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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 Status
69605-0103-03 69605-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
70020-1910-01 70020-1910 Ixabepilone Ixempra Chemotherapy Antitumor Antibiotic Epothilones Intravenous Oct. 16, 2007 In Use
70121-1482-02 70121-1482 carmustine carmustine Chemotherapy Alkylating Agent Nitrosourea Intravenous Oct. 22, 2018 In Use
70700-0278-97 70700-0278 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Jan. 6, 2021 In Use
70710-1525-09 70710-1525 Carmustine Carmustine Chemotherapy Alkylating Agent Nitrosourea Intravenous Dec. 24, 2020 In Use
72266-0128-01 72266-0128 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Sept. 23, 2019 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Instillation May 1, 2020 In Use
72611-0779-02 72611-0779 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Nov. 1, 2020 In Use
72611-0785-02 72611-0785 Temsirolimus Injection Temsirolimus Chemotherapy Enzyme Inhibitor mTOR Intravenous May 8, 2020 In Use
67457-0864-04 67457-0864 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous March 21, 2018 In Use
62135-0250-37 62135-0250 Prednisolone oral Prednisolone 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2022 In Use
62135-0250-47 62135-0250 Prednisolone oral Prednisolone 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2022 In Use
00002-6902-30 00002-6902 Pirtobrutinib JAYPIRCA 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral Jan. 27, 2023 In Use
00002-7026-60 00002-7026 Pirtobrutinib JAYPIRCA 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral Jan. 27, 2023 In Use
64842-0120-04 64842-0120 FUTIBATINIB LYTGOBI 4.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR Oral Feb. 3, 2023 In Use
64842-0120-05 64842-0120 FUTIBATINIB LYTGOBI 4.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR Oral Feb. 3, 2023 In Use
64842-0120-06 64842-0120 FUTIBATINIB LYTGOBI 4.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR Oral Feb. 3, 2023 In Use
72187-0101-03 72187-0101 Elacestrant ORSERDU 86.0 mg/1 Hormonal Therapy Estrogen Receptor Antagonist ERα Oral Jan. 27, 2023 In Use
72187-0102-03 72187-0102 Elacestrant ORSERDU 345.0 mg/1 Hormonal Therapy Estrogen Receptor Antagonist ERα Oral Jan. 27, 2023 In Use
50881-0006-03 50881-0006 Retifanlimab-dlwr ZYNYZ 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous March 22, 2023 In Use
00006-3061-00 00006-3061 Fosaprepitant Dimeglumine Emend 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb. 3, 2017 In Use
00006-3061-01 00006-3061 Fosaprepitant Dimeglumine Emend 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb. 3, 2017 In Use
00006-3061-04 00006-3061 Fosaprepitant Dimeglumine Emend 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb. 3, 2017 May 25, 2021 In Use
00006-3061-02 00006-3061 Fosaprepitant Dimeglumine Emend 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Feb. 3, 2017 May 16, 2021 In Use
00078-1154-21 00078-1154 Dabrafenib Tafinlar 10.0 mg/1 Chemotherapy Enzyme Inhibitor BRAF Oral March 16, 2023 In Use
00078-1161-47 00078-1161 Trametinib Mekinist 0.05 mg/mL Chemotherapy MEK Inhibitor BRAF Oral March 16, 2023 In Use
00143-9753-25 00143-9753 Methylprednisolone Sodium Succinate Methylprednisolone Sodium Succinate 40.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 26, 2022 In Use
00143-9754-25 00143-9754 Methylprednisolone Sodium Succinate Methylprednisolone Sodium Succinate 125.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Sept. 26, 2022 In Use
00078-0650-06 00078-0650 Panobinostat Farydak 10.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Jan. 31, 2023 No Longer Used
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5741-65 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-19 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00093-5742-65 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Jan. 31, 2023 No Longer Used
00310-7720-10 00310-7720 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct. 8, 2019 March 31, 2023 No Longer Used
00378-3099-85 00378-3099 Everolimus Everolimus 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 15, 2022 In Use
00378-5001-93 00378-5001 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral March 10, 2017 April 30, 2023 No Longer Used
00527-2931-37 00527-2931 Prednisone PREDNISONE 2.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00527-2932-37 00527-2932 Prednisone PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00527-2932-43 00527-2932 Prednisone PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 7, 2018 Jan. 31, 2023 No Longer Used
00527-2935-37 00527-2935 Prednisone PREDNISONE 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 4, 2018 April 30, 2023 No Longer Used
00615-0536-05 00615-0536 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 24, 2018 March 31, 2023 No Longer Used
00615-0536-30 00615-0536 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 4, 2014 March 31, 2023 No Longer Used
00615-0536-39 00615-0536 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 9, 2013 March 31, 2023 No Longer Used
00781-3201-94 00781-3201 Levoleucovorin Levoleucovorin 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous April 23, 2015 April 30, 2023 No Longer Used
00904-6745-61 00904-6745 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 Jan. 31, 2023 No Longer Used
00904-6746-04 00904-6746 DRONABINOL DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 Jan. 31, 2023 No Longer Used
16714-0028-01 16714-0028 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 150.0 mg/mL Hormonal Therapy Progestin Intramuscular Nov. 9, 2021 In Use
16714-0028-25 16714-0028 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 150.0 mg/mL Hormonal Therapy Progestin Intramuscular Nov. 9, 2021 In Use
16714-0088-01 16714-0088 Methylprednisolone Acetate Methylprednisolone Acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue May 25, 2021 In Use
16714-0088-25 16714-0088 Methylprednisolone Acetate Methylprednisolone Acetate 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue May 25, 2021 In Use

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