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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
50742-0183-24 50742-0183 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
53964-0001-00 53964-0001 Thiotepa Tepadina 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard /Ethylenimine Intracavitary, Intravenous, Intravesical Jan. 26, 2017 April 18, 2017 In Use
53964-0001-01 53964-0001 Thiotepa Tepadina 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard /Ethylenimine Intracavitary, Intravenous, Intravesical Jan. 26, 2017 Aug. 1, 2018 In Use
63539-0197-90 63539-0197 Dacomitinib Vizimpro 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Feb. 1, 2019 In Use
76189-0535-30 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-60 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-80 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
59572-0415-00 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0415-21 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
51285-0369-01 51285-0369 Methotrexate Trexall 15.0 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral May 3, 2001 In Use
59630-0701-02 59630-0701 Prednisolone Sodium Phosphate Orapred 15.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2006 Aug. 31, 2014 No Longer Used
59630-0701-14 59630-0701 Prednisolone Sodium Phosphate Orapred 15.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2006 Dec. 9, 2011 No Longer Used
59630-0701-48 59630-0701 Prednisolone Sodium Phosphate Orapred 15.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2006 Aug. 31, 2016 No Longer Used
43598-0650-11 43598-0650 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard /Ethylenimine Intracavitary, Intravenous, Intravesical May 4, 2018 In Use
00069-0197-30 00069-0197 dacomitinib Vizimpro 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Oct. 4, 2018 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
69539-0123-01 69539-0123 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical March 4, 2020 In Use
68083-0446-01 68083-0446 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical March 8, 2021 In Use
72205-0045-01 72205-0045 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical Feb. 1, 2020 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
00054-4498-10 00054-4498 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb. 22, 1993 In Use
54868-5915-00 54868-5915 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 8, 2008 In Use
71258-0015-22 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71258-0015-02 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use

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