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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
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
71837-5844-01 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
71839-0104-01 71839-0104 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Oct. 15, 2019 In Use
71872-7205-01 71872-7205 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 13, 2020 In Use
71872-7239-01 71872-7239 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 100.0 mg/10mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 15, 2021 In Use
71905-0400-11 71905-0400 Dexamethasone Dexabliss 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
71921-0190-33 71921-0190 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 15, 2021 In Use
71930-0017-30 71930-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
71930-0017-52 71930-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 6, 2020 In Use
71930-0018-30 71930-0018 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
71930-0018-52 71930-0018 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 6, 2020 In Use
72064-0110-30 72064-0110 avapritinib Ayvakit 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0120-30 72064-0120 avapritinib Ayvakit 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0125-30 72064-0125 avapritinib Ayvakit 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0130-30 72064-0130 avapritinib Ayvakit 300.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0150-30 72064-0150 avapritinib Ayvakit 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0210-12 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 In Use
72064-0210-60 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 In Use
72064-0210-90 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 In Use
72143-0231-30 72143-0231 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 In Use
72143-0233-30 72143-0233 ISOTRETINOIN ACCUTANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 In Use
72143-0234-30 72143-0234 ISOTRETINOIN ACCUTANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 In Use
72187-0401-01 72187-0401 Tagraxofusp Elzonris 1000.0 ug/mL Immunotherapy Fusion Protein IL3/ CD123 Intravenous Jan. 18, 2019 In Use
72189-0008-21 72189-0008 Methylpred DP Methylpred DP 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 26, 2019 In Use

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