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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
63459-0912-12 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-15 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0912-18 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan. 7, 2015 In Use
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
63459-0918-59 63459-0918 tbo-filgrastim GRANIX 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
76961-0101-01 76961-0101 Eflapegrastim-xnst Rolvedon 13.2 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct. 18, 2022 In Use
72851-0042-01 72851-0042 Leuprolide CAMCEVI 42.0 mg/mL Hormonal Therapy GnRH Agonist Subcutaneous Dec. 30, 2022 In Use
51991-0797-98 51991-0797 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous Aug. 7, 2017 Jan. 31, 2024 In Use
69097-0870-67 69097-0870 Lanreotide acetate Lanreotide Acetate 120.0 mg/.5mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
69097-0880-67 69097-0880 Lanreotide acetate Lanreotide Acetate 60.0 mg/.2mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
69097-0890-67 69097-0890 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
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
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
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
69639-0120-01 69639-0120 Mechlorethamine hydrochloride VALCHLOR 0.012 g/60g Chemotherapy Alkylating Agent Nitrogen Mustard TOPICAL Nov. 8, 2018 In Use
00187-5525-60 00187-5525 Bexarotene Targretin 1.0 g/100g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical June 28, 2000 In Use
00187-3204-47 00187-3204 Fluorouracil Efudex 2.0 g/40g Chemotherapy Antimetabolite Pyrimidine Analog Topical July 29, 1970 In Use
51672-4063-01 51672-4063 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Topical Nov. 5, 2003 In Use
54868-0951-00 54868-0951 Fluorouracil Efudex Chemotherapy Antimetabolite Pyrimidine Analog Topical July 29, 1970 Sept. 30, 2011 No Longer Used
54868-6293-00 54868-6293 Fluorouracil Fluorouracil 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 6, 2011 In Use
68682-0004-31 68682-0004 Fluorouracil Fluorouracil Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 1, 2006 Jan. 31, 2015 No Longer Used
68682-0085-31 68682-0085 Fluorouracil Fluorouracil Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 30, 1990 Jan. 31, 2010 No Longer Used
00089-0610-12 00089-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 24, 2011 Jan. 31, 2015 No Longer Used
00093-6126-19 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
00093-6126-64 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
00781-7152-09 00781-7152 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 May 31, 2014 No Longer Used
00781-7152-13 00781-7152 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 May 31, 2014 No Longer Used
54868-4554-01 54868-4554 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 19, 2003 Sept. 30, 2009 No Longer Used
29336-0610-12 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 24, 2010 Jan. 31, 2015 No Longer Used
29336-0610-24 29336-0610 Imiquimod Aldara Immunotherapy Immunomodulator Dermatological Agent Topical June 24, 2011 June 24, 2011 No Longer Used
00115-1476-23 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 June 1, 2017 No Longer Used
00115-1476-59 00115-1476 Imiquimod Imiquimod 50.0 mg/g Immunotherapy Immunomodulator Dermatological Agent Topical Feb. 28, 2011 June 1, 2017 No Longer Used
72189-0084-24 72189-0084 IMIQUIMOD IMIQUIMOD 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical March 23, 2020 In Use
51862-0362-40 51862-0362 FLUOROURACIL FLUOROURACIL 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Dec. 3, 2019 In Use
60505-0501-04 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
60505-0501-05 60505-0501 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical Sept. 14, 2012 March 31, 2018 No Longer Used
45802-0076-00 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0076-62 45802-0076 Imiquimod Imiquimod 50.0 mg/1000mg Immunotherapy Immunomodulator Dermatological Agent Topical April 20, 2010 Aug. 1, 2013 No Longer Used
45802-0368-53 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical July 12, 2012 In Use
45802-0368-62 45802-0368 Imiquimod Imiquimod 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical Nov. 9, 2010 In Use
00378-4791-06 00378-4791 Fluorouracil Fluorouracil 5.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 19, 2013 In Use
42427-0002-60 42427-0002 Mechlorethamine Hydrochloride Valchlor 0.012 g/60g, 0.012 g/60g Chemotherapy Alkylating Agent Nitrogen Mustard Topical Oct. 21, 2013 Oct. 22, 2013 No Longer Used
51672-4118-02 51672-4118 Fluorouracil Fluorouracil 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical March 17, 2017 In Use

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