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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 (Descending) Status
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00093-7663-56 00093-7663 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 9, 2019 In Use
00054-0248-12 00054-0248 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 28, 2018 In Use
00054-0248-22 00054-0248 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 28, 2018 In Use
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
00409-2504-10 00409-2504 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 14, 2018 In Use
00781-3415-75 00781-3415 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 26, 2018 In Use
00093-7664-56 00093-7664 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 9, 2019 In Use
24201-0101-04 24201-0101 Valrubicin Intravesical Solution Valrubicin Intravesical Solution 40.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravesical April 23, 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
70529-0053-01 70529-0053 Dexamethasone Sodium Phosphate, Bupivacaine Hydrochloride Ludaxine Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Nov. 1, 2018 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
43598-0773-11 43598-0773 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
63323-0631-10 63323-0631 Leucovorin Calcium Leucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan. 31, 2017 In Use
63323-0631-50 63323-0631 Leucovorin Calcium Leucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 27, 2018 In Use
55150-0186-05 55150-0186 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 6, 2018 In Use
63323-0673-05 63323-0673 Palonosetron Palonosetron 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 19, 2018 In Use
63323-0673-89 63323-0673 Palonosetron Palonosetron 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 19, 2018 In Use
67184-0514-01 67184-0514 Palonosetron Hydrochloride Palonosetron 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 19, 2018 In Use
67184-0515-02 67184-0515 Palonosetron Hydrochloride Palonosetron 0.075 mg/1.5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 19, 2018 In Use
67457-0317-25 67457-0317 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 20, 2018 In Use
69543-0371-10 69543-0371 Palonosetron hydrochloride Palonosetron hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sept. 19, 2018 In Use
43598-0255-52 43598-0255 Zoledronic acid Zoledronic acid 4.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2019 In Use
61919-0733-90 61919-0733 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 18, 2019 In Use
72266-0101-01 72266-0101 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous March 18, 2019 In Use
60687-0386-21 60687-0386 DRONABINOL DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 9, 2018 In Use
00143-9552-01 00143-9552 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous April 20, 2000 In Use
00143-9553-01 00143-9553 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 23, 1995 In Use
67457-0530-35 67457-0530 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan. 2, 2019 In Use
68083-0278-01 68083-0278 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 20, 2018 In Use
68083-0279-01 68083-0279 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 20, 2018 In Use
58118-7500-08 58118-7500 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 13, 2018 In Use
72266-0123-25 72266-0123 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous April 2, 2019 In Use
16729-0426-05 16729-0426 GEMCITABINE GEMCITABINE 100.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 6, 2018 In Use
00002-5337-54 00002-5337 Abemaciclib Verzenio 150.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral Oct. 6, 2017 In Use
00002-5337-63 00002-5337 Abemaciclib Verzenio 150.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 5, 2020 In Use
49315-0005-10 49315-0005 Arsenic trioxide Arsenic trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
50742-0438-10 50742-0438 arsenic trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 15, 2018 In Use
64679-0793-01 64679-0793 imatinib mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 17, 2019 In Use
64679-0793-02 64679-0793 imatinib mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 17, 2019 In Use
64679-0793-03 64679-0793 imatinib mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 17, 2019 In Use
65162-0794-03 65162-0794 Imatinib Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 8, 2019 In Use
65162-0794-09 65162-0794 Imatinib Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 8, 2019 In Use
65162-0795-03 65162-0795 Imatinib Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 8, 2019 In Use
65162-0795-09 65162-0795 Imatinib Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 8, 2019 In Use
67877-0633-90 67877-0633 imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2019 In Use
67877-0634-30 67877-0634 imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2019 In Use
72485-0202-90 72485-0202 imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral March 15, 2019 In Use
72485-0203-30 72485-0203 imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral March 15, 2019 In Use

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