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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
55700-0208-48 55700-0208 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2017 Oct. 11, 2019 In Use
55700-0208-60 55700-0208 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 6, 2016 In Use
55700-0209-15 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 4, 2015 In Use
55700-0209-20 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 16, 2015 Oct. 11, 2019 In Use
55700-0209-21 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 16, 2015 In Use
55700-0209-30 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 16, 2015 In Use
55700-0209-42 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 16, 2015 In Use
55700-0209-48 55700-0209 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2017 In Use
55700-0458-30 55700-0458 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Nov. 18, 2016 In Use
55700-0458-90 55700-0458 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Nov. 18, 2016 In Use
55700-0484-10 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-12 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-20 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-30 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0504-90 55700-0504 Estradiol Estradiol 0.5 mg/1 Hormonal Therapy Estrogen Oral Feb. 17, 2017 In Use
55700-0508-30 55700-0508 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 3, 2017 June 30, 2019 In Use
55700-0508-90 55700-0508 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 3, 2017 Dec. 31, 2018 In Use
55700-0522-30 55700-0522 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 19, 2017 Dec. 31, 2018 No Longer Used
55700-0627-10 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-12 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-20 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0627-30 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 18, 2018 In Use
55700-0631-06 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-10 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-20 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0631-30 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 In Use
55700-0672-10 55700-0672 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 24, 2018 In Use
55700-0672-30 55700-0672 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 14, 2018 Jan. 1, 2019 In Use
55700-0672-65 55700-0672 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 14, 2018 In Use
55700-0728-20 55700-0728 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 17, 2019 Oct. 31, 2019 In Use
55700-0728-21 55700-0728 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2019 In Use
55700-0733-21 55700-0733 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 15, 2019 In Use
55700-0854-21 55700-0854 Dexamethasone TaperDex 6-day 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 27, 2020 In Use
55700-0952-65 55700-0952 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 11, 2022 In Use
55700-0961-12 55700-0961 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2022 In Use
57237-0062-05 57237-0062 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
57237-0062-30 57237-0062 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
57237-0062-90 57237-0062 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
57237-0075-30 57237-0075 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
57237-0075-50 57237-0075 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 4, 2022 In Use
57237-0076-30 57237-0076 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
57237-0076-50 57237-0076 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 4, 2022 In Use
57237-0077-10 57237-0077 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use
57237-0077-30 57237-0077 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use
57237-0078-10 57237-0078 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use
57237-0078-30 57237-0078 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use
57277-0001-05 57277-0001 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 21, 2017 In Use
57277-0002-10 57277-0002 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 21, 2017 In Use
57277-0105-05 57277-0105 carboplatin Injection Carboplatin 50.0 mg/5mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 29, 2016 In Use
57277-0106-15 57277-0106 carboplatin Injection Carboplatin 150.0 mg/5mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 29, 2016 In Use
57277-0107-45 57277-0107 carboplatin Injection Carboplatin 450.0 mg/5mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sept. 29, 2016 In Use
57377-0025-01 57377-0025 Estradiol pellet Estra-25 25.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan. 1, 2017 In Use
57377-0050-01 57377-0050 Estradiol pellet Estra-50 50.0 mg/1 Hormonal Therapy Estrogen Subcutaneous Jan. 1, 2017 In Use
57377-0060-01 57377-0060 Testosterone, USP and Anastrozole Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan. 1, 2021 In Use
57582-0101-01 57582-0101 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 14, 2018 In Use
57582-0101-02 57582-0101 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 14, 2019 In Use
