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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
75987-0022-01 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 27, 2012 In Use
75987-0022-02 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 27, 2012 In Use
75987-0022-70 75987-0022 Prednisone Rayos 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jul 27, 2012 In Use
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec 1, 2013 In Use
75987-0140-13 75987-0140 Cysteamine bitartrate PROCYSBI 75.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb 14, 2020 In Use
75987-0140-14 75987-0140 Cysteamine bitartrate PROCYSBI 75.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb 14, 2020 In Use
75987-0145-13 75987-0145 Cysteamine bitartrate PROCYSBI 300.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb 14, 2020 In Use
75987-0145-14 75987-0145 Cysteamine bitartrate PROCYSBI 300.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Feb 14, 2020 In Use
76045-0101-20 76045-0101 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous May 3, 2013 In Use
76045-0103-20 76045-0103 ONDANSETRON HYDROCHLORIDE Ondansetron 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 10, 2015 In Use
76045-0106-10 76045-0106 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Oct 30, 2015 In Use
76045-0109-10 76045-0109 DEXAMETHASONE SODIUM PHOSPHATE Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Jul 6, 2018 In Use
76045-0212-10 76045-0212 DEXAMETHASONE SODIUM PHOSPHATE Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb 21, 2024 In Use
76045-0216-20 76045-0216 ONDANSETRON HYDROCHLORIDE ONDANSETRON 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 31, 2022 In Use
76075-0101-01 76075-0101 Carfilzomib Kyprolis 60.0 mg/30mL Chemotherapy Proteasome Inhibitor 20S Intravenous Jul 20, 2012 In Use
76075-0102-01 76075-0102 Carfilzomib Kyprolis 30.0 mg/15mL Chemotherapy Proteasome Inhibitor 20S Intravenous Jul 15, 2016 In Use
76075-0103-01 76075-0103 carfilzomib KYPROLIS 10.0 mg/5mL Chemotherapy Proteasome Inhibitor 20S Intravenous May 23, 2018 In Use
76126-0075-01 76126-0075 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jul 19, 2014 Sep 1, 2017 No Longer Used
76128-0155-75 76128-0155 Porfimer sodium Photofrin 75.0 mg/31.8mL Chemotherapy Photosensitizing Agent Cytotoxin Intravenous Dec 27, 1995 In Use
76135-0005-01 76135-0005 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous Jan 1, 2019 In Use
76135-0006-01 76135-0006 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous Jan 1, 2019 In Use
76135-0009-01 76135-0009 OCTREOTIDE ACETATE OCTREOTIDE ACETATE 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 1, 2019 In Use
76135-0010-01 76135-0010 OCTREOTIDE ACETATE OCTREOTIDE ACETATE 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 1, 2019 In Use
76135-0011-01 76135-0011 OCTREOTIDE ACETATE OCTREOTIDE ACETATE 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Feb 1, 2019 In Use
76189-0113-18 76189-0113 Brigatinib Alunbrig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1/ EGFR Oral Apr 28, 2017 Dec 12, 2020 No Longer Used

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