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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Ascending) Administration Route Package Effective Date Package Discontinuation Date Status
00019-9452-12 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-15 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-17 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-20 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-50 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-75 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
50881-0010-01 50881-0010 Ruxolitinib Jakafi 10.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1 and JAK 2 (Janus Kinase Inhibitor) Oral Nov. 16, 2011 In Use
50881-0010-60 50881-0010 Ruxolitinib Jakafi 10.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1 and JAK 2 (Janus Kinase Inhibitor) Oral Nov. 16, 2011 In Use
81864-0101-30 81864-0101 Momelotinib Ojjaara 200.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Sept. 15, 2023 In Use
81864-0102-30 81864-0102 Momelotinib Ojjaara 150.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Sept. 15, 2023 In Use
81864-0103-30 81864-0103 Momelotinib Ojjaara 100.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Sept. 15, 2023 In Use
50881-0005-60 50881-0005 Ruxolitinib Jakafi 5.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov. 16, 2011 In Use
50881-0015-60 50881-0015 Ruxolitinib Jakafi 15.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov. 16, 2011 In Use
50881-0020-60 50881-0020 Ruxolitinib Jakafi 20.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov. 16, 2011 In Use
50881-0025-60 50881-0025 Ruxolitinib Jakafi 25.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1/2 Oral Nov. 16, 2011 In Use
72482-0100-12 72482-0100 Pacritinib Vonjo 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor JAK2, FLT3 Oral Feb. 28, 2022 In Use
59572-0720-12 59572-0720 Fedratinib Hydrochloride Inrebic 100.0 mg/1 Chemotherapy Enzyme Inhibitor JAK2, FLT3 Oral Aug. 16, 2019 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
55513-0488-02 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
55513-0488-24 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
55513-0488-96 55513-0488 Sotorasib LUMAKRAS 120.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral May 28, 2021 In Use
80739-0812-12 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
80739-0812-18 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
55513-0504-50 55513-0504 Sotorasib LUMAKRAS 320.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral Feb. 2, 2023 In Use
66658-0113-03 66658-0113 Palifermin KEPIVANCE 5.16 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Aug. 4, 2023 In Use
66658-0113-06 66658-0113 Palifermin KEPIVANCE 5.16 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Aug. 4, 2023 In Use
66658-0112-01 66658-0112 Palifermin Kepivance 6.25 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Nov. 14, 2012 April 30, 2023 No Longer Used
66658-0112-03 66658-0112 Palifermin Kepivance 6.25 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Dec. 15, 2009 April 20, 2023 No Longer Used
66658-0112-06 66658-0112 Palifermin Kepivance 6.25 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Dec. 15, 2009 April 20, 2023 No Longer Used
66658-0112-24 66658-0112 Palifermin Kepivance 6.25 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Dec. 15, 2009 April 1, 2016 No Longer Used
55513-0520-01 55513-0520 Palifermin Kepivance Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Dec. 15, 2004 Dec. 15, 2009 No Longer Used
55513-0520-06 55513-0520 Palifermin Kepivance Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Dec. 15, 2004 Dec. 15, 2009 No Longer Used
49281-0880-03 49281-0880 BACILLUS CALMETTE-GUERIN SUBSTRAIN CONNAUGHT LIVE ANTIGEN THERACYS 81.0 mg/3mL Immunotherapy Biological Response Modifier Live Vaccine Intravesical July 22, 2011 May 8, 2017 No Longer Used
00052-0602-02 00052-0602 BACILLUS CALMETTE-GUERIN TICE BCG 50.0 mg/50mL Immunotherapy Biological Response Modifier Live Vaccine Intravesical Aug. 24, 1990 In Use
70255-0010-02 70255-0010 BINIMETINIB MEKTOVI 15.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral June 27, 2018 In Use
70255-0010-03 70255-0010 BINIMETINIB MEKTOVI 15.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral June 27, 2018 In Use
00310-0610-28 00310-0610 SELUMETINIB KOSELUGO 10.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral June 11, 2021 In Use
00310-0610-60 00310-0610 SELUMETINIB KOSELUGO 10.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 2020 In Use
00310-0625-28 00310-0625 SELUMETINIB KOSELUGO 25.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral June 11, 2021 In Use
00310-0625-60 00310-0625 SELUMETINIB KOSELUGO 25.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 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
44087-5000-03 44087-5000 Tepotinib Hydrochloride TEPMETKO 225.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral Feb. 3, 2021 In Use
44087-5000-06 44087-5000 Tepotinib Hydrochloride TEPMETKO 225.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral Feb. 3, 2021 In Use
59676-0610-01 59676-0610 Trabectedin Yondelis 0.05 mg/mL Chemotherapy Alkylating Agent Natural Product Intravenous Oct. 23, 2015 In Use
51144-0020-01 51144-0020 ENFORTUMAB VEDOTIN PADCEV 20.0 mg/2mL Immunotherapy Drug Antibody Conjugate Nectin-4 Intravenous Dec. 18, 2019 In Use
51144-0030-01 51144-0030 ENFORTUMAB VEDOTIN PADCEV 30.0 mg/3mL Immunotherapy Drug Antibody Conjugate Nectin-4 Intravenous Dec. 18, 2019 In Use

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