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NDC-11 (Package) NDC-9 (Product) (Ascending) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
71779-0115-02 71779-0115 duvelisib Copiktra 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0125-01 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0125-02 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
71837-5844-01 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71837-5844-05 71837-5844 SARGRAMOSTIM Leukine 500.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 May 8, 2012 No Longer Used
71839-0104-01 71839-0104 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Oct. 15, 2019 In Use
71872-7205-01 71872-7205 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 13, 2020 In Use
71872-7239-01 71872-7239 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 100.0 mg/10mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 15, 2021 In Use
71905-0400-11 71905-0400 Dexamethasone Dexabliss 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
71921-0178-20 71921-0178 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Aug. 15, 2022 In Use
71921-0190-33 71921-0190 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 15, 2021 In Use
71930-0017-30 71930-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
71930-0017-52 71930-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 6, 2020 In Use
71930-0018-30 71930-0018 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 11, 2018 In Use
71930-0018-52 71930-0018 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 6, 2020 In Use
71997-0100-01 71997-0100 DEXAMETHASONE Dexycu 517.0 ug/.005mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid INTRAOCULAR Oct. 1, 2018 Oct. 1, 2018 No Longer Used
72064-0110-30 72064-0110 avapritinib Ayvakit 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0120-30 72064-0120 avapritinib Ayvakit 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0125-30 72064-0125 avapritinib Ayvakit 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0130-30 72064-0130 avapritinib Ayvakit 300.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0150-30 72064-0150 avapritinib Ayvakit 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor PDGFR, KIT, CSFR1 Oral Jan. 9, 2020 In Use
72064-0210-12 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 No Longer Used
72064-0210-60 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 No Longer Used
72064-0210-90 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 4, 2020 April 30, 2022 No Longer Used
72078-0040-08 72078-0040 DOCETAXEL ANHYDROUS Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Sept. 28, 2018 In Use
72143-0231-30 72143-0231 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Sept. 30, 2023 In Use
72143-0233-30 72143-0233 ISOTRETINOIN ACCUTANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Jan. 31, 2024 In Use
72143-0234-30 72143-0234 ISOTRETINOIN ACCUTANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan. 11, 2021 Dec. 31, 2023 In Use
72143-0251-30 72143-0251 ISOTRETINOIN ACCUTANE 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug. 1, 2022 In Use
72143-0252-30 72143-0252 ISOTRETINOIN ACCUTANE 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug. 1, 2022 In Use
72143-0253-30 72143-0253 ISOTRETINOIN ACCUTANE 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug. 1, 2022 In Use
72143-0254-30 72143-0254 ISOTRETINOIN ACCUTANE 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug. 1, 2022 In Use
72187-0401-01 72187-0401 Tagraxofusp Elzonris 1000.0 ug/mL Immunotherapy Fusion Protein IL3/ CD123 Intravenous Jan. 18, 2019 In Use
72189-0008-21 72189-0008 Methylpred DP Methylpred DP 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 26, 2019 In Use
72189-0084-24 72189-0084 IMIQUIMOD IMIQUIMOD 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical March 23, 2020 In Use
72189-0183-60 72189-0183 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 24, 2021 In Use
72189-0183-90 72189-0183 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 24, 2021 In Use
72189-0198-90 72189-0198 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral April 12, 2021 In Use
72189-0246-07 72189-0246 PREDNISONE PREDNISONE 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 8, 2021 In Use
72189-0254-10 72189-0254 DEXAMETHASONE DEXAMETHASONE 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 20, 2021 In Use
72189-0264-21 72189-0264 METHYLPREDNISOLONE METHYLPREDNISOLONE 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 13, 2021 In Use
72189-0275-21 72189-0275 PREDNISONE PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 17, 2021 In Use
72189-0383-30 72189-0383 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 19, 2022 In Use
72205-0006-60 72205-0006 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral July 21, 2018 In Use
72205-0007-92 72205-0007 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral July 21, 2018 In Use
72205-0026-01 72205-0026 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
72205-0030-92 72205-0030 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral July 10, 2019 In Use
72205-0031-01 72205-0031 Decitabine Decitabine 50.0 mg/10mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 28, 2019 In Use
72205-0036-01 72205-0036 Decitabine Decitabine 50.0 mg/10mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous March 2, 2020 In Use

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