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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
43063-0438-10 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-13 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-30 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-40 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-42 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-50 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
43063-0438-90 43063-0438 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral March 1, 2013 Dec. 31, 2022 In Use
00002-4184-02 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Jan. 1, 2023 In Use
45963-0614-81 45963-0614 Irinotecan Hydrochloride Irinotecan Hydrochloride 20.0 mg/mL Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Intravenous Jan. 17, 2019 Jan. 1, 2023 In Use
00078-0650-06 00078-0650 Panobinostat Farydak 10.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Jan. 31, 2023 No Longer Used
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5741-65 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-65 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00527-2931-37 00527-2931 Prednisone PREDNISONE 2.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00527-2932-37 00527-2932 Prednisone PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00527-2932-43 00527-2932 Prednisone PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00904-6745-61 00904-6745 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 Jan. 31, 2023 No Longer Used
00904-6746-04 00904-6746 DRONABINOL DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 Jan. 31, 2023 No Longer Used
16729-0248-38 16729-0248 Mitomycin Mitomycin 40.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous May 3, 2013 Jan. 31, 2023 No Longer Used
25021-0452-01 25021-0452 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Jan. 31, 2023 In Use
59762-3740-01 59762-3740 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 Jan. 31, 2023 No Longer Used
55289-0816-30 55289-0816 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Oct. 9, 2012 Jan. 31, 2023 In Use
00703-4248-91 00703-4248 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 4, 2015 Jan. 31, 2023 In Use
50242-0060-10 50242-0060 Bevacizumab Avastin 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 1, 2019 Jan. 31, 2023 In Use
60505-6177-08 60505-6177 Busulfan Busulfan 6.0 mg/mL Chemotherapy Alkylating Agent Alkylsulfonate Intravenous Aug. 19, 2019 Jan. 31, 2023 No Longer Used
70860-0782-10 70860-0782 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 30, 2020 Jan. 31, 2023 No Longer Used
89141-0444-01 89141-0444 Ondansetron Zuplenz 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 2, 2010 Feb. 23, 2023 No Longer Used
89141-0444-30 89141-0444 Ondansetron Zuplenz 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 31, 2016 Feb. 23, 2023 No Longer Used
16729-0247-11 16729-0247 Mitomycin Mitomycin 20.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous May 3, 2013 Feb. 28, 2023 No Longer Used
25021-0453-01 25021-0453 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 28, 2023 In Use
62559-0921-14 62559-0921 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0921-51 62559-0921 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0922-14 62559-0922 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0922-51 62559-0922 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0923-14 62559-0923 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0923-51 62559-0923 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0924-14 62559-0924 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
62559-0924-51 62559-0924 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Nov. 16, 2020 Feb. 28, 2023 No Longer Used
70934-0471-10 70934-0471 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 30, 2019 Feb. 28, 2023 No Longer Used
70934-0471-05 70934-0471 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 9, 2021 Feb. 28, 2023 No Longer Used
70934-0471-30 70934-0471 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 9, 2019 Feb. 28, 2023 No Longer Used
70860-0777-20 70860-0777 Ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous March 1, 2018 Feb. 28, 2023 In Use
50242-0061-10 50242-0061 Bevacizumab Avastin 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 1, 2019 Feb. 28, 2023 In Use
60429-0910-30 60429-0910 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Sept. 28, 2016 Feb. 28, 2023 No Longer Used
60505-4533-01 60505-4533 Lenalidomide Lenalidomide 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 March 8, 2023 In Use
60505-4534-01 60505-4534 Lenalidomide Lenalidomide 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 March 8, 2023 In Use
60505-4535-01 60505-4535 Lenalidomide Lenalidomide 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 March 8, 2023 In Use
60505-4537-01 60505-4537 Lenalidomide Lenalidomide 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Sept. 6, 2022 March 8, 2023 In Use
51672-1338-03 51672-1338 Prednisolone Acetate Flo-Pred 16.7 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 17, 2008 March 17, 2023 In Use

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