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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
16714-0929-01 16714-0929 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous March 20, 2020 In Use
00054-9817-25 00054-9817 PredniSONE PredniSONE 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
00054-9817-29 00054-9817 PredniSONE PredniSONE 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
00054-9818-25 00054-9818 PredniSONE PredniSONE 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
00054-9818-29 00054-9818 PredniSONE PredniSONE 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
00054-9828-25 00054-9828 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
00054-9828-31 00054-9828 PredniSONE PredniSONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 23, 2020 In Use
72189-0084-24 72189-0084 IMIQUIMOD IMIQUIMOD 12.5 mg/.25g Immunotherapy Immunomodulator Dermatological Agent Topical March 23, 2020 In Use
00703-3216-01 00703-3216 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous March 25, 2020 In Use
70518-2650-00 70518-2650 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous March 25, 2020 In Use
00781-3492-12 00781-3492 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular March 26, 2020 In Use
70934-0580-30 70934-0580 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 26, 2020 In Use
70934-0645-30 70934-0645 Prednisone PREDNISONE 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 26, 2020 In Use
68071-5221-01 68071-5221 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 27, 2020 In Use
50090-2313-03 50090-2313 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue March 27, 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
00069-0284-03 00069-0284 Palbociclib Ibrance 75.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0688-03 00069-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
00069-0486-03 00069-0486 Palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
68071-5233-01 68071-5233 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2020 In Use
63539-0688-03 63539-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
63539-0284-03 63539-0284 palbociclib Ibrance 75.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
63539-0486-03 63539-0486 palbociclib Ibrance 100.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
72266-0161-01 72266-0161 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous March 30, 2020 In Use
72266-0162-01 72266-0162 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous March 30, 2020 In Use
64239-0300-10 64239-0300 Dexamethasone HEMADY 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 31, 2020 In Use
51662-1514-01 51662-1514 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 31, 2020 In Use
51662-1514-02 51662-1514 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 31, 2020 In Use
68788-7692-01 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
68788-7692-02 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
68788-7692-03 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
68788-7692-04 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
68788-7692-08 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
68788-7692-09 68788-7692 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
70934-0647-30 70934-0647 Prednisone Prednisone 2.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 1, 2020 In Use
42658-0010-02 42658-0010 Cladribine Cladribine 1.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous April 1, 2020 In Use
00310-0512-95 00310-0512 Acalabrutinib Calquence 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral April 1, 2020 July 31, 2025 In Use
71205-0407-15 71205-0407 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 3, 2020 In Use
70518-2676-00 70518-2676 Prednisone PREDNISONE 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 7, 2020 In Use
70518-2675-00 70518-2675 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 7, 2020 In Use
70934-0448-83 70934-0448 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 8, 2020 In Use
71905-0400-11 71905-0400 Dexamethasone Dexabliss 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
70934-0218-10 70934-0218 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
70934-0674-12 70934-0674 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
51655-0410-52 51655-0410 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 10, 2020 In Use
00703-3071-01 00703-3071 Romidepsin Romidepsin 5.0 mg/mL Chemotherapy Enzyme Inhibitor HDAC Intravenous April 14, 2020 In Use
00703-4004-01 00703-4004 Romidepsin Romidepsin 5.0 mg/mL Chemotherapy Enzyme Inhibitor HDAC Intravenous April 14, 2020 In Use
67457-0418-00 67457-0418 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0418-05 67457-0418 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0419-00 67457-0419 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use

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