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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 Package Discontinuation Date Status
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 In Use
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 June 30, 2023 In Use
51991-0005-33 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 19, 2019 Dec. 31, 2022 In Use
51991-0005-90 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 15, 2020 In Use
51991-0797-98 51991-0797 Azacitidine Azacitidine 100.0 mg/50mL Chemotherapy Antimetabolite Pyrimidine Analog Subcutaneous Aug. 7, 2017 Jan. 31, 2024 In Use
55154-2353-05 55154-2353 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Sept. 22, 2009 In Use
55154-2353-08 55154-2353 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Sept. 22, 2009 Feb. 28, 2019 In Use
52584-0039-30 52584-0039 Methylprednisolone Sodium Succinate Solu-Medrol 40.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Aug. 24, 2018 Aug. 31, 2023 In Use
52584-0047-25 52584-0047 Methylprednisolone Sodium Succinate Solu-Medrol 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 25, 2016 Aug. 31, 2024 In Use
52584-0069-00 52584-0069 ONDANSETRON ONDANSETRON 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous July 3, 2018 Nov. 30, 2023 In Use
52584-0414-01 52584-0414 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Sept. 13, 2016 May 1, 2023 In Use
52584-0422-00 52584-0422 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Feb. 18, 2016 Oct. 31, 2023 In Use
55154-4949-00 55154-4949 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 13, 2003 In Use
55154-4949-09 55154-4949 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 13, 2003 Oct. 31, 2012 In Use
60505-0133-00 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0133-01 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0133-02 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-00 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0134-01 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-02 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
61919-0087-10 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-15 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-20 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 10, 2017 In Use
61919-0087-30 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-60 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 10, 2017 In Use
61919-0326-21 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 18, 2019 In Use
61919-0326-05 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2014 In Use
61919-0326-30 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 19, 2022 In Use
63323-0319-04 63323-0319 GRANISETRON HYDROCHLORIDE Granisetron 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 May 31, 2024 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
70934-0259-21 70934-0259 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 25, 2019 In Use
70934-0259-30 70934-0259 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 4, 2019 In Use
70934-0259-42 70934-0259 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 17, 2019 In Use
73150-0200-12 73150-0200 umbralisib UKONIQ 260.2 mg/1 Chemotherapy Enzyme Inhibitor PI3Kδ, CK1ε, ABL1, CXCL12, CCL19 Oral Feb. 5, 2021 July 31, 2023 In Use
76346-0073-01 76346-0073 Mifepristone Korlym 300.0 mg/1 Hormonal Therapy Antiprogestin Cortisol Receptor Blocker Oral Feb. 17, 2012 In Use
76346-0073-02 76346-0073 Mifepristone Korlym 300.0 mg/1 Hormonal Therapy Antiprogestin Cortisol Receptor Blocker Oral Feb. 17, 2012 In Use
00023-5902-04 00023-5902 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist June 15, 2000 In Use
00023-5904-12 00023-5904 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist June 29, 2001 In Use
00023-5906-23 00023-5906 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist March 11, 2010 In Use
00078-0651-06 00078-0651 Panobinostat Farydak 15.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Dec. 31, 2022 No Longer Used
00078-0652-06 00078-0652 Panobinostat Farydak 20.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Dec. 31, 2022 No Longer Used
00093-5740-19 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Dec. 31, 2022 No Longer Used
00093-5740-65 00093-5740 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral June 1, 2015 Dec. 31, 2022 No Longer Used
00115-1696-06 00115-1696 Hydrocortisone Hydrocortisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
00115-1697-01 00115-1697 Hydrocortisone Hydrocortisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
00115-1700-01 00115-1700 Hydrocortisone Hydrocortisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
13925-0166-04 13925-0166 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 5.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2013 In Use
16714-0070-02 16714-0070 fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 23, 2021 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
17856-0090-01 17856-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 11, 2021 In Use

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