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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Descending) Administration Route Package Effective Date Package Discontinuation Date Status
47426-0401-10 47426-0401 APREPITANT APONVIE 32.0 mg/4.4mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 6, 2023 In Use
00006-3066-01 00006-3066 Aprepitant Emend 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Dec. 17, 2015 In Use
00006-3066-03 00006-3066 Aprepitant Emend 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Dec. 17, 2015 In Use
70860-0782-10 70860-0782 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 30, 2020 Jan. 31, 2023 No Longer Used
71288-0418-10 71288-0418 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 15, 2019 March 30, 2023 No Longer Used
00781-3497-75 00781-3497 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 2, 2020 Feb. 29, 2024 In Use
16714-0248-01 16714-0248 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jan. 28, 2023 In Use
81952-0911-01 81952-0911 FOSAPREPITANT FOSAPREPITANT 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous July 14, 2023 In Use
82243-1001-01 82243-1001 FOSAPREPITANT FOCINVEZ 150.0 mg/50mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Aug. 30, 2023 In Use
17156-0524-01 17156-0524 Strontium Chloride Sr-89 Metastron 1.0 mCi/mL Ancillary Therapy Radiopharmaceutical Strontium Sr 89 Intravenous June 18, 1993 Jan. 10, 2019 In Use
70383-0073-01 70383-0073 MOTIXAFORTIDE ACETATE Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sept. 8, 2023 In Use
82737-0073-01 82737-0073 Motixafortide Aphexda 62.0 mg/1.7mL Ancillary Therapy Immunostimulant Stem cell mobilizer Subcutaneous Sept. 8, 2023 In Use
73441-0800-04 73441-0800 omidubicel-onlv OMISIRGE Ancillary Therapy Immunostimulant Stem cell mobilizer Intravenous May 1, 2023 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
58468-0140-01 58468-0140 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Dec. 15, 2008 March 23, 2018 No Longer Used
00480-4320-01 00480-4320 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
55150-0356-01 55150-0356 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 24, 2023 In Use
65219-0284-12 65219-0284 PLERIXAFOR Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous June 22, 2023 In Use
70121-1694-02 70121-1694 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 25, 2023 In Use
70710-1208-01 70710-1208 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
70771-1776-01 70771-1776 Plerixafor PLERIXAFOR 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 28, 2023 In Use
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 24, 2023 In Use
72205-0249-01 72205-0249 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous July 25, 2023 In Use
69488-0003-01 69488-0003 Lutetium Lu 177 dotatate Lutathera 10.0 mCi/mL Chemotherapy Radiopharmaceutical Somatostatin Analog Intravenous Jan. 26, 2018 In Use
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
11994-0016-01 11994-0016 samarium Sm 153 lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
00078-0645-15 00078-0645 Sonidegib Odomzo 200.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral July 24, 2015 Dec. 31, 2017 No Longer Used
00069-0298-60 00069-0298 Glasdegib Daurismo 25.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Dec. 10, 2018 In Use
00069-1531-30 00069-1531 Glasdegib Daurismo 100.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Dec. 10, 2018 In Use
50242-0140-01 50242-0140 Vismodegib Erivedge 150.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Jan. 30, 2012 In Use
50242-0140-86 50242-0140 Vismodegib Erivedge 150.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral April 9, 2013 In Use
00003-2291-11 00003-2291 Elotuzumab Empliciti 300.0 mg/1 Immunotherapy Monoclonal Antibody SLAMF7 Intravenous Nov. 30, 2015 In Use
00003-4522-11 00003-4522 Elotuzumab Empliciti 400.0 mg/1 Immunotherapy Monoclonal Antibody SLAMF7 Intravenous Nov. 30, 2015 In Use
00187-5525-60 00187-5525 Bexarotene Targretin 1.0 g/100g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical June 28, 2000 In Use
00187-5526-75 00187-5526 Bexarotene Targretin 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 1999 In Use
00378-6955-01 00378-6955 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 9, 2015 In Use
68682-0003-10 68682-0003 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 17, 2015 In Use
00004-0155-49 00004-0155 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
00004-0156-49 00004-0156 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
00004-0169-49 00004-0169 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative May 7, 1982 Dec. 22, 2010 No Longer Used
54868-0955-00 54868-0955 Isotretinoin Accutane Hormonal Therapy Immunomodulator Retinoic Acid Derivative Aug. 7, 1995 Dec. 29, 2010 No Longer Used
00555-1054-56 00555-1054 Isotretinoin Claravis 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1054-86 00555-1054 Isotretinoin Claravis 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1055-56 00555-1055 Isotretinoin Claravis 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1055-86 00555-1055 Isotretinoin Claravis 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1056-86 00555-1056 Isotretinoin Claravis 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 18, 2006 In Use
00555-1057-56 00555-1057 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
00555-1057-86 00555-1057 Isotretinoin Claravis 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 9, 2003 In Use
10631-0115-31 10631-0115 Isotretinoin Absorica 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use
10631-0116-31 10631-0116 Isotretinoin Absorica 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral June 8, 2012 In Use

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