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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
67457-0863-01 67457-0863 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous March 21, 2018 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
67457-0886-05 67457-0886 Hydroxyprogesterone Caproate Hydroxyprogesterone Caproate 250.0 mg/mL Hormonal Therapy Progestin Intramuscular Sept. 22, 2017 June 30, 2024 No Longer Used
67457-0889-10 67457-0889 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 In Use
67457-0920-05 67457-0920 Zoledronic acid Zoledronic acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Oct. 12, 2020 May 31, 2021 In Use
67457-0928-02 67457-0928 Dactinomycin Dactinomycin 0.5 mg/mL Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intravenous June 20, 2019 In Use
67457-0991-15 67457-0991 Trastuzumab OGIVRI 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Nov. 29, 2019 Feb. 28, 2027 In Use
67457-0996-20 67457-0996 Mitomycin Mitomycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Aug. 28, 2020 In Use
67457-0997-40 67457-0997 Mitomycin Mitomycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Aug. 28, 2020 In Use
67877-0169-30 67877-0169 ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
67877-0170-30 67877-0170 ondansetron hydrochloride Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 25, 2007 In Use
67877-0171-10 67877-0171 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 28, 2010 In Use
67877-0171-30 67877-0171 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 28, 2010 In Use
67877-0184-02 67877-0184 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2010 In Use
67877-0184-20 67877-0184 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2010 In Use
67877-0288-01 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-05 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-10 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-30 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-33 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 30, 2020 In Use
67877-0288-90 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0537-07 67877-0537 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0537-14 67877-0537 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0538-07 67877-0538 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0538-14 67877-0538 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0539-07 67877-0539 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0539-14 67877-0539 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0540-07 67877-0540 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0540-14 67877-0540 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0541-07 67877-0541 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0541-14 67877-0541 Temozolomide Temozolomide 180.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0542-07 67877-0542 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral April 28, 2017 In Use
67877-0633-90 67877-0633 imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2019 In Use
67877-0634-30 67877-0634 imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Feb. 1, 2019 In Use
67877-0753-60 67877-0753 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
67877-0754-60 67877-0754 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
67877-0755-60 67877-0755 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 3, 2021 In Use
67979-0001-01 67979-0001 Valrubicin Valstar 40.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravesical Oct. 1, 1998 In Use
67979-0001-02 67979-0001 Valrubicin Valstar 40.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravesical Oct. 1, 1998 Oct. 17, 2017 In Use
67979-0500-01 67979-0500 Histrelin Acetate Vantas 50.0 mg/1 Hormonal Therapy GnRH Agonist Subcutaneous Nov. 1, 2004 March 31, 2022 No Longer Used
67979-0501-40 67979-0501 Testosterone Enanthate DELATESTRYL 200.0 mg/mL Hormonal Therapy Androgen Intramuscular Dec. 24, 1953 Nov. 30, 2014 No Longer Used
68001-0005-01 68001-0005 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 2, 2013 In Use
68001-0155-04 68001-0155 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 1, 2014 In Use
68001-0155-08 68001-0155 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 1, 2014 In Use
68001-0246-04 68001-0246 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 13, 2018 In Use
68001-0246-16 68001-0246 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 13, 2014 In Use
68001-0246-17 68001-0246 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 13, 2014 In Use
68001-0247-01 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 13, 2014 Feb. 27, 2018 In Use
68001-0247-04 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 13, 2018 In Use
68001-0247-16 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 13, 2014 In Use

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