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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
25021-0453-01 25021-0453 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 28, 2023 In Use
25021-0454-05 25021-0454 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 March 31, 2021 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
00069-1311-04 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1311-10 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00004-0350-09 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct. 16, 2002 June 30, 2025 In Use
00004-0350-39 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct. 16, 2002 Sept. 1, 2009 In Use
00004-0357-30 00004-0357 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous March 29, 2011 June 30, 2024 In Use
00004-0357-99 00004-0357 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Aug. 22, 2011 Sept. 19, 2014 In Use
00069-1305-10 00069-1305 epoetin alfa-epbx RETACRIT 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1307-10 00069-1307 epoetin alfa-epbx RETACRIT 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1308-10 00069-1308 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1309-04 00069-1309 epoetin alfa-epbx RETACRIT 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1309-10 00069-1309 epoetin alfa-epbx RETACRIT 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1306-10 00069-1306 epoetin alfa-epbx RETACRIT 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
00069-1318-04 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 1, 2020 In Use
00069-1318-10 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
00078-0180-01 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0180-61 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0181-01 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0181-61 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0182-01 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0182-61 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use

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