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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
69539-0091-30 69539-0091 Erlotinib Hydrochloride Erlotinib Hydrochloride 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
69539-0092-30 69539-0092 Erlotinib Hydrochloride Erlotinib Hydrochloride 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
69539-0115-01 69539-0115 Decitabine Decitabine 50.0 mg/10mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 28, 2019 In Use
69539-0123-01 69539-0123 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical March 4, 2020 In Use
69539-0124-01 69539-0124 Thiotepa Thiotepa 100.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard /Ethylenimine Intracavitary, Intravenous, Intravesical March 4, 2020 In Use
69539-0152-30 69539-0152 Toremifene citrate Toremifene citrate 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 20, 2020 In Use
69539-0157-01 69539-0157 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0158-01 69539-0158 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0159-01 69539-0159 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0181-01 69539-0181 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb. 10, 2020 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 Jan. 31, 2026 In Use
69605-0103-03 69605-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
69639-0101-01 69639-0101 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 In Use
69639-0101-04 69639-0101 Netupitant and Palonosetron Akynzeo 300.0 mg/1, 0.5 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Oral Oct. 13, 2014 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
69639-0103-01 69639-0103 Palonosetron hydrochloride Aloxi 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 1, 2018 Nov. 1, 2022 No Longer Used
69639-0103-05 69639-0103 Palonosetron hydrochloride Aloxi 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 1, 2018 Nov. 1, 2022 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
69639-0120-01 69639-0120 Mechlorethamine hydrochloride VALCHLOR 0.012 g/60g Chemotherapy Alkylating Agent Nitrogen Mustard TOPICAL Nov. 8, 2018 In Use
69656-0101-02 69656-0101 Rolapitant Varubi 90.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Oct. 7, 2015 Oct. 31, 2021 No Longer Used
69656-0103-30 69656-0103 Niraparib Zejula 100.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral July 1, 2018 Aug. 31, 2024 In Use
69656-0103-61 69656-0103 Niraparib Zejula 100.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral July 1, 2020 Aug. 31, 2024 In Use
69656-0103-90 69656-0103 Niraparib Zejula 100.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral March 27, 2017 May 31, 2022 In Use
69660-0201-91 69660-0201 Rucaparib Rubraca 200.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral Dec. 19, 2016 Dec. 31, 2025 In Use
69660-0202-91 69660-0202 Rucaparib Rubraca 250.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral May 1, 2017 July 31, 2025 In Use
69660-0203-91 69660-0203 Rucaparib Rubraca 300.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral Dec. 19, 2016 July 31, 2025 In Use
69665-0210-01 69665-0210 Methylprednisolone Tablets medPREDkit Plus Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 24, 2018 Feb. 20, 2018 No Longer Used
69665-0310-01 69665-0310 Methylprednisolone Tablets medPREDkit Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Dec. 25, 2017 Jan. 15, 2018 No Longer Used
69668-0120-20 69668-0120 Prednisone Deltasone 20.0 mg/20mg Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 31, 2015 In Use
69784-0610-25 69784-0610 Chlorambucil LEUKERAN 2.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral June 30, 2022 In Use
69784-0620-25 69784-0620 Busulfan MYLERAN 2.0 mg/1 Chemotherapy Alkylating Agent Alkylsulfonate Oral June 30, 2022 In Use
69784-0630-25 69784-0630 Thioguanine TABLOID 40.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral June 30, 2022 In Use
69784-0712-04 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2022 In Use
69784-0712-15 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2022 In Use
69918-0720-02 69918-0720 Arsenic Trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
69918-0720-10 69918-0720 Arsenic Trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
69945-0450-01 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-02 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-03 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-04 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-05 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-07 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 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
69945-0452-00 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0452-01 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0452-02 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used

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