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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
00069-0227-01 00069-0227 Lorlatinib Lorbrena 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1 Oral Nov. 19, 2018 In Use
00069-0231-01 00069-0231 Lorlatinib Lorbrena 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1 Oral Nov. 19, 2018 In Use
00069-0238-01 00069-0238 Rituximab-pvvr Ruxience 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 23, 2020 In Use
00069-0249-01 00069-0249 Rituximab-pvvr Ruxience 500.0 mg/50mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 23, 2020 In Use
00069-0251-60 00069-0251 CRIZOTINIB Xalkori 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK, HGFR, ROS1, RON Oral Nov. 20, 2023 In Use
00069-0284-03 00069-0284 Palbociclib Ibrance 75.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0291-01 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0291-10 00069-0291 filgrastim-aafi Nivestym 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0292-01 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sept. 24, 2018 In Use
00069-0293-10 00069-0293 filgrastim-aafi Nivestym 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous March 11, 2019 In Use
00069-0296-30 00069-0296 talazoparib Talzenna 0.25 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral Oct. 26, 2018 In Use
00069-0298-60 00069-0298 Glasdegib Daurismo 25.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral Dec. 10, 2018 In Use
00069-0305-01 00069-0305 Trastuzumab-qyyp Trazimera 420.0 mg/20 mL Immunotherapy Monoclonal Antibody HER2 Intravenous Feb. 24, 2020 In Use
00069-0308-01 00069-0308 trastuzumab-qyyp Trazimera 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous March 10, 2021 In Use
00069-0315-01 00069-0315 Bevacizumab-bvzr Zirabev 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Jan. 13, 2020 In Use
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec. 15, 2020 In Use
00069-0342-01 00069-0342 Bevacizumab-bvzr Zirabev 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous Jan. 13, 2020 In Use
00069-0486-03 00069-0486 Palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0507-60 00069-0507 CRIZOTINIB Xalkori 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK, HGFR, ROS1, RON Oral Nov. 20, 2023 In Use
00069-0550-38 00069-0550 Sunitinib Malate Sutent 12.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral Jan. 26, 2006 In Use
00069-0688-03 00069-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0700-12 00069-0700 Ondansetron hydrochloride and dextrose Ondansetron hydrochloride and dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 1, 2009 Nov. 1, 2012 In Use
00069-0770-38 00069-0770 Sunitinib Malate Sutent 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, CSF Oral Jan. 26, 2006 In Use

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