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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 Package Discontinuation Date Status
69117-0004-01 69117-0004 Letrozole Tablets Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Sep 5, 2019 In Use
63739-0333-10 63739-0333 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 24, 2019 In Use
69238-1017-03 69238-1017 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct 2, 2017 In Use
69238-1174-03 69238-1174 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct 2, 2017 In Use
69238-1175-03 69238-1175 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct 2, 2017 In Use
69238-1176-03 69238-1176 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct 2, 2017 In Use
69238-1250-01 69238-1250 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sep 4, 2018 In Use
69238-1423-06 69238-1423 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec 29, 2017 In Use
69238-1754-06 69238-1754 ABIRATERONE ABIRATERONE ACETATE 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan 7, 2019 In Use
69306-0400-21 69306-0400 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Mar 18, 2021 In Use
69315-0164-01 69315-0164 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Jul 9, 2020 In Use
69448-0001-05 69448-0001 Mitomycin Mutamycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Jul 25, 2017 In Use
69448-0003-38 69448-0003 Mitomycin Mutamycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Jul 25, 2017 In Use
69448-0014-63 69448-0014 LEUPROLIDE CAMCEVI 42.0 mg/.37g Hormonal Therapy GnRH Agonist Subcutaneous Apr 5, 2022 In Use
69452-0350-01 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69452-0350-11 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69452-0350-92 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69468-0151-04 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69468-0151-20 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69488-0003-01 69488-0003 Lutetium Lu 177 dotatate Lutathera 10.0 mCi/mL Chemotherapy Radiopharmaceutical Somatostatin Analog Intravenous Jan 26, 2018 In Use
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Mar 23, 2022 In Use
69539-0019-60 69539-0019 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0019-99 69539-0019 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0020-92 69539-0020 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use

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