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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
50242-0070-86 50242-0070 Obinutuzumab Gazyva 1000.0 mg/40mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 4, 2013 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb. 28, 2019 In Use
50242-0087-01 50242-0087 ADO-Trastuzumab Emtansine Kadcyla 20.0 mg/mL, 20.0 mg/mL Immunotherapy Drug Antibody Conjugate HER2 Intravenous Feb. 22, 2013 In Use
50242-0088-01 50242-0088 ADO-Trastuzumab Emtansine Kadcyla 20.0 mg/mL, 20.0 mg/mL Immunotherapy Drug Antibody Conjugate HER2 Intravenous Feb. 22, 2013 In Use
50242-0090-01 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral Aug. 17, 2011 Feb. 28, 2018 In Use
50242-0090-02 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral Sept. 8, 2015 In Use
50242-0090-86 50242-0090 Vemurafenib Zelboraf 240.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral April 10, 2014 In Use
50242-0091-30 50242-0091 ENTRECTINIB Rozlytrek 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0091-86 50242-0091 ENTRECTINIB Rozlytrek 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0092-01 50242-0092 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 No Longer Used
50242-0092-86 50242-0092 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 No Longer Used
50242-0094-47 50242-0094 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0094-90 50242-0094 ENTRECTINIB Rozlytrek 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRKA, TRKB, TRKC, ROS1, ALK Oral Aug. 15, 2019 In Use
50242-0103-01 50242-0103 polatuzumab vedotin POLIVY 30.0 mg/1.88mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Sept. 18, 2020 In Use
50242-0105-01 50242-0105 polatuzumab vedotin POLIVY 140.0 mg/7.52mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous June 10, 2019 In Use
50242-0108-01 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
50242-0108-86 50242-0108 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 23, 2017 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 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
50242-0130-01 50242-0130 ALECTINIB HYDROCHLORIDE Alecensa 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Dec. 11, 2015 In Use
50242-0130-86 50242-0130 ALECTINIB HYDROCHLORIDE Alecensa 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Oct. 10, 2017 In Use
50242-0132-01 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Feb. 10, 2017 In Use
50242-0132-10 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous June 3, 2019 In Use
50242-0134-68 50242-0134 Trastuzumab Herceptin Immunotherapy Monoclonal Antibody HER2 Sept. 25, 1998 April 30, 2019 No Longer Used

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