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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
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
70121-1568-07 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1569-07 70121-1569 Filgrastim RELEUKO 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1570-01 70121-1570 Filgrastim RELEUKO 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 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
70121-1571-07 70121-1571 Filgrastim RELEUKO 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 8, 2017 In Use
70121-1573-01 70121-1573 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue May 20, 2019 In Use
70121-1573-05 70121-1573 Methylprednisolone acetate Methylprednisolone acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intrasynovial, Soft Tissue May 20, 2019 In Use
70121-1574-01 70121-1574 Methylprednisolone acetate Methylprednisolone acetate 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue May 20, 2019 In Use

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