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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
00078-0698-19 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral April 28, 2017 In Use
00078-0698-51 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral April 28, 2017 In Use
00078-0698-99 00078-0698 RYDAPT Rydapt 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FLT3 Oral April 28, 2017 In Use
00378-1940-01 00378-1940 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
00378-1940-21 00378-1940 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
60505-4537-01 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 March 8, 2023 In Use
60505-4537-02 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 In Use
62559-0930-01 62559-0930 CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral June 22, 2020 March 31, 2023 No Longer Used
51991-0890-33 51991-0890 Erlotinib Hydrochloride Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Nov. 5, 2019 April 30, 2024 In Use
42291-0902-28 42291-0902 Sunitinib Malate Sunitinib Malate 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral Oct. 11, 2023 In Use
60505-6095-00 60505-6095 Bendamustine Hydrochloride Bendamustine Hydrochloride 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous June 19, 2023 In Use
00143-9700-01 00143-9700 Cortisone Acetate Cortisone Acetate 25.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 22, 2013 In Use
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 No Longer Used
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 June 30, 2023 No Longer Used
57664-0022-97 57664-0022 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
71779-0125-01 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0125-02 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 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
57377-0025-01 57377-0025 Estradiol pellet Estra-25 25.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan. 1, 2017 In Use
00019-9451-02 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-03 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-04 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-06 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
69945-0451-02 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-03 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-04 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-06 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
70114-0340-01 70114-0340 Toripalimab LOQTORZI 240.0 mg/6mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Oct. 27, 2023 In Use
83718-0000-01 83718-0000 Toripalimab-tpzi LOQTORZI 240.0 mg/6mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Oct. 27, 2023 In Use
59676-0604-14 59676-0604 Apalutamide ERLEADA 240.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Feb. 17, 2023 In Use
59676-0604-30 59676-0604 Apalutamide ERLEADA 240.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Feb. 17, 2023 In Use
50242-0090-01 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral Aug. 17, 2011 Feb. 28, 2018 In Use
50242-0090-02 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral Sept. 8, 2015 In Use
50242-0090-86 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral April 10, 2014 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
43598-0308-23 43598-0308 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Nov. 6, 2023 In Use
68462-0107-40 68462-0107 Ondansetron Ondansetron 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 June 26, 2007 No Longer Used
51672-4110-05 51672-4110 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 28, 2011 In Use
55111-0156-05 55111-0156 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 26, 2006 In Use
55111-0156-11 55111-0156 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 26, 2006 In Use
55111-0156-30 55111-0156 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 26, 2006 In Use

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