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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 (Ascending) Status
16714-0120-01 16714-0120 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jan. 16, 2020 In Use
16714-0929-01 16714-0929 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 20, 2020 In Use
00143-9384-01 00143-9384 FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 8, 2020 In Use
00187-1231-50 00187-1231 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral March 9, 2020 In Use
00338-0008-01 00338-0008 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 5, 2019 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
00143-9289-01 00143-9289 Estradiol Valerate Estradiol Valerate 10.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 In Use
00143-9290-01 00143-9290 Estradiol Valerate Estradiol Valerate 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 In Use
00143-9291-01 00143-9291 Estradiol Valerate Estradiol Valerate 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular April 21, 2020 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
00517-0420-01 00517-0420 ESTRADIOL VALERATE ESTRADIOL VALERATE 20.0 mg/mL Hormonal Therapy Estrogen Intramuscular March 1, 2020 In Use
00517-0440-01 00517-0440 ESTRADIOL VALERATE ESTRADIOL VALERATE 40.0 mg/mL Hormonal Therapy Estrogen Intramuscular March 1, 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
00703-0241-01 00703-0241 Triamcinolone Acetonide Triamcinolone Acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Aug. 29, 2019 In Use
00703-0243-01 00703-0243 Triamcinolone Acetonide Triamcinolone Acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Aug. 29, 2019 In Use
00703-0245-01 00703-0245 Triamcinolone Acetonide Triamcinolone Acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Aug. 29, 2019 In Use
00781-3079-12 00781-3079 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular May 29, 2019 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
16714-0130-01 16714-0130 Triamcinolone Acetonide Triamcinolone Acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Nov. 19, 2019 In Use
16714-0130-25 16714-0130 Triamcinolone Acetonide Triamcinolone Acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Nov. 19, 2019 In Use
16714-0140-01 16714-0140 Triamcinolone Acetonide Triamcinolone Acetonide 200.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Nov. 19, 2019 In Use
16714-0150-01 16714-0150 Triamcinolone Acetonide Triamcinolone Acetonide 400.0 mg/10mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Nov. 19, 2019 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
33261-0667-60 33261-0667 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Oct. 28, 1997 In Use
50242-0051-10 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous June 3, 2019 In Use
50242-0051-21 50242-0051 Rituximab Rituxan 10.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Intravenous Nov. 26, 1997 In Use
50242-0103-01 50242-0103 polatuzumab vedotin POLIVY 30.0 mg/1.88mL Immunotherapy Drug Antibody Conjugate CD79b Intravenous Sept. 18, 2020 In Use
50242-0132-01 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous Feb. 10, 2017 In Use
50242-0132-10 50242-0132 Trastuzumab Herceptin 150.0 mg/7.4mL Immunotherapy Monoclonal Antibody HER2 Intravenous June 3, 2019 In Use
50242-0917-01 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 18, 2016 In Use
50242-0917-86 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Aug. 11, 2016 In Use
16714-0001-01 16714-0001 Doxorubicin hydrochloride Doxorubicin hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous March 22, 2021 In Use
43598-0859-11 43598-0859 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 6, 2019 In Use
43598-0948-11 43598-0948 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous July 1, 2020 In Use
51662-1483-01 51662-1483 SOLU-MEDROL(R) METHYLPREDNISOLONE SODIUM SUCCINAT SOLU-MEDROL(R) METHYLPREDNISOLONE SODIUM SUCCINAT 500.0 mg/4mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Dec. 14, 2019 In Use
55513-0141-01 55513-0141 trastuzumab-anns Kanjinti 150.0 mg/7.15mL Immunotherapy Monoclonal Antibody HER2 Intravenous Oct. 28, 2019 In Use

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