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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class (Ascending) Administration Route Package Effective Date Package Discontinuation Date Status
70771-1152-00 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Oral Dec. 5, 2017 In Use
70771-1152-04 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Oral Dec. 5, 2017 In Use
70771-1152-03 70771-1152 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Oral Dec. 5, 2017 In Use
55700-0627-10 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
55700-0627-12 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
55700-0627-20 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
55700-0627-30 55700-0627 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
55700-0631-06 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Oral May 25, 2018 In Use
55700-0631-10 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Oral May 25, 2018 In Use
55700-0631-20 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Oral May 25, 2018 In Use
55700-0631-30 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Oral May 25, 2018 In Use
16714-0815-01 16714-0815 zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Intravenous May 30, 2018 In Use
54288-0100-01 54288-0100 ZOLEDRONIC ACID ZOLEDRONIC ACID 4.0 mg/5mL Ancillary Therapy Intravenous April 2, 2018 In Use
00527-1452-06 00527-1452 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
00527-1451-06 00527-1451 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
00527-1450-06 00527-1450 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Oral May 18, 2018 In Use
69097-0316-02 69097-0316 exemestane EXEMESTANE 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral April 27, 2018 In Use
25021-0828-50 25021-0828 leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Intramuscular, Intravenous April 15, 2018 In Use
71837-5843-05 71837-5843 SARGRAMOSTIM Leukine 250.0 ug/mL Ancillary Therapy Intravenous, Subcutaneous May 30, 2018 In Use
51013-0190-09 51013-0190 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Oral May 29, 2018 In Use
51013-0190-30 51013-0190 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Oral May 29, 2018 In Use
70771-1347-03 70771-1347 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Oral May 16, 2018 In Use
70771-1347-09 70771-1347 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Oral May 16, 2018 In Use
53345-0037-01 53345-0037 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Oral April 25, 2018 In Use
67457-0864-04 67457-0864 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Intravenous March 21, 2018 In Use
67457-0863-01 67457-0863 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Intravenous March 21, 2018 In Use
68083-0142-01 68083-0142 zoledronic Acid Zoledronic Acid 4.0 mg/100mL Ancillary Therapy Intravenous July 5, 2018 In Use
42858-0869-06 42858-0869 DRONABINOL DRONABINOL 10.0 mg/1 Ancillary Therapy Oral June 26, 2018 In Use
42858-0868-06 42858-0868 DRONABINOL DRONABINOL 5.0 mg/1 Ancillary Therapy Oral June 26, 2018 In Use
42858-0867-06 42858-0867 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Oral June 26, 2018 In Use
00002-4165-02 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Dec. 31, 2017 No Longer Used
00002-4165-07 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Nov. 30, 2017 No Longer Used
00002-4165-30 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Jan. 31, 2018 No Longer Used
00002-4165-34 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Jan. 25, 2011 No Longer Used
00002-4165-61 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 10, 2010 April 3, 2015 No Longer Used
00002-4165-79 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 6, 1998 Jan. 25, 2011 No Longer Used
00002-4165-99 00002-4165 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 6, 2009 March 5, 2012 No Longer Used
00378-0274-01 00378-0274 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Feb. 20, 2003 July 12, 2016 In Use
00378-0274-25 00378-0274 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Feb. 20, 2003 July 12, 2016 In Use
00378-0274-93 00378-0274 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Feb. 20, 2003 In Use
00703-4014-11 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
00703-4014-18 00703-4014 Leuprolide Acetate Leuprolide Acetate Hormonal Therapy GnRH Agonist Subcutaneous Nov. 6, 2000 March 31, 2011 No Longer Used
00781-3029-75 00781-3029 Estradiol Valerate Estradiol Valerate Hormonal Therapy Estrogen Oct. 4, 2007 Dec. 31, 2011 No Longer Used
00781-3030-75 00781-3030 Estradiol Valerate Estradiol Valerate Hormonal Therapy Estrogen Oct. 4, 2007 Jan. 31, 2010 No Longer Used
00781-3031-75 00781-3031 Estradiol Valerate Estradiol Valerate Hormonal Therapy Estrogen Oct. 4, 2007 Aug. 31, 2011 No Longer Used
49349-0287-02 49349-0287 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral June 7, 2011 June 8, 2012 No Longer Used
49349-0287-08 49349-0287 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 12, 2014 Aug. 25, 2016 No Longer Used
50090-1941-00 50090-1941 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 9, 2017 Feb. 9, 2017 No Longer Used
50090-1941-02 50090-1941 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 9, 2017 Feb. 9, 2017 No Longer Used
52125-0562-08 52125-0562 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Feb. 28, 2013 Feb. 28, 2014 No Longer Used

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