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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
70377-0010-22 70377-0010 Everolimus EVEROLIMUS 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
70377-0011-22 70377-0011 Everolimus EVEROLIMUS 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
70377-0012-22 70377-0012 Everolimus EVEROLIMUS 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
70377-0013-22 70377-0013 Everolimus EVEROLIMUS 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
43598-0628-57 43598-0628 Carmustine Carmustine Chemotherapy Alkylating Agent Nitrosourea Intravenous Oct. 4, 2021 In Use
51662-1539-01 51662-1539 ONDANSETRON ONDANSETRON 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 6, 2021 In Use
68083-0462-10 68083-0462 Arsenic Trioxide Arsenic Trioxide 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Oct. 7, 2021 In Use
69097-0439-35 69097-0439 Palonsetron hydrochloride Palonosetron hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Oct. 10, 2021 In Use
72789-0213-98 72789-0213 Abiraterone acetate Abiraterone 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Oct. 11, 2021 In Use
68788-8082-01 68788-8082 Methylprednisolone Acetate Medroloan SUIK 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue Oct. 11, 2021 In Use
63323-0926-88 63323-0926 Romidepsin Romidepsin Chemotherapy Enzyme Inhibitor HDAC Intravenous Oct. 12, 2021 In Use
57894-0505-05 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
57894-0505-20 57894-0505 Daratumumab Darzalex IV 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous Oct. 15, 2021 In Use
55150-0366-10 55150-0366 ARSENIC TRIOXIDE ARSENIC TRIOXIDE 2.0 mg/mL Chemotherapy Miscellaneous Agent PML/RARa Intravenous Oct. 15, 2021 In Use
50090-5812-00 50090-5812 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 18, 2021 In Use
50090-5812-01 50090-5812 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Oct. 18, 2021 In Use
50090-5816-06 50090-5816 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
50090-5814-00 50090-5814 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
50090-5814-01 50090-5814 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
50090-5814-03 50090-5814 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
50090-5814-04 50090-5814 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
50090-5814-07 50090-5814 PREDNISONE Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2021 In Use
72694-0617-60 72694-0617 Ivosidenib Tibsovo 250.0 mg/1 Chemotherapy Enzyme Inhibitor IDH1 Oral Oct. 19, 2021 In Use
68083-0484-01 68083-0484 MITOMYCIN MITOMYCIN 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Oct. 20, 2021 In Use
68083-0483-01 68083-0483 MITOMYCIN MITOMYCIN 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous Oct. 20, 2021 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
70700-0174-22 70700-0174 Docetaxel Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Oct. 25, 2021 In Use
70700-0175-22 70700-0175 Docetaxel Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Oct. 25, 2021 In Use
70700-0176-22 70700-0176 Docetaxel Docetaxel 10.0 mg/mL Chemotherapy Antimitotic Agent Taxane Intravenous Oct. 25, 2021 In Use
55289-0582-15 55289-0582 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 25, 2021 In Use
00574-0930-10 00574-0930 Doxorubicin hydrochloride Doxorubicin hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Oct. 25, 2021 April 30, 2024 No Longer Used
00574-0931-25 00574-0931 Doxorubicin hydrochloride Doxorubicin hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Oct. 25, 2021 April 30, 2024 No Longer Used
00078-1091-20 00078-1091 asciminib SCEMBLIX 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ABL/BCR-ABL1 Oral Oct. 29, 2021 In Use
00078-1091-94 00078-1091 asciminib SCEMBLIX 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ABL/BCR-ABL1 Oral Oct. 29, 2021 In Use
00078-1098-20 00078-1098 asciminib SCEMBLIX 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ABL/BCR-ABL1 Oral Oct. 29, 2021 In Use
00078-1098-30 00078-1098 asciminib SCEMBLIX 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ABL/BCR-ABL1 Oral Oct. 29, 2021 In Use
00078-1098-94 00078-1098 asciminib SCEMBLIX 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ABL/BCR-ABL1 Oral Oct. 29, 2021 In Use
68001-0522-85 68001-0522 Fulvestrant FULVESTRANT 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct. 29, 2021 In Use
16729-0262-32 16729-0262 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Oct. 31, 2021 Oct. 31, 2021 No Longer Used
70121-1552-01 70121-1552 Methylprednisolone acetate Methylprednisolone acetate 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue Nov. 1, 2021 In Use
70121-1552-05 70121-1552 Methylprednisolone acetate Methylprednisolone acetate 80.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Soft Tissue Nov. 1, 2021 In Use
72266-0235-01 72266-0235 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Nov. 1, 2021 In Use
70518-3263-00 70518-3263 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Nov. 2, 2021 In Use
70625-0311-01 70625-0311 FOSAPREPITANT FOSAPREPITANT 150.0 mg/mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov. 3, 2021 In Use
68788-8108-03 68788-8108 Prednisone PREDNISONE 2.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 5, 2021 Dec. 31, 2022 No Longer Used
16714-0028-01 16714-0028 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 150.0 mg/mL Hormonal Therapy Progestin Intramuscular Nov. 9, 2021 In Use
16714-0028-25 16714-0028 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 150.0 mg/mL Hormonal Therapy Progestin Intramuscular Nov. 9, 2021 In Use
00591-2832-01 00591-2832 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Nov. 11, 2021 In Use
16729-0542-35 16729-0542 Fluorouracil Fluorouracil 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Nov. 11, 2021 In Use
70518-3070-01 70518-3070 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 11, 2021 In Use

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