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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name (Ascending) Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
59385-0041-30 59385-0041 Naldemedine, naldemedine tosylate SYMPROIC 0.2 mg/1 Ancillary Therapy Opioid Antagonist Oral June 14, 2019 In Use
20482-0335-30 20482-0335 Dronabinol SYNDROS 5.0 mg/mL Ancillary Therapy Antiemetic CB1/CB2 Oral July 27, 2017 In Use
54868-5985-00 54868-5985 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Feb. 16, 2009 In Use
42747-0726-01 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
42747-0726-72 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
00078-0110-22 00078-0110 Cyclosporine Sandimmune 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 14, 1983 In Use
00078-0109-01 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Nov. 14, 1983 In Use
00078-0109-61 00078-0109 Cyclosporine Sandimmune 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Aug. 10, 2012 In Use
00078-0240-15 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0240-61 00078-0240 Cyclosporine Sandimmune 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00078-0241-15 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 2, 1990 In Use
00078-0241-61 00078-0241 Cyclosporine Sandimmune 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral March 22, 2010 In Use
00078-0183-25 00078-0183 Octreotide Acetate Sandostatin 200.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 July 31, 2019 No Longer Used
00078-0184-25 00078-0184 Octreotide Acetate Sandostatin 1000.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 Jan. 31, 2019 In Use
00078-0180-01 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0180-61 00078-0180 Octreotide Acetate Sandostatin 50.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0181-01 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0181-61 00078-0181 Octreotide Acetate Sandostatin 100.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0182-01 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Oct. 21, 1988 In Use
00078-0182-61 00078-0182 Octreotide Acetate Sandostatin 500.0 ug/mL Hormonal Therapy Somatostatin Analog Intravenous, Subcutaneous Aug. 13, 2012 In Use
00078-0340-61 00078-0340 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Nov. 1, 1988 April 30, 2017 No Longer Used
00078-0341-61 00078-0341 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Nov. 1, 1988 Aug. 31, 2017 No Longer Used
00078-0342-61 00078-0342 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Nov. 1, 1988 Aug. 31, 2017 No Longer Used
00078-0811-81 00078-0811 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-0818-81 00078-0818 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-0825-81 00078-0825 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-0646-81 00078-0646 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Feb. 1, 2015 Nov. 30, 2018 In Use
00078-0647-81 00078-0647 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Feb. 1, 2015 June 30, 2019 No Longer Used
00078-0648-81 00078-0648 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog Feb. 1, 2015 March 31, 2019 No Longer Used
00078-9342-61 00078-9342 Octreotide Acetate Sandostatin LAR Depot Demonstration Kit Hormonal Therapy Somatostatin Analog Nov. 1, 1988 Aug. 31, 2017 No Longer Used
00024-0654-01 00024-0654 Isatuximab Sarclisa 100.0 mg/5mL Immunotherapy Monoclonal Antibody CD38 Intravenous March 2, 2020 In Use
00024-0656-01 00024-0656 Isatuximab Sarclisa 500.0 mg/25mL Immunotherapy Monoclonal Antibody CD38 Intravenous March 2, 2020 In Use
00019-9450-01 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9450-02 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9450-03 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9450-04 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9450-05 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9450-07 00019-9450 Sodium Iodide I-131 Sodium Iodide I-131 5.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-02 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-03 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-04 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9451-06 00019-9451 Sodium Iodide I-131 Sodium Iodide I-131 25.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Aug. 22, 2011 July 1, 2017 No Longer Used
00019-9452-00 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-01 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-02 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-03 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-04 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-05 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-06 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used
00019-9452-07 00019-9452 Sodium Iodide I-131 Sodium Iodide I-131 1.0 mCi/mL Chemotherapy Radiopharmaceutical Iodine 131 Oral Jan. 25, 2012 July 1, 2017 No Longer Used

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