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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 (Ascending) Package Discontinuation Date Status
67457-0419-00 67457-0419 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0419-01 67457-0419 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0483-00 67457-0483 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2020 In Use
67457-0483-10 67457-0483 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2020 In Use
67457-0484-00 67457-0484 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0484-30 67457-0484 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
00006-5033-02 00006-5033 Trastuzumab Ontruzant 150.0 mg/1 Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
00006-5034-02 00006-5034 Ontruzant Ontruzant Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
42806-0358-01 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
42806-0358-30 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
00310-0610-60 00310-0610 SELUMETINIB KOSELUGO 10.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 2020 In Use
00310-0625-60 00310-0625 SELUMETINIB KOSELUGO 25.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 2020 In Use
50881-0026-01 50881-0026 Pemigatinib PEMAZYRE 4.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use
50881-0027-01 50881-0027 Pemigatinib PEMAZYRE 9.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use
50881-0028-01 50881-0028 Pemigatinib PEMAZYRE 13.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use
70934-0580-40 70934-0580 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 17, 2020 In Use
70934-0580-42 70934-0580 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 17, 2020 In Use
51144-0002-12 51144-0002 Tucatinib TUKYSA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor HER2 Oral April 17, 2020 In Use
51144-0002-60 51144-0002 Tucatinib TUKYSA 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor HER2 Oral April 17, 2020 In Use
51144-0001-60 51144-0001 Tucatinib TUKYSA 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor HER2 Oral April 17, 2020 In Use
00143-9289-01 00143-9289 Estradiol Valerate Estradiol Valerate 10.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 In Use
00143-9290-01 00143-9290 Estradiol Valerate Estradiol Valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 In Use
00143-9291-01 00143-9291 Estradiol Valerate Estradiol Valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 In Use
70518-2703-00 70518-2703 Prednisone Prednisone 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 21, 2020 In Use

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