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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status (Ascending)
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
55513-0057-04 55513-0057 Darbepoetin alfa Aranesp 25.0 ug/.42mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 26, 2006 In Use
55513-0098-01 55513-0098 Darbepoetin alfa Aranesp 10.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Oct. 6, 2015 In Use
55513-0098-04 55513-0098 Darbepoetin alfa Aranesp 10.0 ug/.4mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 26, 2006 In Use
55513-0126-01 55513-0126 Epoetin alfa Epogen 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 30, 1989 In Use
55513-0126-10 55513-0126 Epoetin alfa Epogen 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 30, 1989 In Use
55513-0144-01 55513-0144 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0144-10 55513-0144 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0148-01 55513-0148 Epoetin alfa Epogen 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0148-10 55513-0148 Epoetin alfa Epogen 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 16, 1993 In Use
55513-0192-01 55513-0192 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Feb. 20, 2015 In Use
55513-0209-01 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-10 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0267-01 55513-0267 Epoetin alfa Epogen 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous April 30, 1990 In Use
55513-0267-10 55513-0267 Epoetin alfa Epogen 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous April 30, 1990 In Use
55513-0283-01 55513-0283 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 5, 1994 In Use
55513-0283-10 55513-0283 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 5, 1994 In Use
55513-0478-01 55513-0478 Epoetin alfa Epogen 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous March 3, 1997 In Use
55513-0478-10 55513-0478 Epoetin alfa Epogen 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous March 3, 1997 In Use
59676-0302-00 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0302-01 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0302-02 59676-0302 Erythropoietin Procrit 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Jan. 8, 2014 In Use
59676-0303-00 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0303-01 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0303-02 59676-0303 Erythropoietin Procrit 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Jan. 8, 2014 In Use
59676-0304-00 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0304-01 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0304-02 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Jan. 8, 2014 In Use
59676-0310-00 59676-0310 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0310-01 59676-0310 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0310-02 59676-0310 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0312-00 59676-0312 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0312-01 59676-0312 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Sept. 13, 2012 In Use
59676-0312-04 59676-0312 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0320-00 59676-0320 Erythropoietin Procrit 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0320-01 59676-0320 Erythropoietin Procrit 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 Sept. 13, 2012 In Use
59676-0320-04 59676-0320 Erythropoietin Procrit 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
59676-0340-00 59676-0340 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 8, 2011 In Use
59676-0340-01 59676-0340 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 1, 1989 In Use
60505-0133-00 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60505-0133-01 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60505-0133-02 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60505-0134-00 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60505-0134-01 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60505-0134-02 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Feb. 28, 2025 In Use
60687-0227-11 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 24, 2017 In Use
60687-0227-94 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 24, 2017 In Use
60687-0375-01 60687-0375 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral July 16, 2018 In Use

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