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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
00078-0825-81 00078-0825 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-9342-61 00078-9342 Octreotide Acetate Sandostatin LAR Depot Demonstration Kit Hormonal Therapy Somatostatin Analog Nov. 1, 1988 Aug. 31, 2017 No Longer Used
00641-6177-01 00641-6177 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 8, 2005 In Use
00641-6178-01 00641-6178 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous April 8, 2005 In Use
00781-3166-71 00781-3166 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb. 4, 2014 In Use
00781-3166-95 00781-3166 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb. 4, 2014 In Use
00781-9164-75 00781-9164 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog Oct. 21, 1988 June 29, 2014 No Longer Used
00781-9165-75 00781-9165 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog Oct. 21, 1988 Nov. 17, 2014 No Longer Used
55390-0160-10 55390-0160 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog April 4, 2005 Feb. 28, 2013 No Longer Used
55390-0161-10 55390-0161 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog April 4, 2005 April 30, 2013 No Longer Used
55390-0162-10 55390-0162 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog April 4, 2005 March 31, 2015 No Longer Used
55390-0163-01 55390-0163 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog April 8, 2005 Dec. 31, 2014 No Longer Used
55390-0164-01 55390-0164 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog April 8, 2005 Dec. 31, 2014 No Longer Used
55390-0375-10 55390-0375 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog March 9, 2009 April 30, 2013 No Longer Used
55390-0376-10 55390-0376 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog March 9, 2009 Jan. 31, 2013 No Longer Used
55390-0377-01 55390-0377 Octreotide Acetate Octreotide Acetate Hormonal Therapy Somatostatin Analog March 9, 2009 April 30, 2013 No Longer Used
55648-0632-01 55648-0632 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0633-01 55648-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0633-02 55648-0633 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0634-01 55648-0634 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0635-01 55648-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0635-02 55648-0635 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0636-01 55648-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
55648-0636-02 55648-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
62756-0348-44 62756-0348 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 14, 2007 Jan. 31, 2017 No Longer Used
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
55513-0003-04 55513-0003 Darbepoetin alfa Aranesp 40.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0004-01 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0004-04 55513-0004 Darbepoetin alfa Aranesp 60.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sept. 11, 2006 In Use
55513-0021-01 55513-0021 Darbepoetin alfa Aranesp 40.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0021-04 55513-0021 Darbepoetin alfa Aranesp 40.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0023-01 55513-0023 Darbepoetin alfa Aranesp 60.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0023-04 55513-0023 Darbepoetin alfa Aranesp 60.0 ug/.3mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
25021-0802-10 25021-0802 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2010 Dec. 31, 2014 No Longer Used
25021-0803-10 25021-0803 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2010 Dec. 31, 2014 No Longer Used
42023-0167-01 42023-0167 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 7, 2013 March 16, 2020 No Longer Used
55513-0025-01 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use
55513-0025-04 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 14, 2006 In Use
55513-0057-01 55513-0057 Darbepoetin alfa Aranesp 25.0 ug/.42mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb. 18, 2011 In Use

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