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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date (Ascending) Package Discontinuation Date Status
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
68788-7267-00 68788-7267 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 25, 2018 In Use
68788-7267-01 68788-7267 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 25, 2018 In Use
68788-7267-02 68788-7267 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 25, 2018 In Use
68788-7267-03 68788-7267 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 25, 2018 In Use
73116-0115-01 73116-0115 duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0115-02 73116-0115 duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0125-01 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0125-02 73116-0125 duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0215-28 73116-0215 Duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0215-56 73116-0215 Duvelisib COPIKTRA 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0225-28 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0115-01 71779-0115 duvelisib Copiktra 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0115-02 71779-0115 duvelisib Copiktra 15.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0125-01 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
71779-0125-02 71779-0125 duvelisib Copiktra 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
43598-0773-11 43598-0773 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
50742-0512-20 50742-0512 Clofarabine Clofarabine 1.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Sept. 27, 2018 In Use
61755-0008-01 61755-0008 cemiplimab-rwlc LIBTAYO 50.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sept. 28, 2018 In Use
67457-0531-02 67457-0531 DOCETAXEL ANHYDROUS Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Sept. 28, 2018 In Use
67457-0532-08 67457-0532 DOCETAXEL ANHYDROUS Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Sept. 28, 2018 In Use
00054-0248-12 00054-0248 Imatinib Mesylate Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 28, 2018 In Use

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