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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class (Ascending) Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
00069-4494-02 00069-4494 Elranatamab-bcmm Elrexfio 76.0 mg/1.9mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
00069-2522-02 00069-2522 Elranatamab-bcmm Elrexfio 44.0 mg/1.1mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
50242-0125-01 50242-0125 Glofitamab Columvi 2.5 mg/2.5mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous June 15, 2023 In Use
50242-0127-01 50242-0127 Glofitamab Columvi 10.0 mg/10mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous June 15, 2023 In Use
82705-0002-01 82705-0002 Epcoritamab-bysp EPKINLY 4.0 mg/.8mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous May 19, 2023 In Use
82705-0010-01 82705-0010 Epcoritamab-bysp EPKINLY 48.0 mg/.8mL Immunotherapy Monoclonal Antibody CD20, CD3 Subcutaneous May 19, 2023 In Use
83257-0001-11 83257-0001 Trastuzumab OGIVRI 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous July 28, 2023 In Use
83257-0003-01 83257-0003 Trastuzumab OGIVRI 420.0 mg/20mL Immunotherapy Monoclonal Antibody HER2 Intravenous July 28, 2023 In Use
83257-0004-12 83257-0004 Trastuzumab OGIVRI 420.0 mg/20mL Immunotherapy Monoclonal Antibody HER2 July 28, 2023 In Use
67457-0847-44 67457-0847 Trastuzumab OGIVRI 420.0 mg/ 20 mL Immunotherapy Monoclonal Antibody HER2 Intravenous Nov. 29, 2019 April 30, 2027 In Use
67457-0991-15 67457-0991 Trastuzumab OGIVRI 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Nov. 29, 2019 Feb. 28, 2027 In Use
00006-5033-02 00006-5033 Trastuzumab Ontruzant 150.0 mg/1 Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
00006-5034-02 00006-5034 Ontruzant Ontruzant Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
59630-0222-07 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-30 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-90 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59385-0041-07 59385-0041 Naldemedine, naldemedine tosylate SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 1, 2020 In Use
59385-0041-30 59385-0041 Naldemedine, naldemedine tosylate SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral June 14, 2019 In Use
64067-0216-01 64067-0216 Methoxsalen UVADEX 20.0 ug/mL Chemotherapy Photosensitizing Agent Psoralen Extracorporeal Feb. 25, 1999 In Use
76128-0155-75 76128-0155 Porfimer sodium Photofrin 75.0 mg/31.8mL Chemotherapy Photosensitizing Agent Cytotoxin Intravenous Dec. 27, 1995 In Use
00378-3266-94 00378-3266 Etoposide Etoposide 50.0 mg/1 Chemotherapy Plant Alkaloid Epipodophyllotoxins Oral Oct. 22, 2001 In Use
63459-0177-14 63459-0177 Omacetaxine Mepesuccinate Synribo 3.5 mg/mL Chemotherapy Plant Alkaloid BCR-ABL Subcutaneous Nov. 19, 2012 In Use
16729-0114-08 16729-0114 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous March 3, 2015 In Use
16729-0114-11 16729-0114 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous March 3, 2015 In Use
16729-0114-31 16729-0114 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous March 22, 2015 In Use

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