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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
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
55513-0006-01 55513-0006 Darbepoetin alfa Aranesp 200.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
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
55513-0190-01 55513-0190 Pegfilgrastim Neulasta 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous April 1, 2002 In Use
00024-5862-01 00024-5862 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Sept. 1, 2013 In Use
00143-9240-01 00143-9240 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
00143-9241-01 00143-9241 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
43598-0678-11 43598-0678 AZACITIDINE AZACITIDINE 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Dec. 13, 2017 In Use
00409-0323-20 00409-0323 BLEOMYCIN Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous April 25, 2018 In Use
69097-0368-40 69097-0368 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous May 4, 2018 In Use
00004-0360-09 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 Feb. 8, 2018 No Longer Used
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 Jan. 31, 2019 No Longer Used
16714-0908-01 16714-0908 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Dec. 1, 2018 In Use
16714-0886-01 16714-0886 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Dec. 1, 2018 In Use
16729-0306-10 16729-0306 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Jan. 9, 2019 In Use
00703-4014-11 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
00703-4014-18 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
62756-0093-40 62756-0093 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 7, 2012 Jan. 31, 2017 No Longer Used
62756-0093-44 62756-0093 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 31, 2012 Jan. 31, 2017 No Longer Used
62756-0094-40 62756-0094 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 7, 2012 Nov. 30, 2016 No Longer Used
62756-0094-44 62756-0094 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 31, 2012 Nov. 30, 2016 No Longer Used
62756-0095-40 62756-0095 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 7, 2012 Nov. 30, 2016 No Longer Used
62756-0095-44 62756-0095 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 31, 2012 Nov. 30, 2016 No Longer Used
00069-0291-01 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0291-10 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0292-01 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0293-10 00069-0293 filgrastim-aafi Nivestym 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
70114-0101-01 70114-0101 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 2, 2018 In Use
72485-0201-01 72485-0201 azacitidine AZACITIDINE 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Sept. 10, 2018 In Use
69097-0364-36 69097-0364 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous March 11, 2019 In Use
71288-0106-10 71288-0106 Bleomycin Sulfate Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
71288-0107-20 71288-0107 Bleomycin Sulfate Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use

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