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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
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0918-59 63459-0918 tbo-filgrastim GRANIX 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
63539-0026-01 63539-0026 Axitinib Inlyta 1.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral Jan. 27, 2012 In Use
63539-0044-01 63539-0044 Axitinib Inlyta 5.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral Jan. 27, 2012 In Use
63539-0044-02 63539-0044 Axitinib Inlyta 5.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral Jan. 27, 2012 In Use
63539-0051-30 63539-0051 Talazoparib Talzenna 0.5 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral June 21, 2023 In Use
63539-0117-01 63539-0117 Bosutinib monohydrate, Bosutinib Bosulif 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 4, 2012 In Use
63539-0189-11 63539-0189 Palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral Feb. 3, 2015 In Use
63539-0197-90 63539-0197 Dacomitinib Vizimpro 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Feb. 1, 2019 In Use
63539-0252-02 63539-0252 Elranatamab-bcmm Elrexfio 44.0 mg/1.1mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Aug. 15, 2023 In Use
63539-0284-03 63539-0284 palbociclib Ibrance 75.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
63539-0295-30 63539-0295 talazoparib Talzenna 1.0 mg/1 Chemotherapy Enzyme Inhibitor PARP Oral Dec. 10, 2018 In Use
63539-0486-03 63539-0486 palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
63539-0688-03 63539-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
63539-0927-01 63539-0927 Lorlatinib Lorbrena 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1 Oral Jan. 3, 2023 In Use
63561-0120-01 63561-0120 PredniSONE PredniSONE Tablets, USP, 5 mg 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63561-0120-02 63561-0120 PredniSONE PredniSONE Tablets, USP, 5 mg 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63561-0121-01 63561-0121 PredniSONE PredniSONE Tablets, USP, 10 mg 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63561-0121-02 63561-0121 PredniSONE PredniSONE Tablets, USP, 10 mg 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63561-0122-01 63561-0122 PredniSONE PredniSONE Tablets, USP, 20 mg 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63561-0122-02 63561-0122 PredniSONE PredniSONE Tablets, USP, 20 mg 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 6, 2024 In Use
63629-1472-01 63629-1472 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral June 4, 2014 In Use
63629-1472-02 63629-1472 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Jan. 16, 2008 In Use
63629-1472-03 63629-1472 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral April 19, 2010 In Use

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