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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
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
50242-0210-60 50242-0210 Pralsetinib Gavreto 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral July 1, 2021 In Use
50242-0210-83 50242-0210 Pralsetinib Gavreto 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral July 1, 2021 In Use
50242-0210-86 50242-0210 Pralsetinib Gavreto 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sept. 15, 2020 Feb. 11, 2022 In Use
50242-0210-90 50242-0210 Pralsetinib Gavreto 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral July 1, 2021 In Use
50242-0245-01 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous June 29, 2020 In Use
50242-0245-86 50242-0245 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 30000.0 U/15mL, 1200.0 mg/15mL, 600.0 mg/15mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
50242-0260-01 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous June 29, 2020 In Use
50242-0260-86 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous May 3, 2021 In Use
50242-0333-01 50242-0333 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Feb. 10, 2017 Feb. 10, 2017 No Longer Used
50242-0717-01 50242-0717 Cobimetinib Cotellic 20.0 mg/1 Chemotherapy MAPK/MEK Inhibitor BRAF Oral Nov. 10, 2015 In Use
50242-0717-86 50242-0717 Cobimetinib Cotellic 20.0 mg/1 Chemotherapy MAPK/MEK Inhibitor BRAF Oral Nov. 10, 2015 In Use
50242-0917-01 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 18, 2016 In Use
50242-0917-86 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Aug. 11, 2016 In Use
50242-0918-01 50242-0918 Atezolizumab TECENTRIQ 840.0 mg/14mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous March 8, 2019 In Use
50242-0918-86 50242-0918 Atezolizumab TECENTRIQ 840.0 mg/14mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous March 8, 2019 March 18, 2019 In Use
50268-0075-15 50268-0075 ANASTROZOLE ANASTROZOLE 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 11, 2019 In Use
50268-0154-13 50268-0154 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral March 12, 2018 In Use
50268-0290-11 50268-0290 Estradiol Estradiol 0.5 mg/1 Hormonal Therapy Estrogen Oral Sept. 30, 2014 March 19, 2018 No Longer Used
50268-0290-15 50268-0290 Estradiol Estradiol 0.5 mg/1 Hormonal Therapy Estrogen Oral Dec. 12, 2014 March 19, 2018 No Longer Used
50268-0291-11 50268-0291 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 30, 2014 March 19, 2018 No Longer Used
50268-0291-15 50268-0291 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Dec. 12, 2014 March 19, 2018 No Longer Used
50268-0292-11 50268-0292 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 30, 2014 March 19, 2018 No Longer Used
50268-0292-15 50268-0292 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral Dec. 12, 2014 March 19, 2018 No Longer Used
50268-0314-15 50268-0314 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 23, 2019 In Use
50268-0323-11 50268-0323 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 21, 2011 July 31, 2019 In Use
50268-0323-15 50268-0323 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 21, 2011 July 31, 2019 In Use
50268-0405-15 50268-0405 Hydrocortisone HYDROCORTISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
50268-0406-15 50268-0406 Hydrocortisone HYDROCORTISONE 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
50268-0407-15 50268-0407 Hydrocortisone HYDROCORTISONE 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
50268-0426-12 50268-0426 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 24, 2017 In Use
50268-0427-12 50268-0427 Imatinib Mesylate Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug. 24, 2017 In Use
50268-0476-15 50268-0476 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 2, 2019 In Use
50268-0527-15 50268-0527 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral May 26, 2021 In Use
50268-0621-11 50268-0621 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 5, 2016 In Use
50268-0621-15 50268-0621 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 5, 2016 In Use
50268-0622-11 50268-0622 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 5, 2016 In Use
50268-0622-15 50268-0622 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 5, 2016 In Use
50268-0647-14 50268-0647 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 20, 2023 In Use

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