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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 (Ascending) Status
00904-7144-61 00904-7144 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
00904-7145-04 00904-7145 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
16714-0160-01 16714-0160 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 6, 2021 In Use
16714-0200-30 16714-0200 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 27, 2021 In Use
16714-0201-10 16714-0201 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 27, 2021 In Use
16714-0201-30 16714-0201 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 27, 2021 In Use
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
43598-0027-48 43598-0027 Melphalan Hydrochloride Melphalan Hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous April 26, 2021 In Use
44278-0025-30 44278-0025 EXEMESTANE Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 22, 2013 In Use
43063-0383-06 43063-0383 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Aug. 23, 2018 In Use
43063-0383-15 43063-0383 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Aug. 20, 2012 In Use
69238-1754-06 69238-1754 ABIRATERONE ABIRATERONE ACETATE 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan. 7, 2019 In Use
72606-0566-01 72606-0566 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan. 7, 2020 In Use
69539-0049-92 69539-0049 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral July 10, 2019 In Use
68001-0489-07 68001-0489 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Feb. 26, 2021 In Use
72205-0030-92 72205-0030 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral July 10, 2019 In Use
59651-0236-30 59651-0236 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 24, 2020 In Use
59651-0236-90 59651-0236 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 24, 2020 In Use
69918-0720-02 69918-0720 Arsenic Trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
69918-0720-10 69918-0720 Arsenic Trioxide ARSENIC TRIOXIDE 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Nov. 14, 2018 In Use
70121-1483-07 70121-1483 Arsenic Trioxide Arsenic Trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Jan. 25, 2021 In Use
70710-1610-06 70710-1610 Arsenic trioxide Arsenic trioxide 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Sept. 3, 2019 In Use
71288-0153-95 71288-0153 Azacitidine Azacitidine 100.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Nov. 2, 2020 In Use
62559-0890-30 62559-0890 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Oct. 26, 2020 In Use

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