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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
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
63323-0365-01 63323-0365 OCTREOTIDE ACETATE Octreotide 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 June 30, 2017 No Longer Used
63323-0365-04 63323-0365 OCTREOTIDE ACETATE Octreotide 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous March 14, 2006 June 30, 2017 No Longer Used
70720-0950-36 70720-0950 Goserelin ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous March 31, 2018 In Use
70720-0951-30 70720-0951 Goserelin ZOLADEX 10.8 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Jan. 26, 2018 In Use
00024-5843-01 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Nov. 5, 2013 Dec. 30, 2021 No Longer Used
00024-5843-05 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 1, 1991 Dec. 30, 2021 No Longer Used
00024-5844-01 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec. 1, 1996 Dec. 30, 2021 No Longer Used
00024-5844-05 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec. 1, 1996 Dec. 30, 2021 No Longer Used
68001-0527-54 68001-0527 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Feb. 15, 2022 In Use
70121-1237-01 70121-1237 AZACITIDINE AZACITIDINE 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Feb. 9, 2022 In Use
47426-0101-01 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug. 9, 2016 Aug. 9, 2016 In Use
47426-0101-06 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug. 9, 2016 In Use
55513-0002-01 55513-0002 Darbepoetin alfa Aranesp 25.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0002-04 55513-0002 Darbepoetin alfa Aranesp 25.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0003-01 55513-0003 Darbepoetin alfa Aranesp 40.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
15054-0060-01 15054-0060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-0090-01 15054-0090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-0120-01 15054-0120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
41616-0936-40 41616-0936 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Dec. 15, 2014 Aug. 31, 2015 No Longer Used
00641-6175-01 00641-6175 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00641-6175-10 00641-6175 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00641-6176-01 00641-6176 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00641-6176-10 00641-6176 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
62935-0452-45 62935-0452 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 April 26, 2019 No Longer Used
55513-0005-01 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0005-04 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0027-01 55513-0027 Darbepoetin alfa Aranesp 150.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0027-04 55513-0027 Darbepoetin alfa Aranesp 150.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec. 15, 2020 In Use
00143-9606-01 00143-9606 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous June 8, 2020 In Use
16714-0927-01 16714-0927 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous May 8, 2019 In Use
43817-0906-01 43817-0906 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous May 6, 2019 In Use
68083-0337-01 68083-0337 Cytarabine Cytarabine 100.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intrathecal, Intravenous, Subcutaneous Dec. 23, 2019 In Use
68083-0343-05 68083-0343 Cytarabine Cytarabine 20.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intrathecal, Intravenous, Subcutaneous Dec. 23, 2019 In Use
71288-0153-95 71288-0153 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Nov. 2, 2020 In Use
50090-1922-00 50090-1922 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue July 15, 2015 March 31, 2019 In Use

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