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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength (Descending) SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
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
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct. 25, 2022 In Use
69656-0101-02 69656-0101 Rolapitant Varubi 90.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Oct. 7, 2015 Oct. 31, 2021 No Longer Used
15054-0090-01 15054-0090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 Aug. 31, 2016 No Longer Used
15054-1090-03 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Nov. 14, 2007 June 30, 2022 In Use
15054-1090-04 15054-1090 Lanreotide acetate Somatuline Depot 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Sept. 1, 2019 In Use
76282-0710-67 76282-0710 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous June 1, 2022 In Use
69097-0890-67 69097-0890 Lanreotide acetate Lanreotide Acetate 90.0 mg/.3mL Hormonal Therapy Somatostatin Analog Subcutaneous Dec. 24, 2021 In Use
00069-0109-01 00069-0109 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Dec. 31, 2017 No Longer Used
59923-0603-10 59923-0603 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug. 6, 2013 In Use
61703-0326-18 61703-0326 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Oct. 1, 2005 In Use
67457-0446-10 67457-0446 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 In Use
00517-0746-01 00517-0746 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug. 9, 2010 Nov. 1, 2012 No Longer Used
25021-0803-10 25021-0803 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan. 15, 2010 Dec. 31, 2014 No Longer Used
67457-0610-10 67457-0610 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 1, 2008 June 30, 2018 No Longer Used
00703-4085-51 00703-4085 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Nov. 8, 2005 Sept. 30, 2012 In Use
63323-0735-10 63323-0735 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 19, 2002 Aug. 27, 2015 In Use
50881-0027-01 50881-0027 Pemigatinib PEMAZYRE 9.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use
72187-0101-03 72187-0101 Elacestrant ORSERDU 86.0 mg/1 Hormonal Therapy Estrogen Receptor Antagonist ERĪ± Oral Jan. 27, 2023 In Use
68001-0552-41 68001-0552 Pemetrexed disodium Pemetrexed 850.0 mg/34mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Sept. 7, 2022 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
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

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