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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
54868-2984-03 54868-2984 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral April 24, 1995 In Use
54868-2985-00 54868-2985 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Sept. 19, 1995 In Use
54868-2985-01 54868-2985 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Sept. 19, 1995 In Use
54868-2985-02 54868-2985 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Sept. 19, 1995 In Use
54868-2985-03 54868-2985 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Sept. 19, 1995 In Use
54868-3004-01 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 Nov. 7, 2011 In Use
54868-3004-02 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-03 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-04 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3004-05 54868-3004 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral April 26, 1994 In Use
54868-3050-00 54868-3050 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous Aug. 14, 2006 In Use
54868-3084-00 54868-3084 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 11, 1994 March 31, 2014 No Longer Used
54868-3084-01 54868-3084 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 11, 1994 March 31, 2014 No Longer Used
54868-3084-02 54868-3084 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 11, 1994 March 31, 2014 No Longer Used
54868-3157-00 54868-3157 Dexamethasone Dexamethasone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 21, 2005 In Use
54868-3157-01 54868-3157 Dexamethasone Dexamethasone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 21, 2005 In Use
54868-3188-00 54868-3188 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Dec. 1, 1996 June 30, 2012 No Longer Used
54868-3189-00 54868-3189 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral June 7, 2005 June 30, 2011 No Longer Used
54868-3189-01 54868-3189 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral June 7, 2005 June 30, 2011 No Longer Used
54868-3189-02 54868-3189 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral June 7, 2005 June 30, 2011 No Longer Used
54868-3189-03 54868-3189 Dronabinol Marinol Ancillary Therapy Antiemetic CB1/CB2 Oral June 7, 2005 June 30, 2011 No Longer Used
54868-3310-00 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-01 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-03 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-04 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3344-00 54868-3344 Triamcinolone Hexacetonide Aristospan Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 12, 1994 June 30, 2011 No Longer Used
54868-3348-01 54868-3348 Medroxyprogesterone Acetate Depo-Provera 400.0 mg/mL Hormonal Therapy Progestin Intramuscular Jan. 13, 1995 In Use
54868-3613-00 54868-3613 Medroxyprogesterone Acetate Depo-Provera Hormonal Therapy Progestin Jan. 24, 2000 June 30, 2011 No Longer Used
54868-3623-00 54868-3623 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3637-00 54868-3637 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3637-01 54868-3637 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3826-00 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-01 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-02 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-03 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-04 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-05 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-06 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-07 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-08 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-09 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3896-00 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 7, 1997 June 30, 2011 No Longer Used
54868-3896-01 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid May 3, 2005 June 30, 2012 No Longer Used
54868-3896-02 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 7, 1997 June 30, 2011 No Longer Used
54868-3924-00 54868-3924 Hydrocortisone Cortef Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 15, 1952 June 30, 2001 No Longer Used
54868-4030-00 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use
54868-4030-01 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use
54868-4030-02 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use
54868-4031-00 54868-4031 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral May 7, 2003 In Use

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