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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name (Descending) Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
59651-0415-01 59651-0415 HYDROCORTISONE HYDROCORTISONE 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral July 17, 2023 In Use
68788-8455-03 68788-8455 hydrocortisone HYDROCORTISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 5, 2023 In Use
68788-8455-06 68788-8455 hydrocortisone HYDROCORTISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 5, 2023 In Use
68788-8455-09 68788-8455 hydrocortisone HYDROCORTISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 5, 2023 In Use
65174-0880-00 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
65174-0880-25 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
65174-0880-50 65174-0880 Sodium Iodide I 131 HICON 1000.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral April 7, 2003 In Use
63459-0303-43 63459-0303 TRASTUZUMAB HERZUMA 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous March 16, 2020 In Use
63459-0305-47 63459-0305 TRASTUZUMAB HERZUMA Immunotherapy Monoclonal Antibody HER2 March 16, 2020 In Use
64239-0300-10 64239-0300 Dexamethasone HEMADY 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 31, 2020 In Use
63459-0910-01 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0910-11 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0910-12 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0910-15 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0910-17 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0910-18 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan. 7, 2015 In Use
63459-0910-36 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0912-01 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-11 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-12 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-15 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 11, 2013 In Use
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
63459-0912-18 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jan. 7, 2015 In Use
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 2, 2015 In Use
52547-0801-30 52547-0801 Granisetron Granisol Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist March 7, 2008 July 30, 2014 No Longer Used

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