57664-0020-97 57664-0020 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0021-97 57664-0021 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0022-97 57664-0022 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0023-97 57664-0023 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0024-97 57664-0024 Isotretinoin Isotretinoin 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0025-97 57664-0025 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57665-0331-01 57665-0331 Cytarabine DepoCyt 50.0 mg/5mL Chemotherapy Antimetabolite Pyrimidine Analog Intrathecal Oct. 22, 2010 June 30, 2018 No Longer Used
57881-0444-01 57881-0444 Ondansetron Zuplenz 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 8, 2014 In Use
57881-0444-10 57881-0444 Ondansetron Zuplenz 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 8, 2014 In Use
57881-0448-01 57881-0448 Ondansetron Zuplenz 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 8, 2014 In Use
57881-0448-10 57881-0448 Ondansetron Zuplenz 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 8, 2014 In Use
57884-2021-01 57884-2021 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral May 16, 2013 In Use
57884-3021-00 57884-3021 Docetaxel Docetaxel 40.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Feb. 15, 2017 Oct. 29, 2021 In Use
57894-0050-60 57894-0050 NIRAPARIB TOSYLATE MONOHYDRATE and ABIRATERONE ACETATE AKEEGA 500.0 mg/1, 50.0 mg/1 Chemotherapy Androgen Receptor Inhibitor, Enzyme Inhibitor CYP 17, PARP Oral Aug. 11, 2023 In Use
57894-0100-60 57894-0100 NIRAPARIB TOSYLATE MONOHYDRATE and ABIRATERONE ACETATE AKEEGA 500.0 mg/1, 100.0 mg/1 Chemotherapy Androgen Receptor Inhibitor, Enzyme Inhibitor CYP17, PARP Oral Aug. 11, 2023 In Use
57894-0111-01 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
57894-0111-02 57894-0111 ciltacabtagene autoleucel CARVYKTI 100000000.0 1/1 Immunotherapy CAR-T BCMA Intravenous Feb. 28, 2022 In Use
57894-0150-12 57894-0150 Abiraterone Acetate Zytiga 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 28, 2011 In Use
57894-0150-25 57894-0150 Abiraterone Acetate Zytiga 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Sept. 1, 2015 Aug. 31, 2018 In Use
57894-0155-12 57894-0155 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Feb. 9, 2018 In Use
57894-0184-12 57894-0184 Abiraterone Acetate Zytiga 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 17, 2017 April 18, 2017 No Longer Used
57894-0195-06 57894-0195 Abiraterone Acetate Zytiga 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 17, 2017 In Use
57894-0195-15 57894-0195 Abiraterone Acetate Zytiga 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 17, 2017 In Use
57894-0199-06 57894-0199 Abiraterone acetate Abiraterone acetate 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral March 5, 2018 Sept. 2, 2021 In Use
57894-0420-01 57894-0420 Siltuximab Sylvant 100.0 mg/1 Immunotherapy Monoclonal Antibody Interleukin-6 Antagonists Intravenous April 23, 2014 Jan. 31, 2021 No Longer Used
57894-0421-01 57894-0421 Siltuximab Sylvant 400.0 mg/1 Immunotherapy Monoclonal Antibody Interleukin-6 Antagonists Intravenous April 1, 2014 Jan. 31, 2021 No Longer Used
57894-0449-01 57894-0449 Teclistamab TECVAYLI 10.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct. 25, 2022 In Use
57894-0450-01 57894-0450 Teclistamab TECVAYLI 90.0 mg/mL Immunotherapy Monoclonal Antibody BCMA, CD3 Subcutaneous Oct. 25, 2022 In Use
57894-0469-01 57894-0469 Talquetamab TALVEY 3.0 mg/1.5mL Immunotherapy T Cell Receptor (TCR) GPRC5D, CD3 Subcutaneous Aug. 9, 2023 In Use
57894-0470-01 57894-0470 Talquetamab TALVEY 40.0 mg/mL Immunotherapy T Cell Receptor (TCR) GPRC5D, CD3 Subcutaneous Aug. 9, 2023 In Use
57894-0501-01 57894-0501 Amivantamab Rybrevant 350.0 mg/1 Immunotherapy Monoclonal Antibody EGFR, MET Intravenous May 21, 2021 In Use
57894-0502-05 57894-0502 Daratumumab Darzalex 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Nov. 16, 2015 In Use
57894-0502-20 57894-0502 Daratumumab Darzalex 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Nov. 16, 2015 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
57894-0505-05 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
57894-0505-20 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
57902-0249-05 57902-0249 Asparaginase Erwinaze 10000.0 [iU]/mL Chemotherapy Miscellaneous Agent Enzyme Intramuscular, Intravenous Nov. 18, 2011 July 23, 2021 No Longer Used
57902-0860-03 57902-0860 Samarium SM 153 Lexidronam Quadramet 50.0 mCi/mL Ancillary Therapy Radiopharmaceutical Samarium Sm 153 Intravenous May 19, 1997 In Use
57962-0007-12 57962-0007 Ibrutinib Imbruvica 70.0 mg/mL Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Aug. 24, 2022 In Use
57962-0014-28 57962-0014 Ibrutinib IMBRUVICA 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb. 16, 2018 In Use
57962-0070-28 57962-0070 Ibrutinib IMBRUVICA 70.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Dec. 20, 2017 In Use
57962-0140-09 57962-0140 Ibrutinib Imbruvica 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Nov. 13, 2013 In Use
57962-0140-12 57962-0140 Ibrutinib Imbruvica 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Nov. 13, 2013 In Use
57962-0280-28 57962-0280 Ibrutinib IMBRUVICA 280.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb. 16, 2018 In Use

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