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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
50742-0182-24 50742-0182 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
50742-0183-24 50742-0183 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
50742-0184-25 50742-0184 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 30, 2020 In Use
70934-0786-90 70934-0786 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral July 30, 2020 In Use
55150-0386-01 55150-0386 CARBOPLATIN CARBOPLATIN 600.0 mg/60mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Aug. 3, 2020 In Use
70255-0025-05 70255-0025 Encorafenib BRAFTOVI 75.0 mg/1 Chemotherapy BRAF Inhibitor V600E Oral Aug. 3, 2020 In Use
70255-0025-06 70255-0025 Encorafenib BRAFTOVI 75.0 mg/1 Chemotherapy BRAF Inhibitor V600E Oral Aug. 3, 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
00469-1725-56 00469-1725 Enzalutamide Xtandi 40.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral Aug. 4, 2020 In Use
73535-0208-01 73535-0208 Tafasitamab-cxix MONJUVI 200.0 mg/5mL Immunotherapy Monoclonal Antibody CD19 Intravenous Aug. 5, 2020 In Use
00173-0896-01 00173-0896 Belantamab Blenrep 50.0 mg/mL Immunotherapy Drug Antibody Conjugate BCMA Intravenous Aug. 5, 2020 June 30, 2024 In Use
10019-0982-01 10019-0982 Cyclophosphamide Cyclophosphamide 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 7, 2020 In Use
10019-0984-01 10019-0984 Cyclophosphamide Cyclophosphamide 50.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral Aug. 7, 2020 In Use
70518-2829-00 70518-2829 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral Aug. 7, 2020 In Use
70934-0580-20 70934-0580 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2020 In Use
71205-0403-07 71205-0403 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 13, 2020 Aug. 31, 2023 No Longer Used
59651-0299-60 59651-0299 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
59651-0300-30 59651-0300 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
59651-0300-90 59651-0300 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
72603-0107-01 72603-0107 Decitabine Decitabine 50.0 mg/10mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 17, 2020 In Use
43598-0262-02 43598-0262 Fulvestrant Fulvestrant 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 17, 2020 In Use
69448-0005-38 69448-0005 Carboplatin Paraplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Aug. 17, 2020 In Use
70934-0634-82 70934-0634 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 18, 2020 Aug. 31, 2023 In Use
77651-1113-02 77651-1113 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 19, 2020 In Use
77651-1112-01 77651-1112 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 19, 2020 In Use
69539-0152-30 69539-0152 Toremifene citrate Toremifene citrate 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 20, 2020 In Use
70518-2115-02 70518-2115 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 21, 2020 In Use
00574-0792-01 00574-0792 pilocarpine hydrchloride pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Aug. 24, 2020 In Use
16729-0486-01 16729-0486 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Aug. 24, 2020 In Use
60760-0715-21 60760-0715 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 25, 2020 In Use
64842-0727-09 64842-0727 CEDAZURIDINE and DECITABINE INQOVI 100.0 mg/1, 35.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog + CDA Inhibitor Oral Aug. 25, 2020 In Use
71205-0421-42 71205-0421 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 25, 2020 In Use
72205-0063-01 72205-0063 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
72205-0062-01 72205-0062 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
72205-0061-01 72205-0061 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0158-01 69539-0158 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0159-01 69539-0159 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
69539-0157-01 69539-0157 Paclitaxel Paclitaxel 6.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Aug. 26, 2020 In Use
70518-2864-00 70518-2864 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 28, 2020 In Use
67457-0996-20 67457-0996 Mitomycin Mitomycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Aug. 28, 2020 In Use
67457-0997-40 67457-0997 Mitomycin Mitomycin 40.0 mg/80mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Aug. 28, 2020 In Use
70934-0634-95 70934-0634 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 31, 2020 May 31, 2025 In Use
59572-0730-14 59572-0730 azacitidine ONUREG 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Sept. 1, 2020 In Use
59572-0740-14 59572-0740 azacitidine ONUREG 300.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Sept. 1, 2020 In Use
70756-0816-22 70756-0816 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Sept. 1, 2020 In Use
70756-0815-60 70756-0815 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral Sept. 1, 2020 In Use
72611-0716-01 72611-0716 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Sept. 1, 2020 In Use
72205-0050-30 72205-0050 Toremifene citrate Toremifene citrate 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Sept. 2, 2020 In Use
00781-3497-75 00781-3497 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sept. 2, 2020 Feb. 29, 2024 No Longer Used

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