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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
68382-0775-01 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
68382-0775-05 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
68382-0775-10 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
68382-0775-16 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
68382-0775-60 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
68382-0775-77 68382-0775 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Feb. 9, 2017 In Use
69189-0063-01 69189-0063 Erlotinib Hydrochloride Tarceva 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral April 1, 2015 May 24, 2017 No Longer Used
69189-0382-01 69189-0382 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 18, 2015 May 24, 2017 No Longer Used
69189-0383-01 69189-0383 Cyclophosphamide Cyclophosphamide 50.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral April 23, 2015 May 24, 2017 No Longer Used
69189-0403-01 69189-0403 Imatinib Mesylate Gleevec 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral March 1, 2015 May 24, 2017 No Longer Used
69189-4581-01 69189-4581 Mercaptopurine Mercaptopurine 50.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral March 1, 2015 May 24, 2017 No Longer Used
69189-7096-01 69189-7096 Bromocriptine Mesylate Bromocriptine Mesylate 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral March 8, 2016 May 24, 2017 No Longer Used
69189-7638-01 69189-7638 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral June 11, 2015 May 24, 2017 No Longer Used
69945-0450-01 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-02 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-03 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-04 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-05 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0450-07 69945-0450 sodium iodide, i-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-02 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-03 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-04 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0451-06 69945-0451 sodium iodide, i-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0452-00 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used
69945-0452-01 69945-0452 sodium iodide i 131 SODIUM IODIDE I 131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Oct. 27, 2015 July 1, 2018 No Longer Used

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