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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
62935-0461-50 62935-0461 Leuprolide acetate Eligard 45.0 mg/.375mL Hormonal Therapy GnRH Agonist Subcutaneous March 6, 2023 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
00641-6174-01 00641-6174 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00641-6174-10 00641-6174 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 4, 2005 In Use
00781-9253-94 00781-9253 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous March 27, 2014 Sept. 30, 2024 In Use
25021-0455-05 25021-0455 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 29, 2020 In Use
43598-0426-60 43598-0426 Bortexomib Bortezomib 3.5 mg/1 Chemotherapy Proteasome Inhibitor 26S Intravenous, Subcutaneous July 26, 2022 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
62935-0303-30 62935-0303 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb. 26, 2003 In Use
68001-0504-54 68001-0504 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous June 11, 2021 In Use
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
42238-0111-12 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
00703-3154-01 00703-3154 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous June 30, 2000 In Use
00703-3155-01 00703-3155 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous June 30, 2000 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
72606-0558-01 72606-0558 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Jan. 6, 2020 In Use
59353-0220-10 59353-0220 Epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
59353-0120-10 59353-0120 Epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov. 9, 2020 In Use
61314-0866-01 61314-0866 pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov. 4, 2019 In Use
44206-0458-24 44206-0458 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 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
13925-0523-01 13925-0523 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous May 17, 2017 Feb. 13, 2018 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

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