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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class (Ascending) Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
59651-0632-03 59651-0632 ISOTRETINOIN ISOTRETINOIN 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 29, 2024 In Use
59651-0633-03 59651-0633 ISOTRETINOIN ISOTRETINOIN 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 29, 2024 In Use
59651-0634-03 59651-0634 ISOTRETINOIN ISOTRETINOIN 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 29, 2024 In Use
59651-0635-03 59651-0635 ISOTRETINOIN ISOTRETINOIN 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 29, 2024 In Use
59651-0636-03 59651-0636 ISOTRETINOIN ISOTRETINOIN 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 29, 2024 In Use
61269-0750-10 61269-0750 Tretinoin Vesanoid 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb. 1, 2024 In Use
61269-0850-10 61269-0850 Tretinoin TRETINOIN 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb. 1, 2024 In Use
00574-0866-10 00574-0866 Cyclosporine Cyclosporine 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Oct. 7, 2003 Aug. 1, 2024 No Longer Used
72143-0231-30 72143-0231 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Dec. 31, 2023 No Longer Used
72143-0233-30 72143-0233 ISOTRETINOIN ACCUTANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Jan. 31, 2024 No Longer Used
72143-0234-30 72143-0234 ISOTRETINOIN ACCUTANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Dec. 31, 2023 No Longer Used
54868-2522-00 54868-2522 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous June 8, 1994 In Use
54868-2522-01 54868-2522 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous June 8, 1994 In Use
54868-3050-00 54868-3050 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous Aug. 14, 2006 In Use
54868-5020-00 54868-5020 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous March 11, 2004 In Use
54868-5229-00 54868-5229 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Feb. 23, 2006 Dec. 31, 2011 No Longer Used
55513-0190-01 55513-0190 Pegfilgrastim Neulasta 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous April 1, 2002 In Use
00024-5862-01 00024-5862 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Sept. 1, 2013 In Use
50419-0002-33 50419-0002 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Sept. 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-14 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-30 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
54868-3188-00 54868-3188 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Dec. 1, 1996 June 30, 2012 No Longer Used
58468-0181-01 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
58468-0181-02 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
00069-0291-01 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use

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