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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
68152-0112-01 68152-0112 levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan 2, 2019 In Use
71335-2160-06 71335-2160 Prednisone Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 28, 2024 In Use
51991-0620-33 51991-0620 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jun 28, 2010 In Use
63187-0243-15 63187-0243 Prednisone Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sep 1, 2014 In Use
51662-1288-03 51662-1288 METOCLOPRAMIDE METOCLOPRAMIDE 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Oct 1, 2022 In Use
68382-0827-06 68382-0827 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan 3, 2018 In Use
40051-0606-53 40051-0606 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug 1, 2016 In Use
42708-0136-21 42708-0136 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Apr 23, 2021 In Use
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 5, 2016 In Use
49999-0028-65 49999-0028 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 11, 2010 Jun 1, 2017 In Use
50242-0260-01 50242-0260 Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Phesgo 20000.0 U/10mL, 600.0 mg/10mL, 600.0 mg/10mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Jun 29, 2020 In Use
54868-6366-00 54868-6366 Isotretinoin Myorisan 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Aug 23, 2012 In Use
61748-0301-01 61748-0301 Isotretinoin Myorisan 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral May 1, 2012 In Use
68788-9177-08 68788-9177 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 21, 2011 Feb 22, 2019 In Use
50242-0125-01 50242-0125 Glofitamab Columvi 2.5 mg/2.5mL Immunotherapy Monoclonal Antibody CD20, CD3 Intravenous Jun 15, 2023 In Use
75929-0174-03 75929-0174 Belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral Jul 16, 2021 In Use
21695-0765-21 21695-0765 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 12, 2002 In Use
42291-0771-50 42291-0771 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Apr 22, 2020 In Use
70518-3142-02 70518-3142 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec 9, 2021 In Use
53808-0399-01 53808-0399 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 1, 2009 In Use
00781-3166-95 00781-3166 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 4, 2014 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
54569-6048-01 54569-6048 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 6, 2016 In Use
54868-4170-01 54868-4170 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 11, 2000 In Use
00555-0572-35 00555-0572 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Nov 1, 1990 In Use

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