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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
68180-0686-01 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0686-11 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0687-55 68180-0687 Methylprednisolone Methylprednisolone 8.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin May 1, 2020 In Use
60760-0313-10 60760-0313 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 2, 2020 In Use
68788-7705-01 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
68788-7705-03 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
61314-0866-01 61314-0866 pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov. 4, 2019 In Use
60219-1707-01 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-03 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-05 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1708-01 60219-1708 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1708-05 60219-1708 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
55700-0854-21 55700-0854 Dexamethasone TaperDex 6-day 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 27, 2020 In Use
51662-1370-01 51662-1370 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 13, 2019 In Use
61919-0827-15 61919-0827 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 15, 2020 In Use
61919-0827-21 61919-0827 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 15, 2020 In Use
51662-1432-01 51662-1432 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Dec. 21, 2019 In Use
76420-0077-01 76420-0077 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Feb. 11, 2020 In Use
70069-0025-10 70069-0025 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous June 11, 2019 In Use
71872-7205-01 71872-7205 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 13, 2020 In Use
51662-1391-01 51662-1391 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 8, 2019 In Use
72893-0015-06 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 In Use
72893-0015-24 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 In Use
63187-0561-00 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-10 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 3, 2016 In Use
63187-0561-15 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 1, 2019 In Use
63187-0561-24 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-30 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-60 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-90 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63629-4127-01 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-02 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-03 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-04 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-05 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-06 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-07 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4127-08 63629-4127 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-01 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-02 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-03 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-04 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-05 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
63629-4129-06 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use
52959-0392-06 52959-0392 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 28, 1983 In Use
52959-0392-12 52959-0392 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 28, 1983 In Use
52959-0392-15 52959-0392 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 28, 1983 In Use
52959-0392-21 52959-0392 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 28, 1983 In Use
52959-0392-28 52959-0392 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 28, 1983 In Use

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