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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
83831-0101-02 83831-0101 Docetaxel DOCIVYX 20.0 mg/2mL Chemotherapy Antimitotic Agent Taxane Intravenous May 9, 2024 In Use
83831-0102-08 83831-0102 Docetaxel DOCIVYX 80.0 mg/8mL Chemotherapy Antimitotic Agent Taxane Intravenous May 9, 2024 In Use
83831-0103-16 83831-0103 Docetaxel DOCIVYX 160.0 mg/16mL Chemotherapy Antimitotic Agent Taxane Intravenous May 9, 2024 In Use
83831-0105-01 83831-0105 Palonosetron Posfrea 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous July 30, 2024 In Use
83831-0116-01 83831-0116 Cyclophosphamide Cyclophosphamide 500.0 mg/mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Aug. 1, 2024 In Use
83831-0117-02 83831-0117 Cyclophosphamide Cyclophosphamide 1.0 g/2mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Aug. 1, 2024 In Use
83831-0118-04 83831-0118 Cyclophosphamide Cyclophosphamide 2.0 g/4mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Aug. 1, 2024 In Use
83858-0101-60 83858-0101 Dasatinib PHYRAGO 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0102-60 83858-0102 Dasatinib PHYRAGO 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0103-60 83858-0103 Dasatinib PHYRAGO 70.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0104-30 83858-0104 Dasatinib PHYRAGO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0105-30 83858-0105 Dasatinib PHYRAGO 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0106-30 83858-0106 Dasatinib PHYRAGO 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
73116-0225-28 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0225-56 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 28, 2018 In Use
00781-3491-94 00781-3491 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Aug. 21, 2024 In Use
25021-0465-01 25021-0465 Octreotide acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous June 15, 2023 In Use
51655-0012-03 51655-0012 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2014 In Use
51655-0012-87 51655-0012 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2014 In Use
60687-0428-01 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Sept. 9, 2019 In Use
60687-0428-65 60687-0428 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 20, 2020 In Use
60687-0455-21 60687-0455 Abiraterone Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Nov. 1, 2019 Feb. 28, 2025 In Use
63629-2612-01 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral June 13, 2011 In Use
63629-2612-02 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63739-0588-10 63739-0588 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 30, 2014 Dec. 31, 2025 In Use
63629-2612-03 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 12, 2011 In Use
63629-2612-04 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral June 14, 2016 In Use
63629-2612-05 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 28, 2021 In Use
63629-2612-06 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 8, 2024 In Use
63629-2612-07 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Oct. 9, 2017 In Use
68001-0611-33 68001-0611 Zoledronic acid Zoledronic acid 5.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous July 6, 2024 In Use
72893-0015-06 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 Feb. 28, 2026 In Use
72893-0015-24 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 Feb. 28, 2026 In Use
72903-0853-01 72903-0853 Mirvetuximab soravtansine ELAHERE 5.0 mg/mL Immunotherapy Drug Antibody Conjugate FR-alpha, DM4 Intravenous Nov. 14, 2022 In Use
00574-0866-10 00574-0866 Cyclosporine Cyclosporine 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Oct. 7, 2003 Aug. 1, 2024 No Longer Used
00615-8391-05 00615-8391 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2021 June 30, 2024 No Longer Used
00615-8391-30 00615-8391 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 11, 2021 March 31, 2024 No Longer Used
00615-8391-39 00615-8391 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2021 June 30, 2024 No Longer Used
00615-8395-05 00615-8395 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 27, 2021 July 31, 2024 No Longer Used
00615-8395-30 00615-8395 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 4, 2021 July 31, 2024 No Longer Used
00615-8395-39 00615-8395 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 27, 2021 July 31, 2024 No Longer Used
43598-0661-11 43598-0661 Cyclophosphamide Cyclophosphamide 1.0 g/2mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous July 24, 2023 In Use
43598-0662-11 43598-0662 Cyclophosphamide Cyclophosphamide 2.0 g/4mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous July 24, 2023 In Use
47426-0101-01 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug. 9, 2016 Aug. 9, 2016 In Use
47426-0101-06 47426-0101 Granisetron Sustol 10.0 mg/.4mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Subcutaneous Aug. 9, 2016 In Use
60687-0636-01 60687-0636 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 20, 2022 July 31, 2024 No Longer Used
68001-0517-36 68001-0517 fosaprepitant fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Aug. 23, 2021 July 31, 2024 No Longer Used
68071-2304-01 68071-2304 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 23, 2020 In Use
68071-5195-02 68071-5195 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 10, 2020 In Use
68071-5196-01 68071-5196 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 10, 2020 In Use

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