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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 (Descending) Status
72893-0004-01 72893-0004 Levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 In Use
72893-0006-01 72893-0006 Levoleucovorin KHAPZORY 300.0 mg/6mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan. 2, 2019 In Use
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0105-25 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
59762-0055-01 59762-0055 Medroxyprogesterone acetate Medroxyprogesterone acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Aug. 20, 2018 In Use
59762-0055-02 59762-0055 Medroxyprogesterone acetate Medroxyprogesterone acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Nov. 2, 2020 In Use
59762-0058-01 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Jan. 2, 2019 In Use
59762-0058-02 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral May 11, 2020 In Use
70860-0214-61 70860-0214 Melphalan hydrochloride Melphalan hydrochloride 50.0 mg/10ml Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous July 30, 2019 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 In Use
00002-4184-30 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use
72205-0046-01 72205-0046 Thiotepa Thiotepa 100.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical Feb. 1, 2020 In Use
72611-0779-02 72611-0779 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Nov. 1, 2020 In Use
68180-0685-01 68180-0685 Methylprednisolone Methylprednisolone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0688-08 68180-0688 Methylprednisolone Methylprednisolone 16.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0689-55 68180-0689 Methylprednisolone Methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0686-01 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0686-11 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0687-55 68180-0687 Methylprednisolone Methylprednisolone 8.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin May 1, 2020 In Use
60760-0313-10 60760-0313 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 2, 2020 In Use
61314-0866-01 61314-0866 pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov. 4, 2019 In Use
60219-1707-01 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-03 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-05 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use

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