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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength (Descending) SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous March 23, 2022 In Use
73150-0200-12 73150-0200 umbralisib UKONIQ 260.2 mg/1 Chemotherapy Enzyme Inhibitor PI3Kδ, CK1ε, ABL1, CXCL12, CCL19 Oral Feb. 5, 2021 July 31, 2023 No Longer Used
69639-0105-01 69639-0105 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Intravenous June 15, 2020 In Use
69639-0106-01 69639-0106 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 Intravenous Aug. 1, 2023 In Use
69639-0102-01 69639-0102 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/1, 0.28 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Intravenous April 20, 2018 In Use
65597-0511-04 65597-0511 QUIZARTINIB VANFLYTA 26.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral July 20, 2023 In Use
65597-0511-28 65597-0511 QUIZARTINIB VANFLYTA 26.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral July 20, 2023 In Use
00024-5843-01 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Nov. 5, 2013 Dec. 30, 2021 No Longer Used
00024-5843-05 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 1, 1991 Dec. 30, 2021 No Longer Used
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Intravenous, Subcutaneous Sept. 1, 2023 In Use
67157-0111-05 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular In Use
67157-0111-25 67157-0111 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Dec. 2, 2016 Dec. 2, 2016 In Use
62559-0540-15 62559-0540 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular June 3, 2016 July 31, 2018 No Longer Used
62559-0540-55 62559-0540 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular June 3, 2016 June 3, 2016 No Longer Used
80978-0111-06 80978-0111 Nelarabine injection NELARABINE 250.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous April 12, 2023 In Use
67457-0886-05 67457-0886 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Sept. 22, 2017 June 30, 2024 In Use
68001-0484-85 68001-0484 Fulvestrant Fulvestrant 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular March 1, 2021 In Use
70121-1463-02 70121-1463 Fulvestrant Fulvestrant 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular March 4, 2019 In Use
68001-0522-85 68001-0522 Fulvestrant FULVESTRANT 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct. 29, 2021 In Use
16729-0436-30 16729-0436 Fulvestrant FULVESTRANT 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Jan. 21, 2021 In Use
00591-5019-02 00591-5019 Fulvestrant Fulvestrant 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 22, 2019 June 30, 2024 In Use
00009-0013-05 00009-0013 Hydrocortisone Sodium Succinate Solu-Cortef 250.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 27, 1955 In Use
00009-0013-06 00009-0013 Hydrocortisone Sodium Succinate Solu-Cortef 250.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 27, 1955 In Use
51662-1262-01 51662-1262 SOLU-CORTEF SOLU-CORTEF 250.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 3, 2018 In Use
43598-0773-11 43598-0773 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
72266-0235-01 72266-0235 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Nov. 1, 2021 In Use
00013-8717-62 00013-8717 Dexrazoxane Zinecard 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 26, 1995 April 30, 2021 No Longer Used
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
68083-0388-01 68083-0388 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 16, 2019 In Use
00069-8140-20 00069-8140 Crizotinib Xalkori 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Aug. 26, 2011 In Use
00078-0671-19 00078-0671 Lapatinib TYKERB 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR/HER2 Oral Aug. 3, 2016 In Use
00173-0752-00 00173-0752 Lapatinib TYKERB 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR/HER2 Oral March 16, 2007 Nov. 30, 2017 No Longer Used
00904-6948-04 00904-6948 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Nov. 23, 2018 In Use
16714-0963-01 16714-0963 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral May 19, 2020 In Use
68180-0801-36 68180-0801 lapatinib Lapatinib 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR/HER2 Oral Sept. 29, 2020 In Use
72606-0566-01 72606-0566 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan. 7, 2020 In Use
69539-0049-92 69539-0049 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral July 10, 2019 In Use
68001-0489-07 68001-0489 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Feb. 26, 2021 In Use
72205-0030-92 72205-0030 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral July 10, 2019 In Use
00093-1125-89 00093-1125 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Nov. 21, 2018 In Use
00143-9597-21 00143-9597 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Nov. 23, 2018 In Use
64980-0418-12 64980-0418 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Feb. 25, 2019 In Use
69238-1165-07 69238-1165 Abiraterone Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan. 7, 2019 In Use
00310-0482-30 00310-0482 Gefitinib IRESSA 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral July 13, 2015 In Use
00310-0482-93 00310-0482 Gefitinib IRESSA 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral July 25, 2016 Aug. 31, 2019 In Use
00054-0325-03 00054-0325 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral March 24, 2016 March 24, 2016 No Longer Used
57894-0184-12 57894-0184 Abiraterone Acetate Zytiga 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 17, 2017 April 18, 2017 No Longer Used
16729-0051-53 16729-0051 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral March 7, 2017 In Use
40051-0609-11 40051-0609 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0609-12 40051-0609 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use

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