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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength (Ascending) SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
00006-4121-02 00006-4121 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec. 10, 2014 In Use
50090-1523-01 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
50090-1523-09 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular June 8, 2006 In Use
64067-0216-01 64067-0216 Methoxsalen UVADEX 20.0 ug/mL Chemotherapy Photosensitizing Agent Psoralen Extracorporeal Feb. 25, 1999 In Use
00002-6216-54 00002-6216 Abemaciclib Verzenio 200.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral Oct. 6, 2017 In Use
00069-8141-20 00069-8141 Crizotinib Xalkori 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK Oral Aug. 26, 2011 In Use
00078-0645-15 00078-0645 Sonidegib Odomzo 200.0 mg/1 Chemotherapy Hedgehog Pathway Inhibitor SMO Oral July 24, 2015 Dec. 31, 2017 No Longer Used
50419-0488-58 50419-0488 Sorafenib Nexavar 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FGF, PDGFR, KIT, RET, CRAF, BRAF Oral Dec. 20, 2005 In Use
00078-0526-51 00078-0526 Nilotinib Tasigna 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 29, 2007 In Use
00078-0526-87 00078-0526 Nilotinib Tasigna 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 29, 2007 In Use
59572-0730-07 59572-0730 azacitidine ONUREG 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Dec. 18, 2020 In Use
59572-0730-14 59572-0730 azacitidine ONUREG 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Sept. 1, 2020 In Use
63759-3028-01 63759-3028 gemcitabine GEMCITABINE 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous June 19, 2019 In Use
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
79802-0200-30 79802-0200 belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral July 16, 2021 In Use
00143-9394-01 00143-9394 Gemcitabine Gemcitabine 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous June 25, 2021 In Use
71288-0113-10 71288-0113 GEMCITABINE HYDROCHLORIDE GEMCITABINE 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Nov. 1, 2018 In Use
72607-0100-00 72607-0100 tazemetostat TAZVERIK 200.0 mg/1 Chemotherapy Enzyme Inhibitor EZH2 Oral Jan. 23, 2020 In Use
00078-0701-84 00078-0701 Alpelisib PIQRAY 200.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral May 24, 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
16714-0909-01 16714-0909 Gemcitabine Hydrochloride Gemcitabine 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Nov. 1, 2018 In Use

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