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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
73116-0125-01 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0125-02 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0215-28 73116-0215 Duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0215-56 73116-0215 Duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0225-28 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0225-56 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 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 In Use
73153-0900-01 73153-0900 Lisocabtagene maraleucel BREYANZI Immunotherapy CAR-T CD19 Feb. 5, 2021 In Use
73207-0101-30 73207-0101 Ripretinib QINLOCK 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor KIT, PDGFRA Oral May 15, 2020 In Use
73207-0101-31 73207-0101 Ripretinib QINLOCK 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor KIT, PDGFRA Oral May 15, 2020 In Use
73380-4700-01 73380-4700 MOXETUMOMAB PASUDOTOX LUMOXITI 1.0 mg/mL Immunotherapy Drug Antibody Conjugate CD22 Intravenous May 15, 2020 In Use
73462-0101-01 73462-0101 Trilaciclib Cosela 300.0 mg/20mL Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Intravenous Feb. 12, 2021 In Use
73534-0505-01 73534-0505 PREDNISOLONE MILLIPRED 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 31, 2022 In Use
73535-0208-01 73535-0208 Tafasitamab-cxix MONJUVI 200.0 mg/5mL Immunotherapy Monoclonal Antibody CD19 Intravenous Aug. 5, 2020 In Use
73536-0500-01 73536-0500 ROPEGINTERFERON ALFA-2B BESREMi 500.0 ug/mL Immunotherapy Cytokine Interferon Subcutaneous Nov. 12, 2021 In Use
73657-0020-01 73657-0020 melphalan flufenamide Pepaxto 20.0 mg/50mL, 20.0 mg/50mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Feb. 26, 2021 In Use
74527-0022-02 74527-0022 margetuximab-cmkb MARGENZA 25.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jan. 15, 2021 In Use
74527-0022-03 74527-0022 margetuximab-cmkb MARGENZA 25.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous Jan. 15, 2021 In Use
75834-0132-05 75834-0132 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0132-14 75834-0132 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0142-05 75834-0142 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0142-14 75834-0142 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0143-05 75834-0143 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0143-14 75834-0143 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0144-05 75834-0144 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0144-14 75834-0144 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0145-05 75834-0145 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0145-14 75834-0145 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0146-05 75834-0146 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Dec. 7, 2021 In Use
75834-0190-01 75834-0190 Decitabine Decitabine 50.0 mg/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Dec. 17, 2020 In Use
75840-0111-00 75840-0111 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 1, 2012 In Use
75840-0111-01 75840-0111 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 1, 2012 In Use
75921-0459-10 75921-0459 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
75987-0020-01 75987-0020 Prednisone Rayos 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0020-02 75987-0020 Prednisone Rayos 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0020-70 75987-0020 Prednisone Rayos 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0021-01 75987-0021 Prednisone Rayos 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0021-02 75987-0021 Prednisone Rayos 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0021-70 75987-0021 Prednisone Rayos 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0022-01 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0022-02 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0022-70 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 27, 2012 In Use
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 In Use
75987-0140-13 75987-0140 Cysteamine bitartrate PROCYSBI 75.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb. 14, 2020 In Use
75987-0140-14 75987-0140 Cysteamine bitartrate PROCYSBI 75.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb. 14, 2020 In Use
75987-0145-13 75987-0145 Cysteamine bitartrate PROCYSBI 300.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb. 14, 2020 In Use
75987-0145-14 75987-0145 Cysteamine bitartrate PROCYSBI 300.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb. 14, 2020 In Use
76045-0101-20 76045-0101 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous May 3, 2013 In Use
76045-0103-20 76045-0103 ONDANSETRON HYDROCHLORIDE Ondansetron 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 10, 2015 In Use
76045-0106-10 76045-0106 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Oct. 30, 2015 In Use

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