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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
50090-6619-04 50090-6619 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 24, 2023 In Use
50090-6619-07 50090-6619 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 24, 2023 In Use
50090-6621-06 50090-6621 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 24, 2023 In Use
50090-6623-00 50090-6623 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 24, 2023 In Use
50111-0823-76 50111-0823 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb. 14, 2017 Feb. 16, 2017 No Longer Used
50111-0824-78 50111-0824 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb. 14, 2017 Feb. 16, 2017 No Longer Used
50228-0306-20 50228-0306 Raloxifene hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Oct. 12, 2016 In Use
50228-0306-30 50228-0306 Raloxifene hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Oct. 12, 2016 In Use
50242-0051-10 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous June 3, 2019 In Use
50242-0051-21 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 26, 1997 In Use
50242-0053-06 50242-0053 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 26, 1997 In Use
50242-0060-01 50242-0060 Bevacizumab Avastin 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Feb. 26, 2004 In Use
50242-0060-10 50242-0060 Bevacizumab Avastin 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 1, 2019 Jan. 31, 2023 In Use
50242-0061-01 50242-0061 Bevacizumab Avastin 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Feb. 26, 2004 In Use
50242-0061-10 50242-0061 Bevacizumab Avastin 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 1, 2019 Feb. 28, 2023 In Use
50242-0062-01 50242-0062 Erlotinib Hydrochloride Tarceva 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2005 In Use
50242-0063-01 50242-0063 Erlotinib Hydrochloride Tarceva 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2005 In Use
50242-0064-01 50242-0064 Erlotinib Hydrochloride Tarceva 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2005 In Use
50242-0070-01 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 1, 2013 In Use
50242-0070-86 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 4, 2013 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb. 28, 2019 In Use
50242-0087-01 50242-0087 ADO-Trastuzumab Emtansine Kadcyla 20.0 mg/mL, 20.0 mg/mL Immunotherapy Drug Antibody Conjugate HER2 Intravenous Feb. 22, 2013 In Use
50242-0088-01 50242-0088 ADO-Trastuzumab Emtansine Kadcyla 20.0 mg/mL, 20.0 mg/mL Immunotherapy Drug Antibody Conjugate HER2 Intravenous Feb. 22, 2013 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
50242-0091-30 50242-0091 ENTRECTINIB Rozlytrek 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0091-86 50242-0091 ENTRECTINIB Rozlytrek 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0092-01 50242-0092 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 No Longer Used
50242-0092-86 50242-0092 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 No Longer Used
50242-0094-47 50242-0094 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0094-90 50242-0094 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0103-01 50242-0103 polatuzumab vedotin POLIVY 30.0 mg/1.88mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Sept. 18, 2020 In Use
50242-0105-01 50242-0105 polatuzumab vedotin POLIVY 140.0 mg/7.52mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous June 10, 2019 In Use
50242-0108-01 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 23, 2017 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
50242-0125-01 50242-0125 Glofitamab Columvi 2.5 mg/2.5mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous June 15, 2023 In Use
50242-0127-01 50242-0127 Glofitamab Columvi 10.0 mg/10mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous June 15, 2023 In Use
50242-0130-01 50242-0130 ALECTINIB HYDROCHLORIDE Alecensa 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Dec. 11, 2015 In Use
50242-0130-86 50242-0130 ALECTINIB HYDROCHLORIDE Alecensa 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Oct. 10, 2017 In Use
50242-0132-01 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Feb. 10, 2017 In Use
50242-0132-10 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous June 3, 2019 In Use
50242-0134-68 50242-0134 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Sept. 25, 1998 April 30, 2019 No Longer Used
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
50242-0142-01 50242-0142 Mosunetuzumab Lunsumio 30.0 mg/30mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous Dec. 22, 2022 In Use
50242-0145-01 50242-0145 Pertuzumab Perjeta 30.0 mg/mL Immunotherapy Monoclonal Antibody HER2 Intravenous June 8, 2012 In Use
50242-0159-01 50242-0159 Mosunetuzumab Lunsumio 1.0 mg/mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous Dec. 22, 2022 In Use
50242-0210-12 50242-0210 Pralsetinib Gavreto 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 28, 2022 In Use

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