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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
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov. 23, 2021 In Use
79802-0200-30 79802-0200 belumosudil Rezurock 200.0 mg/1 Chemotherapy Rho Kinase Inhibitor ROCK 1, ROCK2 Oral July 16, 2021 In Use
00245-0570-01 00245-0570 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
00245-0571-01 00245-0571 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
00245-0573-01 00245-0573 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
00378-0005-85 00378-0005 Everolimus Everolimus 2.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
00378-0006-85 00378-0006 Everolimus Everolimus 3.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
00378-0007-85 00378-0007 Everolimus Everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Oct. 1, 2021 In Use
16729-0542-35 16729-0542 Fluorouracil Fluorouracil 50.0 mg/g Chemotherapy Antimetabolite Pyrimidine Analog Topical Nov. 11, 2021 In Use
36000-0326-02 36000-0326 palonosetron hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 12, 2021 In Use
63323-0926-88 63323-0926 Romidepsin Romidepsin Chemotherapy Enzyme Inhibitor HDAC Intravenous Oct. 12, 2021 In Use
63629-5269-00 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 5, 2021 In Use
63629-5269-01 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral March 21, 2014 In Use
63629-5269-02 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Aug. 13, 2014 In Use
63629-5269-03 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 26, 2016 In Use
63629-5269-04 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 20, 2018 In Use
63629-5269-05 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 1, 2021 In Use
63629-5269-06 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral June 25, 2018 In Use
63629-5269-07 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 20, 2019 In Use
63629-5269-08 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral March 6, 2019 In Use
63629-5269-09 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 7, 2020 In Use
68308-0570-30 68308-0570 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0571-30 68308-0571 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0573-30 68308-0573 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 21, 2021 In Use
68308-0575-30 68308-0575 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 3, 2021 In Use
70700-0186-23 70700-0186 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 13, 2021 In Use
70700-0187-23 70700-0187 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 13, 2021 In Use
70700-0188-22 70700-0188 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 13, 2021 In Use
70700-0189-22 70700-0189 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 13, 2021 In Use
43066-0014-01 43066-0014 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 19, 2018 In Use
43066-0018-01 43066-0018 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Feb. 19, 2018 In Use
43547-0258-01 43547-0258 Fluorouracil Fluorouracil 50.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Topical June 1, 2010 July 1, 2018 In Use
43975-0252-05 43975-0252 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0252-14 43975-0252 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0253-05 43975-0253 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0253-14 43975-0253 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0254-05 43975-0254 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0254-14 43975-0254 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0255-05 43975-0255 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0255-14 43975-0255 Temozolomide Temozolomide 140.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0257-05 43975-0257 Temozolomide Temozolomide 250.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral July 13, 2016 In Use
43975-0307-10 43975-0307 CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE 25.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral March 20, 2018 In Use
43975-0308-10 43975-0308 CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE 50.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral March 20, 2018 In Use
44087-5000-03 44087-5000 Tepotinib Hydrochloride TEPMETKO 225.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral Feb. 3, 2021 In Use
44087-5000-06 44087-5000 Tepotinib Hydrochloride TEPMETKO 225.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor MET Oral Feb. 3, 2021 In Use
44567-0507-01 44567-0507 Teniposide Teniposide 10.0 mg/mL Chemotherapy Plant Alkaloid Epipodophyllotoxins Intravenous April 30, 2013 In Use
45963-0608-60 45963-0608 Epirubicin Hydrochloride Epirubicin Hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Nov. 28, 2011 Oct. 31, 2020 No Longer Used
45963-0608-68 45963-0608 Epirubicin Hydrochloride Epirubicin Hydrochloride 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Nov. 28, 2011 June 30, 2021 No Longer Used
45963-0612-57 45963-0612 Gemcitabine Hydrochloride Gemcitabine Hydrochloride 200.0 mg/5mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Feb. 2, 2015 Oct. 31, 2020 No Longer Used

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