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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
00069-0293-10 00069-0293 filgrastim-aafi Nivestym 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
70114-0101-01 70114-0101 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 2, 2018 In Use
59353-0002-10 59353-0002 Epoetin alfa-epbx RETACRIT 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0003-10 59353-0003 Epoetin alfa-epbx RETACRIT 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0004-10 59353-0004 Epoetin alfa-epbx RETACRIT 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 2018 In Use
59353-0010-10 59353-0010 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous June 18, 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
72485-0201-01 72485-0201 azacitidine AZACITIDINE 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Sept. 10, 2018 In Use
69097-0364-36 69097-0364 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous March 11, 2019 In Use
71288-0106-10 71288-0106 Bleomycin Sulfate Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
71288-0107-20 71288-0107 Bleomycin Sulfate Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
59572-0711-01 59572-0711 Luspatercept REBLOZYL 25.0 mg/1 Ancillary Therapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use
59572-0775-01 59572-0775 Luspatercept Reblozyl 75.0 mg/1 Immunotherapy Erythropoiesis-Stimulating Agent Subcutaneous Nov. 8, 2019 In Use
13925-0523-01 13925-0523 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous May 17, 2017 Feb. 13, 2018 No Longer Used
51991-0797-98 51991-0797 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous Aug. 7, 2017 In Use
00143-9240-01 00143-9240 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
00143-9241-01 00143-9241 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
43598-0678-11 43598-0678 AZACITIDINE AZACITIDINE 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Dec. 13, 2017 In Use
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
00409-0323-20 00409-0323 BLEOMYCIN Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous April 25, 2018 In Use
69097-0368-40 69097-0368 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous May 4, 2018 In Use
00004-0360-09 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 Feb. 8, 2018 No Longer Used
00004-0360-30 00004-0360 Peginterferon alfa-2a Pegasys 135.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 1, 2011 Jan. 31, 2019 No Longer Used
00004-0350-09 00004-0350 Peginterferon alfa-2a Pegasys 180.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Oct. 16, 2002 In Use

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