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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
72603-0368-01 72603-0368 Eribulin Mesylate Eribulin Mesylate 0.5 mg/mL Chemotherapy Antimitotic Agent Furopyrans Intravenous Dec 5, 2025 In Use
72819-0153-02 72819-0153 Mitomycin Mitomycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Apr 25, 2022 In Use
72789-0473-01 72789-0473 PredniSONE PredniSONE Tablets, USP, 20 mg 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 22, 2025 In Use
00006-4121-02 00006-4121 Human Papillomavirus 9-valent Vaccine, Recombinant GARDASIL 9 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Dec 10, 2014 In Use
87063-0045-60 87063-0045 PREDNISONE PREDNISONE 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec 3, 2025 In Use
75907-0189-35 75907-0189 Cyclophosphamide CYCLOPHOSPHAMIDE 200.0 mg/mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Jun 20, 2024 In Use
82943-0101-05 82943-0101 Cyclophosphamide CYCLOPHOSPHAMIDE 200.0 mg/mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Jan 1, 2024 In Use
83090-0009-01 83090-0009 Arsenic trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov 9, 2023 In Use
85000-0011-01 85000-0011 Dr Adam Au P- PACK PREDNISONE 20MG, 7- DAY TAPERING DOSE PACK 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 12, 2002 In Use
00006-4045-01 00006-4045 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jun 8, 2006 In Use
00009-0280-03 00009-0280 Methylprednisolone Acetate Depo-Medrol 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intralesional, Intramuscular, Intrasynovial, Soft Tissue May 28, 1959 In Use
00003-7125-11 00003-7125 nivolumab and relatlimab-rmbw OPDUALAG 12.0 mg/mL, 4.0 mg/mL Immunotherapy Checkpoint Inhibitor, Monoclonal Antibody PD-1, LAG3 Intravenous Mar 18, 2022 In Use
00409-0021-03 00409-0021 PEMETREXED PEMETREXED 500.0 mg/20mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Feb 1, 2023 In Use
00781-3522-75 00781-3522 METHYLPREDNISOLONE ACETATE METHYLPREDNISOLONE ACETATE 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intralesional, Intramuscular, Intrasynovial, Soft Tissue Mar 14, 2024 In Use
10135-0776-10 10135-0776 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb 1, 2023 In Use
49884-0127-91 49884-0127 Everolimus Everolimus 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec 10, 2019 In Use
00054-4183-25 00054-4183 Dexamethasone Dexamethasone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 26, 1982 In Use
25021-0235-51 25021-0235 Gemcitabine Hydrochloride Gemcitabine 1.0 g/25mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Dec 15, 2022 In Use
31722-0260-21 31722-0260 LENALIDOMIDE LENALIDOMIDE 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 11, 2023 In Use
00143-9771-06 00143-9771 Ondansetron Hydrochloride and Dextrose Ondansetron Hydrochloride and Dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Aug 4, 2009 In Use
55513-0005-01 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sep 11, 2006 In Use
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
42806-0089-05 42806-0089 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral Apr 10, 2017 In Use
43598-0516-63 43598-0516 Lenalidomide Lenalidomide 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sep 6, 2022 In Use
75987-0021-70 75987-0021 Prednisone Rayos 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 27, 2012 In Use

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