
63323-0377-01 63323-0377 OCTREOTIDE ACETATE Octreotide 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
63323-0377-04 63323-0377 OCTREOTIDE ACETATE Octreotide 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
63323-0378-05 63323-0378 OCTREOTIDE ACETATE Octreotide 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
63323-0379-05 63323-0379 OCTREOTIDE ACETATE Octreotide 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 In Use
00641-6177-01 00641-6177 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 8, 2005 In Use
00641-6178-01 00641-6178 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 8, 2005 In Use
00781-3166-71 00781-3166 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb. 4, 2014 In Use
00781-3166-95 00781-3166 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb. 4, 2014 In Use
55648-0632-01 55648-0632 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0633-01 55648-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0633-02 55648-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0634-01 55648-0634 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0635-01 55648-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0635-02 55648-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0636-01 55648-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0636-02 55648-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
62756-0348-44 62756-0348 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Jan. 31, 2017 No Longer Used
62756-0349-44 62756-0349 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Nov. 30, 2016 No Longer Used
62756-0350-40 62756-0350 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Jan. 31, 2017 No Longer Used
62756-0351-44 62756-0351 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Nov. 30, 2016 No Longer Used
62756-0352-40 62756-0352 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Jan. 31, 2017 No Longer Used
64679-0632-01 64679-0632 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0633-01 64679-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0633-02 64679-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0634-01 64679-0634 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0635-01 64679-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0635-02 64679-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0636-01 64679-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0636-02 64679-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
00004-0365-09 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 In Use
00004-0365-30 00004-0365 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 In Use
55513-0003-04 55513-0003 Darbepoetin alfa Aranesp 40.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0004-01 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0004-04 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use

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