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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
54868-5039-00 54868-5039 Isotretinoin Amnesteem 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 2, 2010 In Use
54868-5041-00 54868-5041 Isotretinoin Amnesteem 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 14, 2009 In Use
54868-5043-00 54868-5043 Isotretinoin Amnesteem 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral July 14, 2009 In Use
54868-5089-00 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5089-01 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5089-02 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5089-03 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5089-04 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5089-05 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 9, 2004 June 30, 2011 No Longer Used
54868-5114-00 54868-5114 Dutasteride Avodart 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral July 16, 2004 In Use
54868-5114-01 54868-5114 Dutasteride Avodart 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral July 16, 2004 In Use
54868-5213-00 54868-5213 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 25, 2005 In Use
54868-5218-00 54868-5218 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 17, 1999 In Use
54868-5218-01 54868-5218 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 17, 1999 In Use
54868-5229-00 54868-5229 Pegfilgrastim Neulasta Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Feb. 23, 2006 Dec. 31, 2011 No Longer Used
54868-5230-00 54868-5230 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 25, 2005 In Use
54868-5231-01 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
54868-5231-02 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
54868-5231-03 54868-5231 Aprepitant Emend 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral June 29, 2005 In Use
54868-5242-00 54868-5242 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2005 In Use
54868-5242-01 54868-5242 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 3, 2005 In Use
54868-5260-00 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5260-01 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5260-02 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5260-03 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5260-05 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5260-09 54868-5260 Capecitabine Xeloda 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 28, 2005 In Use
54868-5261-00 54868-5261 Exemestane Aromasin 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 29, 2005 In Use
54868-5282-00 54868-5282 Mercaptopurine Mercaptopurine 50.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral May 23, 2005 In Use
54868-5282-01 54868-5282 Mercaptopurine Mercaptopurine 50.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral May 23, 2005 In Use
54868-5282-02 54868-5282 Mercaptopurine Mercaptopurine 50.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral May 23, 2005 In Use
54868-5289-00 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-01 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-02 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-03 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5289-04 54868-5289 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Oct. 7, 2005 June 30, 2013 No Longer Used
54868-5290-00 54868-5290 Erlotinib Hydrochloride Tarceva 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral July 1, 2005 In Use
54868-5305-00 54868-5305 Isotretinoin Amnesteem Hormonal Therapy Immunomodulator Retinoic Acid Derivative Jan. 6, 2012 Sept. 16, 2008 No Longer Used
54868-5325-00 54868-5325 Aprepitant Emend Ancillary Therapy Antiemetic Substance P/Neurokinin 1 June 24, 2005 In Use
54868-5334-00 54868-5334 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 13, 2005 In Use
54868-5334-01 54868-5334 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 13, 2005 In Use
54868-5348-01 54868-5348 Temozolomide Temodar 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Oct. 20, 2005 In Use
54868-5350-00 54868-5350 Temozolomide Temodar 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Oct. 7, 2005 In Use
54868-5350-02 54868-5350 Temozolomide Temodar 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Oct. 7, 2005 In Use
54868-5350-03 54868-5350 Temozolomide Temodar 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Oct. 7, 2005 In Use
54868-5350-04 54868-5350 Temozolomide Temodar 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Oct. 7, 2005 In Use
54868-5354-00 54868-5354 Temozolomide Temodar 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 13, 2006 In Use
54868-5385-00 54868-5385 Anagrelide Anagrelide Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Aug. 15, 2005 June 30, 2011 No Longer Used
54868-5385-01 54868-5385 Anagrelide Anagrelide Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Aug. 15, 2005 June 30, 2011 No Longer Used
54868-5427-00 54868-5427 Imatinib Mesylate Gleevec Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 9, 2005 June 30, 2013 No Longer Used

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