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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 Status
69452-0278-20 69452-0278 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug 1, 2023 In Use
69452-0350-01 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69452-0350-11 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69452-0350-92 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
69468-0151-04 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69468-0151-20 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
69488-0003-01 69488-0003 Lutetium Lu 177 dotatate Lutathera 10.0 mCi/mL Chemotherapy Radiopharmaceutical Somatostatin Analog Intravenous Jan 26, 2018 In Use
69488-0010-61 69488-0010 Lutetium Lu 177 vipivotide tetraxetan PLUVICTO 27.0 mCi/mL Radiopharmaceutical Radiopharmaceutical PSMA Intravenous Mar 23, 2022 In Use
69539-0019-60 69539-0019 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0019-99 69539-0019 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0020-92 69539-0020 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0020-99 69539-0020 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Jul 2, 2018 In Use
69539-0034-01 69539-0034 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use
69539-0049-92 69539-0049 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jul 10, 2019 In Use
69539-0090-30 69539-0090 Erlotinib Hydrochloride Erlotinib Hydrochloride 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
69539-0091-30 69539-0091 Erlotinib Hydrochloride Erlotinib Hydrochloride 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
69539-0092-30 69539-0092 Erlotinib Hydrochloride Erlotinib Hydrochloride 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 11, 2021 In Use
69539-0115-01 69539-0115 Decitabine Decitabine 50.0 mg/10mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug 28, 2019 In Use
69539-0123-01 69539-0123 Thiotepa Thiotepa 15.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical Mar 4, 2020 In Use
69539-0124-01 69539-0124 Thiotepa Thiotepa 100.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard /Ethylenimine Intracavitary, Intravenous, Intravesical Mar 4, 2020 In Use
69539-0152-30 69539-0152 Toremifene citrate Toremifene citrate 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug 20, 2020 In Use
69539-0157-01 69539-0157 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug 26, 2020 In Use
69539-0158-01 69539-0158 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug 26, 2020 In Use
69539-0159-01 69539-0159 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug 26, 2020 In Use

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