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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Ascending) Administration Route Package Effective Date Package Discontinuation Date Status
58160-0830-05 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular March 20, 2012 Nov. 29, 2016 No Longer Used
58160-0830-11 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Oct. 16, 2009 Aug. 24, 2012 No Longer Used
58160-0830-32 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Oct. 16, 2009 Sept. 3, 2013 No Longer Used
58160-0830-34 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular March 20, 2012 Nov. 29, 2016 No Longer Used
58160-0830-41 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular July 25, 2011 Sept. 3, 2013 No Longer Used
58160-0830-43 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular July 25, 2011 Nov. 29, 2016 No Longer Used
58160-0830-46 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Oct. 16, 2009 Sept. 3, 2013 No Longer Used
58160-0830-52 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular July 25, 2011 Nov. 29, 2016 No Longer Used
52125-0833-01 52125-0833 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Feb. 13, 2014 Feb. 11, 2015 No Longer Used
50090-1523-01 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
50090-1523-09 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4045-00 00006-4045 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4045-01 00006-4045 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4045-41 00006-4045 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4109-01 00006-4109 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4109-02 00006-4109 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4109-06 00006-4109 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 May 6, 2011 In Use
00006-4109-09 00006-4109 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
00006-4119-01 00006-4119 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 In Use
00006-4119-02 00006-4119 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 May 22, 2019 In Use
00006-4119-03 00006-4119 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 In Use
00006-4121-01 00006-4121 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 In Use
00006-4121-02 00006-4121 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 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
00944-2656-03 00944-2656 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
44206-0456-21 44206-0456 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0456-94 44206-0456 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0457-22 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
44206-0457-95 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan. 1, 2020 In Use
00944-2620-01 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 1, 1998 May 1, 1998 In Use
00944-2620-02 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 July 18, 2015 In Use
00944-2620-03 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2620-04 00944-2620 Human Immunoglobulin G GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 Sept. 2, 2015 In Use
00944-2623-02 00944-2623 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2625-03 00944-2625 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2627-04 00944-2627 Human Immunoglobulin G, Immune Globulin Intravenous (Human) GAMMAGARD Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 June 21, 2014 In Use
00944-2655-03 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 May 10, 1994 In Use
00944-2655-04 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G Jan. 3, 2011 Aug. 26, 2015 In Use
71258-0015-02 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71258-0015-22 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
72694-0617-60 72694-0617 Ivosidenib Tibsovo 250.0 mg/1 Chemotherapy Enzyme Inhibitor IDH1 Oral Oct. 19, 2021 In Use
71334-0100-01 71334-0100 Ivosidenib Tibsovo 250.0 mg/1 Chemotherapy Enzyme Inhibitor IDH1 Oral July 20, 2018 Nov. 30, 2024 In Use
71332-0005-01 71332-0005 Olutasidenib REZLIDHIA 150.0 mg/1 Chemotherapy Enzyme Inhibitor IDH1 Oral Dec. 1, 2022 In Use
59572-0705-30 59572-0705 Enasidenib mesylate Idhifa 50.0 mg/1 Chemotherapy Enzyme Inhibitor IDH2 Oral Aug. 1, 2017 In Use
59572-0710-30 59572-0710 Enasidenib mesylate Idhifa 100.0 mg/1 Chemotherapy Enzyme Inhibitor IDH2 Oral Aug. 1, 2017 In Use
55566-1050-01 55566-1050 Nadofaragene firadenovec-vncg ADSTILADRIN 300000000000.0 {VP}/mL Immunotherapy Gene Therapy IFN⍺2b Intravesical Sept. 5, 2023 In Use
72187-0401-01 72187-0401 Tagraxofusp Elzonris 1000.0 ug/mL Immunotherapy Fusion Protein IL3/ CD123 Intravenous Jan. 18, 2019 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

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