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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
71205-0755-90 71205-0755 PREDNISONE Prednisone 50.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 31, 2023 In Use
71288-0165-53 71288-0165 Nelarabine Nelarabine 5.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Jan. 10, 2023 In Use
71288-0166-10 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0166-91 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0166-92 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0167-50 71288-0167 Pemetrexed disodium Pemetrexed 500.0 mg/50mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71288-0167-95 71288-0167 Pemetrexed disodium Pemetrexed 500.0 mg/50mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
71335-2149-01 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-02 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-03 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-04 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-05 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-06 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71335-2149-07 71335-2149 PREDNISONE Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 9, 2022 In Use
71921-0177-06 71921-0177 Abiraterone acetate Abiraterone acetate 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral April 10, 2023 In Use
72162-1878-06 72162-1878 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72162-1879-06 72162-1879 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72162-1880-06 72162-1880 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral March 30, 2023 In Use
72189-0415-30 72189-0415 ANASTROZOLE ANASTROZOLE 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 30, 2023 In Use
72189-0468-15 72189-0468 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 4, 2023 In Use
72189-0468-21 72189-0468 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 4, 2023 In Use
72606-0011-01 72606-0011 Bevacizumab-adcd Vegzelma 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0011-10 72606-0011 Bevacizumab-adcd Vegzelma 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0012-01 72606-0012 Bevacizumab-adcd Vegzelma 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72606-0012-10 72606-0012 Bevacizumab-adcd Vegzelma 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous April 3, 2023 In Use
72819-0152-95 72819-0152 Mitomycin Mitomycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous March 11, 2022 In Use
72819-0152-05 72819-0152 Mitomycin Mitomycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72819-0153-02 72819-0153 Mitomycin Mitomycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72819-0154-04 72819-0154 Mitomycin Mitomycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous April 25, 2022 In Use
72974-0120-01 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Dec. 18, 2020 In Use
72974-0120-97 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Oct. 21, 2021 In Use
72974-0120-95 72974-0120 Relugolix Orgovyx 120.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor GnRH Receptor Antagonist Oral Jan. 27, 2023 In Use
80425-0075-01 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-02 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-03 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-04 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-05 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0230-01 80425-0230 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0231-01 80425-0231 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0242-02 80425-0242 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0255-01 80425-0255 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0261-01 80425-0261 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 16, 2023 In Use
80425-0262-01 80425-0262 Triamcinolone acetonide Triamcinolone acetonide 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intramuscular Feb. 15, 2023 In Use
80425-0328-01 80425-0328 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 24, 2023 In Use
80725-0610-25 80725-0610 Chlorambucil LEUKERAN 2.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral May 15, 2023 In Use
80725-0620-25 80725-0620 Busulfan MYLERAN 2.0 mg/1 Chemotherapy Alkylating Agent Alkylsulfonate Oral May 15, 2023 In Use
80725-0630-25 80725-0630 Thioguanine TABLOID 40.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral May 15, 2023 In Use
80978-0111-06 80978-0111 Nelarabine injection NELARABINE 250.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous April 12, 2023 In Use
82982-0041-63 82982-0041 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 21, 2023 In Use
82982-0042-15 82982-0042 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 15, 2023 In Use

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