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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 (Ascending) Package Discontinuation Date Status
54868-0109-00 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-01 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-02 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-03 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-05 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-06 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-07 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-0109-08 54868-0109 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral July 6, 1994 In Use
54868-3344-00 54868-3344 Triamcinolone Hexacetonide Aristospan Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 12, 1994 June 30, 2011 No Longer Used
00054-4550-15 00054-4550 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Aug. 1, 1994 In Use
00054-4550-25 00054-4550 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Aug. 1, 1994 In Use
00054-8550-25 00054-8550 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Aug. 1, 1994 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
00591-3591-60 00591-3591 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 11, 1994 May 31, 2019 No Longer Used
00591-3593-60 00591-3593 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Aug. 11, 1994 Sept. 30, 2019 No Longer Used
54868-2523-01 54868-2523 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug. 11, 1994 In Use
00378-9040-01 00378-9040 Cysteamine bitartrate Cystagon 50.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Aug. 15, 1994 Sept. 4, 2018 In Use
00378-9045-01 00378-9045 Cysteamine bitartrate Cystagon 150.0 mg/1 Chemotherapy Cystine-Depleting Agent Oral Aug. 15, 1994 Sept. 4, 2018 In Use
54868-0776-01 54868-0776 Methylprednisolone Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 28, 1994 June 30, 2011 No Longer Used
54868-4952-00 54868-4952 Methylprednisolone Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 28, 1994 June 30, 2011 No Longer Used
54868-4952-01 54868-4952 Methylprednisolone Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 28, 1994 June 30, 2011 No Longer Used
54868-6624-01 54868-6624 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 29, 1994 In Use
55513-0283-01 55513-0283 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 5, 1994 In Use
55513-0283-10 55513-0283 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec. 5, 1994 In Use
54868-3348-01 54868-3348 Medroxyprogesterone Acetate Depo-Provera 400.0 mg/mL Hormonal Therapy Progestin Intramuscular Jan. 13, 1995 In Use
54868-1185-00 54868-1185 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 31, 1995 June 30, 2012 No Longer Used
00004-0241-26 00004-0241 Granisetron Kytril Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 16, 1995 Sept. 14, 2011 No Longer Used
00004-0241-33 00004-0241 Granisetron Kytril Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 16, 1995 Sept. 14, 2011 No Longer Used
43975-0226-80 43975-0226 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 16, 1995 May 10, 2010 No Longer Used
43975-0226-81 43975-0226 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 16, 1995 May 10, 2010 No Longer Used
54868-2984-00 54868-2984 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral April 24, 1995 In Use
54868-2984-02 54868-2984 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral April 24, 1995 In Use
54868-2984-03 54868-2984 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral April 24, 1995 In Use
00143-9553-01 00143-9553 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 23, 1995 In Use
00013-8717-62 00013-8717 Dexrazoxane Zinecard 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 26, 1995 April 30, 2021 No Longer Used
00013-8727-89 00013-8727 Dexrazoxane Zinecard 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 26, 1995 Feb. 28, 2019 In Use
51079-0670-05 51079-0670 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral July 12, 1995 Jan. 31, 2030 In Use
51079-0670-01 51079-0670 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral July 13, 1995 In Use
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0248-15 00078-0248 Cyclosporine Modified NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0274-22 00078-0274 Cyclosporine NeOral 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
55154-3418-00 55154-3418 cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 Nov. 30, 2015 No Longer Used
54868-0871-00 54868-0871 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 21, 1995 June 30, 2012 No Longer Used
54868-0871-01 54868-0871 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 21, 1995 June 30, 2012 No Longer Used
54868-0871-06 54868-0871 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 21, 1995 June 30, 2012 No Longer Used
54868-0365-00 54868-0365 Estrogens, Conjugated Premarin Hormonal Therapy Estrogen Oral July 26, 1995 June 30, 2012 No Longer Used
54868-0365-01 54868-0365 Estrogens, Conjugated Premarin Hormonal Therapy Estrogen Oral July 26, 1995 July 6, 2010 No Longer Used
54868-0365-02 54868-0365 Estrogens, Conjugated Premarin Hormonal Therapy Estrogen Oral July 26, 1995 June 30, 2012 No Longer Used

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