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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
64679-0636-02 64679-0636 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous May 11, 2011 In Use
64679-0810-08 64679-0810 Dexamethasone Baycadron 0.5 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 27, 1983 In Use
64725-1473-01 64725-1473 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec 4, 1985 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
64842-0727-09 64842-0727 CEDAZURIDINE and DECITABINE INQOVI 100.0 mg/1, 35.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog + CDA Inhibitor Oral Aug 25, 2020 In Use
64842-1020-01 64842-1020 Trifluridine and Tipiracil Lonsurf 8.19 mg/1, 20.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Oct 7, 2015 In Use
64842-1020-02 64842-1020 Trifluridine and Tipiracil Lonsurf 8.19 mg/1, 20.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Nov 11, 2015 In Use
64842-1020-03 64842-1020 Trifluridine and Tipiracil Lonsurf 8.19 mg/1, 20.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Oct 21, 2015 In Use
64842-1025-02 64842-1025 Trifluridine and Tipiracil Lonsurf 6.14 mg/1, 15.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Nov 11, 2015 In Use
64842-1025-03 64842-1025 Trifluridine and Tipiracil Lonsurf 6.14 mg/1, 15.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Oct 21, 2015 In Use
64980-0224-03 64980-0224 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov 20, 2015 In Use
64980-0224-09 64980-0224 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov 20, 2015 In Use
64980-0404-03 64980-0404 Toremifene Citrate Toremifene Citrate 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan 18, 2019 In Use
64980-0418-12 64980-0418 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Feb 25, 2019 In Use
64980-0509-24 64980-0509 Dexamethasone Dexamethasone 0.5 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 1, 2011 In Use
65084-0333-10 65084-0333 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 24, 2019 In Use
65162-0057-03 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan 20, 2016 In Use
65162-0057-33 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan 20, 2016 In Use
65162-0057-50 65162-0057 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan 20, 2016 In Use
65162-0240-03 65162-0240 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec 29, 2018 In Use
65162-0794-03 65162-0794 Imatinib Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb 8, 2019 In Use
65162-0794-09 65162-0794 Imatinib Imatinib Mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb 8, 2019 In Use
65162-0795-03 65162-0795 Imatinib Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb 8, 2019 In Use
65162-0795-09 65162-0795 Imatinib Imatinib Mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb 8, 2019 In Use

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