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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
00069-0188-21 00069-0188 Palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral Feb. 3, 2015 In Use
00069-0189-21 00069-0189 Palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral Feb. 3, 2015 In Use
00069-0192-01 00069-0192 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue May 11, 2011 Dec. 31, 2017 No Longer Used
00069-0192-02 00069-0192 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue May 11, 2011 Dec. 31, 2017 No Longer Used
00069-0193-01 00069-0193 Bosutinib monohydrate, Bosutinib BOSULIF 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 18, 2017 In Use
00069-0197-30 00069-0197 dacomitinib Vizimpro 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Oct. 4, 2018 In Use
00069-0201-01 00069-0201 Cladribine Cladribine 1.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Oct. 7, 2011 Dec. 31, 2017 No Longer Used
00069-0204-01 00069-0204 Methotrexate Sodium Methotrexate Sodium 25.0 mg/mL Chemotherapy Antimetabolite Folic Acid Analog Intra-arterial, Intramuscular, Intrathecal, Intravenous March 30, 2012 Dec. 31, 2017 No Longer Used
00069-0204-10 00069-0204 Methotrexate Sodium Methotrexate Sodium 25.0 mg/mL Chemotherapy Antimetabolite Folic Acid Analog Intra-arterial, Intramuscular, Intrathecal, Intravenous March 30, 2012 Dec. 31, 2017 No Longer Used
00069-0205-10 00069-0205 Vinorelbine Vinorelbine 10.0 mg/mL Chemotherapy Antimitotic Agent Vinca Alkaloid Intravenous Sept. 1, 2012 Aug. 31, 2016 No Longer Used
00069-0205-50 00069-0205 Vinorelbine Vinorelbine 10.0 mg/mL Chemotherapy Antimitotic Agent Vinca Alkaloid Intravenous Sept. 1, 2012 Aug. 31, 2016 No Longer Used
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
00069-0252-30 00069-0252 Talazoparib Talzenna 0.1 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral April 17, 2024 In Use
00069-0277-02 00069-0277 Doxorubicin Hydrochloride Doxorubicin Hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Aug. 19, 2024 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

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