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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 Package Discontinuation Date Status
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
59923-0601-10 59923-0601 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug. 6, 2013 In Use
59923-0602-10 59923-0602 Pamidronate Disodium Pamidronate Disodium 6.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug. 6, 2013 In Use
59923-0603-10 59923-0603 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug. 6, 2013 In Use
61703-0324-18 61703-0324 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Oct. 1, 2005 In Use
61703-0325-18 61703-0325 Pamidronate Disodium Pamidronate Disodium 6.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous July 28, 2003 In Use
61703-0326-18 61703-0326 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Oct. 1, 2005 In Use
67457-0430-10 67457-0430 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 In Use
67457-0446-10 67457-0446 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 In Use
54868-5229-00 54868-5229 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Feb. 23, 2006 Dec. 31, 2011 No Longer Used
55513-0190-01 55513-0190 Pegfilgrastim Neulasta 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous April 1, 2002 In Use
00024-5862-01 00024-5862 Plerixafor Mozobil 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Sept. 1, 2013 In Use
00024-5150-10 00024-5150 Rasburicase Elitek Ancillary Therapy Metabolic Agent Enzyme July 12, 2002 In Use
00024-5151-75 00024-5151 Rasburicase Elitek Ancillary Therapy Metabolic Agent Enzyme June 1, 2006 In Use
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
50419-0002-33 50419-0002 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Sept. 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-14 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
50419-0050-30 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used
54868-3188-00 54868-3188 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Dec. 1, 1996 June 30, 2012 No Longer Used
58468-0181-01 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
58468-0181-02 58468-0181 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 15, 2010 Dec. 31, 2013 No Longer Used
69468-0151-04 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral March 1, 2016 In Use
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral March 1, 2016 In Use
69468-0151-20 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral March 1, 2016 In Use
00143-9642-01 00143-9642 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous June 3, 2013 In Use
17478-0327-05 17478-0327 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 22, 2014 In Use
17478-0327-45 17478-0327 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 22, 2014 In Use
43598-0330-11 43598-0330 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Aug. 19, 2013 In Use
47335-0035-40 47335-0035 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 4, 2013 Sept. 30, 2015 No Longer Used
55111-0685-07 55111-0685 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 4, 2013 In Use
55150-0266-05 55150-0266 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Sept. 26, 2016 In Use
55648-0186-01 55648-0186 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 2, 2013 In Use
64679-0186-01 64679-0186 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 2, 2013 In Use
68083-0116-01 68083-0116 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Sept. 20, 2013 In Use
63739-0161-10 63739-0161 Methylprednisolone Methylprednisolone Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 21, 2007 June 30, 2012 No Longer Used
57962-0014-28 57962-0014 Ibrutinib IMBRUVICA 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb. 16, 2018 In Use
68788-7102-09 68788-7102 ESTRADIOL ESTRADIOL 1.0 mg/1 Hormonal Therapy Estrogen Oral March 12, 2018 In Use
68788-7102-01 68788-7102 ESTRADIOL ESTRADIOL 1.0 mg/1 Hormonal Therapy Estrogen Oral March 12, 2018 In Use
68788-7102-06 68788-7102 ESTRADIOL ESTRADIOL 1.0 mg/1 Hormonal Therapy Estrogen Oral March 12, 2018 In Use
68788-7102-03 68788-7102 ESTRADIOL ESTRADIOL 1.0 mg/1 Hormonal Therapy Estrogen Oral March 12, 2018 In Use
70518-0920-00 70518-0920 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral Dec. 22, 2017 In Use
00003-3734-13 00003-3734 nivolumab OPDIVO 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec. 8, 2017 In Use
00143-9306-01 00143-9306 Idarubicin Hydrochloride Idarubicin Hydrochloride 1.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Jan. 12, 2018 In Use
00143-9307-01 00143-9307 Idarubicin Hydrochloride Idarubicin Hydrochloride 1.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Jan. 12, 2018 In Use
00143-9308-01 00143-9308 Idarubicin Hydrochloride Idarubicin Hydrochloride 1.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Jan. 12, 2018 In Use
58463-0010-08 58463-0010 dexamethasone Decadron 0.5 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 15, 2018 In Use
00143-9240-01 00143-9240 Bleomycin Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
00143-9241-01 00143-9241 Bleomycin Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Jan. 9, 2018 In Use
69238-1423-06 69238-1423 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 29, 2017 In Use

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