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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
57962-0140-12 57962-0140 Ibrutinib Imbruvica 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Nov. 13, 2013 In Use
68084-0149-01 68084-0149 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 13, 2013 In Use
68084-0149-11 68084-0149 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 13, 2013 In Use
68001-0265-22 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
68001-0265-23 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
68001-0265-24 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
68001-0265-25 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
68001-0265-26 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
68001-0265-27 68001-0265 Etoposide Etoposide 20.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous Nov. 14, 2013 In Use
58118-6666-04 58118-6666 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 14, 2013 Aug. 25, 2016 No Longer Used
10544-0212-06 10544-0212 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 15, 2013 In Use
10544-0274-21 10544-0274 Prednisone Prednisone 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 15, 2013 In Use
10544-0274-30 10544-0274 Prednisone Prednisone 1.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 15, 2013 In Use
52125-0775-08 52125-0775 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2013 Feb. 10, 2016 No Longer Used
58118-0001-00 58118-0001 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2013 June 15, 2017 No Longer Used
58118-0001-02 58118-0001 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2013 June 15, 2017 No Longer Used
58118-0001-03 58118-0001 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2013 June 15, 2017 No Longer Used
58118-0001-08 58118-0001 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 20, 2013 June 15, 2017 No Longer Used
44278-0025-30 44278-0025 EXEMESTANE Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 22, 2013 In Use
58118-9918-02 58118-9918 Prednisolone Prednisolone 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 25, 2013 Aug. 31, 2016 No Longer Used
52125-0744-03 52125-0744 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 25, 2013 Nov. 25, 2014 No Longer Used
52125-0744-14 52125-0744 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 25, 2013 April 14, 2016 No Longer Used
52125-0334-16 52125-0334 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 25, 2013 Nov. 26, 2013 No Longer Used
52125-0574-08 52125-0574 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 25, 2013 Nov. 25, 2014 No Longer Used
63629-1579-05 63629-1579 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 26, 2013 In Use
61703-0309-25 61703-0309 Vincristine Sulfate Vincristine Sulfate 1.0 mg/mL Chemotherapy Antimitotic Agent Vinca Alkaloid Intravenous Nov. 27, 2013 In Use
42238-0111-01 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
42238-0111-12 42238-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 Jan. 17, 2018 No Longer Used
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 July 31, 2020 In Use
25021-0814-67 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Dec. 31, 2020 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Sept. 30, 2020 In Use
25021-0816-67 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Jan. 31, 2022 In Use
75987-0111-11 75987-0111 Interferon gamma-1b Actimmune 100.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Dec. 1, 2013 In Use
52125-0775-38 52125-0775 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 2, 2013 Feb. 12, 2016 No Longer Used
52125-0775-50 52125-0775 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 4, 2013 Dec. 4, 2014 No Longer Used
52125-0574-14 52125-0574 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec. 5, 2013 Dec. 5, 2014 No Longer Used
10544-0211-10 10544-0211 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 10, 2013 In Use
63629-4014-02 63629-4014 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 12, 2013 In Use
25021-0452-01 25021-0452 Octreotide Acetate Octreotide Acetate 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Jan. 31, 2023 In Use
25021-0451-01 25021-0451 Octreotide Acetate Octreotide Acetate 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 In Use
25021-0453-01 25021-0453 Octreotide Acetate Octreotide Acetate 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 28, 2023 In Use
25021-0454-05 25021-0454 Octreotide Acetate Octreotide Acetate 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 March 31, 2021 In Use
25021-0455-05 25021-0455 Octreotide Acetate Octreotide Acetate 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Dec. 15, 2013 Feb. 29, 2020 In Use
52125-0744-01 52125-0744 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec. 17, 2013 Dec. 17, 2014 No Longer Used
00093-6126-19 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
00093-6126-64 00093-6126 Imiquimod Imiquimod Immunotherapy Immunomodulator Dermatological Agent Topical Dec. 19, 2013 April 30, 2015 No Longer Used
52125-0366-02 52125-0366 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 28, 2013 Aug. 18, 2014 No Longer Used
61919-0464-10 61919-0464 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2014 In Use
61919-0464-30 61919-0464 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2014 In Use
61919-0465-06 61919-0465 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2014 In Use

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