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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
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
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
50242-0245-01 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous June 29, 2020 In Use
50242-0245-86 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
50242-0260-01 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous June 29, 2020 In Use
50242-0260-86 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 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
62935-0452-45 62935-0452 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Jan. 23, 2002 April 26, 2019 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
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
50242-0108-01 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 23, 2017 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
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb. 20, 2015 In Use
67457-0833-06 67457-0833 pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous July 9, 2018 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb. 28, 2019 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 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
62756-0452-36 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous April 29, 2020 In Use
62756-0452-37 62756-0452 Octreotide acetate BYNFEZIA Pen 2.5 mg/mL Hormonal Therapy Somatostatin Analog Subcutaneous April 29, 2020 In Use
00185-7400-14 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Jan. 6, 2011 In Use
00185-7400-85 00185-7400 Leuprolide Acetate Leuprolide Acetate 1.0 mg/.2mL Hormonal Therapy GnRH Agonist Subcutaneous Aug. 4, 1998 In Use
62935-0222-05 62935-0222 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Aug. 26, 2002 April 26, 2019 In Use
62935-0302-30 62935-0302 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous Feb. 26, 2003 April 26, 2019 In Use
62935-0752-75 62935-0752 Leuprolide Acetate Eligard Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2002 April 26, 2019 In Use
00310-0950-36 00310-0950 Goserelin acetate Zoladex 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 5, 2003 May 31, 2020 No Longer Used
00310-0951-30 00310-0951 Goserelin acetate Zoladex 10.8 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 5, 2003 March 31, 2020 No Longer Used
50090-3466-00 50090-3466 Goserelin acetate ZOLADEX 3.6 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous May 30, 2018 In Use
58468-0140-01 58468-0140 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Dec. 15, 2008 March 23, 2018 No Longer Used
67979-0500-01 67979-0500 Histrelin Acetate Vantas 50.0 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Nov. 1, 2004 March 31, 2022 No Longer Used
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 12, 2021 In Use
57377-0060-01 57377-0060 Testosterone, USP and Anastrozole Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan. 1, 2021 In Use
69448-0014-63 69448-0014 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous April 5, 2022 In Use
15054-1060-03 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1060-04 15054-1060 Lanreotide acetate Somatuline Depot 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
15054-1090-03 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1090-04 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
15054-1120-03 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1120-04 15054-1120 Lanreotide acetate Somatuline Depot 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
76282-0709-67 76282-0709 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous June 1, 2022 In Use

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