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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
69367-0190-50 69367-0190 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Feb. 2, 2023 In Use
70114-0120-01 70114-0120 Pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous March 6, 2023 In Use
70121-1232-01 70121-1232 Pemetrexed Pemetrexed disodium 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 16, 2023 In Use
70121-1568-07 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1568-01 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb. 25, 2022 In Use
70121-1743-04 70121-1743 Nelarabine Nelarabine 5.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous April 10, 2023 In Use
70518-1922-01 70518-1922 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 28, 2019 In Use
70518-2314-03 70518-2314 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 9, 2022 In Use
70518-2368-00 70518-2368 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Oct. 19, 2019 In Use
70518-2368-02 70518-2368 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral April 13, 2022 In Use
70518-3182-00 70518-3182 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 5, 2021 In Use
70518-3182-02 70518-3182 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 2, 2023 In Use
70518-3600-01 70518-3600 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 28, 2022 In Use
70518-3600-02 70518-3600 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 28, 2023 In Use
70518-3600-03 70518-3600 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 1, 2023 In Use
70518-3622-00 70518-3622 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 25, 2023 In Use
70518-3672-00 70518-3672 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral March 6, 2023 In Use
70518-3716-00 70518-3716 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 16, 2023 In Use
70700-0273-22 70700-0273 ESTRADIOL VALERATE Estradiol valerate 10.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
70700-0274-22 70700-0274 ESTRADIOL VALERATE Estradiol valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
70700-0275-22 70700-0275 ESTRADIOL VALERATE Estradiol valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular May 1, 2023 In Use
70710-1030-01 70710-1030 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1030-07 70710-1030 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1034-01 70710-1034 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1034-08 70710-1034 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70710-1656-01 70710-1656 Decitabine Decitabine 50.0 mg/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous May 11, 2023 In Use
70710-1895-06 70710-1895 Arsenic trioxide Arsenic trioxide 1.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Feb. 28, 2023 In Use
70710-1896-06 70710-1896 Arsenic trioxide Arsenic trioxide 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Feb. 28, 2023 In Use
70771-1676-01 70771-1676 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1676-07 70771-1676 LENALIDOMIDE LENALIDOMIDE 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1680-01 70771-1680 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1680-08 70771-1680 LENALIDOMIDE LENALIDOMIDE 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 7, 2023 In Use
70771-1713-01 70771-1713 Decitabine Decitabine 50.0 mg/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous May 11, 2023 In Use
70954-0402-10 70954-0402 Dexamethasone Dexamethasone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 9, 2023 In Use
71205-0741-06 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-10 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-14 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-15 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-20 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-21 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-24 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-28 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-30 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-60 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0741-90 71205-0741 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 6, 2023 In Use
71205-0755-05 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-06 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-07 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-10 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-12 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-14 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-15 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-18 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-20 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-21 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-24 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-28 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-30 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-60 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71205-0755-90 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71288-0165-53 71288-0165 Nelarabine Nelarabine 5.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Jan. 10, 2023 In Use
71288-0166-10 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0166-91 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0166-92 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0167-50 71288-0167 Pemetrexed disodium Pemetrexed 500.0 mg/50mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0167-95 71288-0167 Pemetrexed disodium Pemetrexed 500.0 mg/50mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71335-2149-01 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-02 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-03 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-04 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-05 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-06 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-07 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71921-0177-06 71921-0177 Abiraterone acetate Abiraterone acetate 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 10, 2023 In Use
72162-1878-06 72162-1878 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72162-1879-06 72162-1879 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72162-1880-06 72162-1880 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72189-0415-30 72189-0415 ANASTROZOLE ANASTROZOLE 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 30, 2023 In Use
72189-0468-15 72189-0468 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 4, 2023 In Use
72189-0468-21 72189-0468 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 4, 2023 In Use
72606-0011-01 72606-0011 Bevacizumab-adcd Vegzelma 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0011-10 72606-0011 Bevacizumab-adcd Vegzelma 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0012-01 72606-0012 Bevacizumab-adcd Vegzelma 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0012-10 72606-0012 Bevacizumab-adcd Vegzelma 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72819-0152-95 72819-0152 Mitomycin Mitomycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous March 11, 2022 In Use
72819-0152-05 72819-0152 Mitomycin Mitomycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72819-0153-02 72819-0153 Mitomycin Mitomycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72819-0154-04 72819-0154 Mitomycin Mitomycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72974-0120-01 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Dec. 18, 2020 In Use
72974-0120-97 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Oct. 21, 2021 In Use
72974-0120-95 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Jan. 27, 2023 In Use
80425-0075-01 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-02 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-03 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-04 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-05 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0230-01 80425-0230 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0231-01 80425-0231 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0242-02 80425-0242 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0255-01 80425-0255 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use

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