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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

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