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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
70771-1523-03 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1523-07 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
70771-1523-09 70771-1523 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 30, 2020 In Use
59923-0725-30 59923-0725 Erlotinib Erlotinib 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
59923-0726-30 59923-0726 Erlotinib Erlotinib 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
59923-0727-30 59923-0727 Erlotinib Erlotinib 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 1, 2020 In Use
51991-0065-97 51991-0065 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 1, 2020 May 2, 2020 No Longer Used
68788-7705-01 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
68788-7705-03 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
69605-0103-03 69605-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
70518-2721-00 70518-2721 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 1, 2020 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
48102-0047-20 48102-0047 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2020 June 30, 2022 No Longer Used
63459-0103-10 63459-0103 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
63459-0104-50 63459-0104 Rituximab-abbs Truxima 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous May 4, 2020 In Use
00078-0709-56 00078-0709 Capmatinib TABRECTA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0709-94 00078-0709 Capmatinib TABRECTA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0716-56 00078-0716 Capmatinib TABRECTA 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
00078-0716-94 00078-0716 Capmatinib TABRECTA 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral May 6, 2020 In Use
42195-0721-21 42195-0721 Dexamethasone DEXAMETHASONE 6-Day 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 7, 2020 In Use
00002-2980-26 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-2980-60 00002-2980 Selpercatinib RETEVMO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
00002-3977-60 00002-3977 Selpercatinib RETEVMO 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral May 8, 2020 In Use
72611-0785-02 72611-0785 Temsirolimus Injection Temsirolimus Chemotherapy Enzyme Inhibitor mTOR Intravenous May 8, 2020 In Use

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