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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date (Ascending) Package Discontinuation Date Status
68382-0913-16 68382-0913 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0913-84 68382-0913 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0914-06 68382-0914 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0914-16 68382-0914 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0914-84 68382-0914 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0915-06 68382-0915 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0915-16 68382-0915 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
68382-0915-84 68382-0915 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1521-03 70771-1521 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1521-07 70771-1521 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1521-09 70771-1521 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1522-03 70771-1522 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1522-07 70771-1522 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1522-09 70771-1522 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1523-03 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1523-07 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1523-09 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
59923-0725-30 59923-0725 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
59923-0726-30 59923-0726 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
59923-0727-30 59923-0727 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
51991-0065-97 51991-0065 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 1, 2020 May 2, 2020 No Longer Used
68788-7705-01 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
68788-7705-03 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
69605-0103-03 69605-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
48102-0047-20 48102-0047 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2020 June 30, 2022 No Longer Used
70518-2721-00 70518-2721 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 1, 2020 In Use
63459-0103-10 63459-0103 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
63459-0104-50 63459-0104 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
00078-0709-56 00078-0709 Capmatinib TABRECTA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0709-94 00078-0709 Capmatinib TABRECTA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0716-56 00078-0716 Capmatinib TABRECTA 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0716-94 00078-0716 Capmatinib TABRECTA 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
42195-0721-21 42195-0721 Dexamethasone DEXAMETHASONE 6-Day 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 7, 2020 In Use
00002-2980-26 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-2980-60 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-3977-60 00002-3977 Selpercatinib RETEVMO 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
72611-0785-02 72611-0785 Temsirolimus Injection Temsirolimus Chemotherapy Enzyme Inhibitor mTOR Intravenous May 8, 2020 In Use
59762-0058-02 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral May 11, 2020 In Use
72205-0083-01 72205-0083 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous May 12, 2020 In Use
72205-0054-01 72205-0054 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous May 12, 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
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
42658-0010-01 42658-0010 Cladribine Cladribine 1.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous May 18, 2020 In Use
71205-0407-18 71205-0407 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 19, 2020 In Use
16714-0963-01 16714-0963 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral May 19, 2020 In Use
70934-0215-90 70934-0215 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral May 19, 2020 In Use
70518-2314-02 70518-2314 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 19, 2020 Aug. 17, 2020 In Use

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