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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
54868-5802-00 54868-5802 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 13, 2007 In Use
54868-5867-00 54868-5867 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent March 20, 2008 June 30, 2013 No Longer Used
54868-5887-00 54868-5887 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 8, 2008 In Use
54868-5887-01 54868-5887 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 8, 2008 In Use
54868-5888-00 54868-5888 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 8, 2008 In Use
54868-5903-00 54868-5903 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 30, 2008 In Use
54868-5915-00 54868-5915 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 8, 2008 In Use
54868-5929-00 54868-5929 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 19, 2008 In Use
54868-5934-00 54868-5934 Estrogens, Esterified Menest 0.625 mg/1 Hormonal Therapy Estrogen Oral Sept. 5, 2008 In Use
54868-5934-01 54868-5934 Estrogens, Esterified Menest 0.625 mg/1 Hormonal Therapy Estrogen Oral Sept. 5, 2008 In Use
54868-5980-00 54868-5980 Temozolomide Temodar 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Jan. 26, 2009 In Use
54868-5985-00 54868-5985 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Feb. 16, 2009 In Use
54868-6099-00 54868-6099 Dexamethasone Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Jan. 15, 2010 In Use
54868-6130-00 54868-6130 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 1, 2010 In Use
54868-6130-01 54868-6130 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 1, 2010 In Use
54868-6133-00 54868-6133 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Aug. 9, 2010 In Use
54868-6185-00 54868-6185 Isotretinoin Claravis 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 4, 2013 In Use
54868-6199-00 54868-6199 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 2, 1959 June 30, 2012 No Longer Used
54868-6211-00 54868-6211 Estrogens, Esterified Menest 0.3 mg/1 Hormonal Therapy Estrogen Oral Dec. 9, 2010 In Use
54868-6211-01 54868-6211 Estrogens, Esterified Menest 0.3 mg/1 Hormonal Therapy Estrogen Oral Dec. 9, 2010 In Use
54868-6212-00 54868-6212 Estrogens, Esterified Menest 1.25 mg/1 Hormonal Therapy Estrogen Oral Dec. 16, 2010 In Use
54868-6212-01 54868-6212 Estrogens, Esterified Menest 1.25 mg/1 Hormonal Therapy Estrogen Oral Dec. 16, 2010 In Use
54868-6232-00 54868-6232 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 10, 2011 In Use
54868-6252-00 54868-6252 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral May 4, 2011 In Use
54868-6293-00 54868-6293 Fluorouracil Fluorouracil 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 6, 2011 In Use

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