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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
59762-0055-02 59762-0055 Medroxyprogesterone acetate Medroxyprogesterone acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Nov. 2, 2020 In Use
59762-0058-01 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Jan. 2, 2019 In Use
59762-0058-02 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral May 11, 2020 In Use
59762-0058-04 59762-0058 Medroxyprogesterone acetate Medroxyprogesterone acetate 5.0 mg/1 Hormonal Therapy Progestin Oral March 9, 2020 Sept. 16, 2020 In Use
70860-0214-61 70860-0214 Melphalan hydrochloride Melphalan hydrochloride 50.0 mg/10ml Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous July 30, 2019 In Use
72647-0331-01 72647-0331 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 12, 2019 In Use
72647-0331-04 72647-0331 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 12, 2019 In Use
70625-0237-01 70625-0237 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 28, 2019 In Use
70625-0237-11 70625-0237 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 28, 2019 In Use
00002-4184-02 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use
00002-4184-07 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Nov. 30, 2019 In Use
00002-4184-30 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use
00002-7501-01 00002-7501 Gemcitabine hydrochloride Gemzar 200.0 mg/5mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous May 22, 1996 May 31, 2020 No Longer Used
72205-0046-01 72205-0046 Thiotepa Thiotepa 100.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard/Ethyleneimine Intracavitary, Intravenous, Intravesical Feb. 1, 2020 In Use
72611-0779-02 72611-0779 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Nov. 1, 2020 In Use
68180-0685-01 68180-0685 Methylprednisolone Methylprednisolone 2.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0688-08 68180-0688 Methylprednisolone Methylprednisolone 16.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0689-55 68180-0689 Methylprednisolone Methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0686-01 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0686-11 68180-0686 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
68180-0687-55 68180-0687 Methylprednisolone Methylprednisolone 8.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 1, 2020 In Use
72493-0103-03 72493-0103 Mitomycin JELMYTO Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin May 1, 2020 In Use
59630-0222-07 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-30 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
59630-0222-90 59630-0222 Naldemedine SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral July 5, 2018 Dec. 31, 2020 No Longer Used
60760-0313-10 60760-0313 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 2, 2020 In Use
68788-7705-01 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
68788-7705-03 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
61314-0866-01 61314-0866 pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov. 4, 2019 In Use
60219-1707-01 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-03 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1707-05 60219-1707 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1708-01 60219-1708 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
60219-1708-05 60219-1708 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 24, 2020 In Use
55700-0854-21 55700-0854 Dexamethasone TaperDex 6-day 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 27, 2020 In Use
51662-1370-01 51662-1370 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 13, 2019 In Use
61919-0827-15 61919-0827 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 15, 2020 In Use
61919-0827-21 61919-0827 Dexamethasone Dexamethasone 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 15, 2020 In Use
51662-1432-01 51662-1432 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Dec. 21, 2019 In Use
76420-0077-01 76420-0077 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Feb. 11, 2020 In Use
70069-0025-10 70069-0025 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous June 11, 2019 In Use
71872-7205-01 71872-7205 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Feb. 13, 2020 In Use
51662-1391-01 51662-1391 Dexamethasone sodium phosphate Dexamethasone sodium phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 8, 2019 In Use
72893-0015-06 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 In Use
72893-0015-24 72893-0015 Dexamethasone Hemady 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 11, 2020 In Use
63187-0561-00 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-10 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 3, 2016 In Use
63187-0561-15 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 1, 2019 In Use
63187-0561-24 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-30 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use

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