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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 (Descending) Package Discontinuation Date Status
68001-0285-40 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
68001-0286-38 68001-0286 Leucovorin Calcium Leucovorin 20.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
68001-0286-39 68001-0286 Leucovorin Calcium Leucovorin 20.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 1, 2016 Feb. 1, 2021 No Longer Used
00378-5260-14 00378-5260 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 March 31, 2018 No Longer Used
00378-5260-98 00378-5260 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 March 31, 2018 No Longer Used
00378-5261-14 00378-5261 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 March 31, 2018 No Longer Used
00378-5261-98 00378-5261 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 March 31, 2018 No Longer Used
00378-5262-14 00378-5262 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5262-98 00378-5262 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5263-14 00378-5263 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5263-98 00378-5263 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5264-14 00378-5264 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5264-98 00378-5264 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
00378-5265-98 00378-5265 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 29, 2016 Feb. 28, 2018 No Longer Used
50090-0294-09 50090-0294 METHOTREXATE Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral June 29, 2016 Jan. 31, 2021 In Use
58118-0450-08 58118-0450 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 29, 2016 Oct. 23, 2019 In Use
50090-0414-00 50090-0414 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous June 29, 2016 Feb. 28, 2018 In Use
50090-0256-00 50090-0256 Triamcinolone Acetonide Kenalog-40 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intramuscular June 29, 2016 In Use
50090-0295-01 50090-0295 Triamcinolone Acetonide Kenalog-10 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional June 29, 2016 In Use
50090-0312-01 50090-0312 Methylprednisolone Acetate Depo-Medrol 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intralesional, Intramuscular, Intrasynovial, Soft Tissue June 29, 2016 In Use
50090-0436-00 50090-0436 Methylprednisolone Acetate Depo-Medrol 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Soft Tissue June 29, 2016 In Use
50090-0439-00 50090-0439 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 29, 2016 In Use
50090-0485-01 50090-0485 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 29, 2016 In Use
50090-0490-02 50090-0490 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral June 29, 2016 In Use
50090-0491-01 50090-0491 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral June 29, 2016 In Use

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