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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
00074-7269-50 00074-7269 Cyclosporine Modified Gengraf 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 25, 2010 In Use
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00078-0248-15 00078-0248 Cyclosporine Modified NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0248-61 00078-0248 Cyclosporine Modified NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00187-1221-03 00187-1221 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral Nov. 1, 2009 Nov. 13, 2017 No Longer Used
55700-0484-10 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-12 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-20 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
55700-0484-30 55700-0484 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 13, 2017 In Use
00173-0569-00 00173-0569 Ondansetron Hydrochloride Zofran ODT 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 1, 1999 Sept. 30, 2017 No Longer Used
43063-0746-12 43063-0746 ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 17, 2017 In Use
00054-0399-25 00054-0399 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 11, 2020 In Use
00093-7766-24 00093-7766 Everolimus Everolimus 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 10, 2020 In Use
00093-7767-24 00093-7767 Everolimus Everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 10, 2020 In Use
00093-7768-24 00093-7768 Everolimus Everolimus 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 10, 2020 In Use
00069-0688-03 00069-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0486-03 00069-0486 Palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00054-0480-13 00054-0480 Everolimus Everolimus 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Feb. 12, 2021 In Use
00054-0480-14 00054-0480 Everolimus Everolimus 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 8, 2020 In Use
00054-0481-13 00054-0481 Everolimus Everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Feb. 12, 2021 In Use
00054-0481-14 00054-0481 Everolimus Everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 8, 2020 In Use
00054-0497-13 00054-0497 Everolimus Everolimus 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Feb. 12, 2021 In Use
00054-0497-14 00054-0497 Everolimus Everolimus 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral June 8, 2020 In Use
00310-0512-28 00310-0512 Acalabrutinib Calquence 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral April 1, 2018 July 31, 2021 In Use
00310-0512-60 00310-0512 Acalabrutinib Calquence 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral Oct. 31, 2017 In Use
00310-0512-95 00310-0512 Acalabrutinib Calquence 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral April 1, 2020 In Use
10019-0982-01 10019-0982 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 7, 2020 In Use
10019-0984-01 10019-0984 Cyclophosphamide Cyclophosphamide 50.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 7, 2020 In Use
16729-0486-01 16729-0486 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Aug. 24, 2020 In Use
00187-1231-50 00187-1231 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral March 9, 2020 In Use
31722-0960-60 31722-0960 dronabinol DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
31722-0961-60 31722-0961 dronabinol DRONABINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
31722-0962-60 31722-0962 dronabinol DRONABINOL 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb. 10, 2020 In Use
35356-0853-06 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 11, 2015 In Use
35356-0853-09 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 11, 2015 In Use
35356-0853-10 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
35356-0853-20 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
35356-0853-30 35356-0853 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 27, 2007 In Use
00378-0642-01 00378-0642 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 11, 2020 In Use
00378-0642-05 00378-0642 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 6, 2020 In Use
00378-0642-10 00378-0642 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 11, 2020 In Use
00378-6921-91 00378-6921 abiraterone acetate Abiraterone Acetate 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Dec. 14, 2020 In Use
00469-0625-99 00469-0625 enzalutamide Xtandi 40.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Aug. 4, 2020 In Use
00469-0725-60 00469-0725 enzalutamide Xtandi 80.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Aug. 4, 2020 In Use
00615-1542-39 00615-1542 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 13, 2003 In Use
00904-6914-61 00904-6914 methylprednisolone methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2018 In Use
00904-6948-04 00904-6948 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Nov. 23, 2018 In Use
16714-0963-01 16714-0963 Abiraterone Acetate Abiraterone Acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral May 19, 2020 In Use
33261-0667-30 33261-0667 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Oct. 28, 1997 In Use

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