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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
72789-0393-30 72789-0393 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 17, 2024 In Use
72789-0393-06 72789-0393 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 6, 2024 In Use
72789-0393-14 72789-0393 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 21, 2024 In Use
72789-0393-05 72789-0393 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 12, 2024 In Use
72789-0393-12 72789-0393 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 17, 2024 In Use
68083-0155-01 68083-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous May 3, 2024 In Use
72789-0401-10 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 4, 2024 In Use
72789-0401-30 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 3, 2024 In Use
72789-0401-40 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 3, 2024 In Use
72789-0401-50 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 3, 2024 In Use
72789-0401-21 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 25, 2024 In Use
72789-0401-20 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 20, 2024 In Use
72789-0401-12 72789-0401 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 10, 2024 In Use
70121-2631-01 70121-2631 FOSAPREPITANT DIMEGLUMINE FOCINVEZ 150.0 mg/50mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous June 15, 2024 In Use
70518-3913-00 70518-3913 Medroxyprogesterone acetate Medroxyprogesterone acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 10, 2023 In Use
70518-3913-01 70518-3913 Medroxyprogesterone acetate Medroxyprogesterone acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 4, 2024 In Use
70518-4145-00 70518-4145 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 18, 2024 In Use
71288-0165-53 71288-0165 Nelarabine Nelarabine 5.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Jan. 10, 2023 Jan. 2, 2025 In Use
71288-0165-54 71288-0165 Nelarabine Nelarabine 5.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Jan. 10, 2023 In Use
71288-0569-90 71288-0569 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous May 15, 2024 In Use
72162-1878-06 72162-1878 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72162-1878-01 72162-1878 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72266-0152-01 72266-0152 Zoledronic acid Zoledronic acid 5.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous June 12, 2023 In Use
75907-0047-30 75907-0047 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 1, 2024 In Use
75907-0095-40 75907-0095 FLUOROURACIL FLUOROURACIL 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical April 15, 2024 In Use
76282-0696-48 76282-0696 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2024 In Use
76282-0700-47 76282-0700 Lenalidomide Lenalidomide 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2024 In Use
82448-0100-14 82448-0100 Nirogacestat OGSIVEO 100.0 mg/1 Ancillary Therapy Miscellaneous Agent Ɣ Secretase Inhibitor Oral Nov. 27, 2023 In Use
82448-0150-14 82448-0150 Nirogacestat OGSIVEO 150.0 mg/1 Ancillary Therapy Miscellaneous Agent Ɣ Secretase Inhibitor Oral Nov. 27, 2023 In Use
82449-0231-01 82449-0231 FOSAPREPITANT DIMEGLUMINE FOCINVEZ 150.0 mg/50mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous June 26, 2024 In Use
83634-0777-05 83634-0777 Palonosetron hydrochloride Palonosetron Hydrochloride 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 15, 2024 In Use
83634-0779-02 83634-0779 Metoclopramide hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous June 30, 2024 In Use
83703-0531-02 83703-0531 Palonosetron hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 12, 2021 In Use
83831-0111-01 83831-0111 Pemetrexed dipotassium PEMETREXED DIPOTASSIUM 100.0 mg/4mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous June 28, 2024 In Use
83831-0112-01 83831-0112 Pemetrexed dipotassium PEMETREXED DIPOTASSIUM 500.0 mg/20mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous June 28, 2024 In Use
55513-0059-01 55513-0059 Tarlatamab-dlle IMDELLTRA (AMG757) 1.0 mg/1 Immunotherapy T Cell Receptor (TCR) DLL3, CD3 Intravenous May 16, 2024 In Use
81481-0803-01 81481-0803 Nogapendekin alfa inbakicept-pmln ANKTIVA 400.0 ug/.4mL Immunotherapy Cytokine IL-15 (⍺,β,ɣ) Intravesical May 6, 2024 In Use
82950-0001-16 82950-0001 TOVORAFENIB OJEMDA 100.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF, CRAF Oral April 30, 2024 In Use
82950-0001-20 82950-0001 TOVORAFENIB OJEMDA 100.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF, CRAF Oral April 30, 2024 In Use
82950-0001-24 82950-0001 TOVORAFENIB OJEMDA 100.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF, CRAF Oral April 30, 2024 In Use
82950-0012-01 82950-0012 Tovorafenib OJEMDA 25.0 mg/ml Chemotherapy Enzyme Inhibitor BRAF, CRAF ORAL April 30, 2024 In Use
82959-0111-01 82959-0111 imetelstat sodium RYTELO 188.0 mg/1 Chemotherapy Enzyme Inhibitor Telomerase Intravenous June 6, 2024 In Use
82959-0112-01 82959-0112 imetelstat sodium RYTELO 47.0 mg/1 Chemotherapy Enzyme Inhibitor Telomerase Intravenous June 6, 2024 In Use
17856-0691-01 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-02 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-04 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-05 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-06 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-07 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use
17856-0691-08 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 17, 2024 In Use

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