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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
00143-9428-01 00143-9428 FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous May 1, 2021 In Use
45629-0089-01 45629-0089 Tivozanib FOTIVDA 0.89 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral March 10, 2021 In Use
45629-0134-01 45629-0134 Tivozanib FOTIVDA 1.34 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral March 10, 2021 In Use
70700-0284-98 70700-0284 fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 19, 2021 In Use
68001-0522-85 68001-0522 Fulvestrant FULVESTRANT 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Oct. 29, 2021 In Use
70771-1626-08 70771-1626 Fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Dec. 14, 2021 In Use
70710-1688-08 70710-1688 fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Dec. 14, 2021 In Use
16714-0070-02 16714-0070 fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 23, 2021 In Use
16729-0436-30 16729-0436 Fulvestrant FULVESTRANT 250.0 mg/5mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Jan. 12, 2021 In Use
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
11399-0005-01 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used
11399-0005-07 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used
11399-0005-30 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used
42747-0327-07 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 Oct. 27, 2016 In Use
42747-0327-30 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 In Use
42747-0327-72 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 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
00078-0650-06 00078-0650 Panobinostat Farydak 10.0 mg/1 Chemotherapy Enzyme Inhibitor HDAC Oral Feb. 23, 2015 Jan. 31, 2023 No Longer Used
00310-0720-10 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 1, 2010 In Use
00310-0720-25 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Nov. 1, 2010 Sept. 21, 2010 In Use
00310-0720-50 00310-0720 Fulvestrant Faslodex 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular May 20, 2002 Oct. 31, 2015 In Use
00078-0249-15 00078-0249 Letrozole Femara 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral July 31, 1997 In Use
54868-4151-00 54868-4151 Letrozole Femara 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Feb. 10, 2005 In Use
67877-0288-01 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-05 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-10 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-30 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
67877-0288-33 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 30, 2020 In Use
67877-0288-90 67877-0288 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 5, 2017 In Use
70518-2363-00 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 16, 2019 In Use
70518-2363-02 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb. 26, 2021 In Use
70518-2363-03 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 17, 2021 In Use
70518-2363-05 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 11, 2022 In Use
16729-0090-01 16729-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 24, 2010 In Use
16729-0090-10 16729-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 28, 2010 In Use
16729-0090-15 16729-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral June 8, 2010 In Use
16729-0090-16 16729-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov. 15, 2011 In Use
16729-0090-17 16729-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 23, 2017 In Use
31722-0525-01 31722-0525 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2010 In Use
31722-0525-05 31722-0525 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2010 In Use
31722-0525-10 31722-0525 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2010 In Use
31722-0525-30 31722-0525 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2010 In Use
31722-0525-90 31722-0525 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2010 In Use
50090-1093-00 50090-1093 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 4, 2016 Jan. 31, 2018 No Longer Used
50090-1093-01 50090-1093 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral March 4, 2016 Jan. 31, 2018 No Longer Used
50742-0123-30 50742-0123 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2011 Jan. 31, 2015 No Longer Used
50742-0123-90 50742-0123 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug. 1, 2011 Jan. 31, 2015 No Longer Used
55111-0172-01 55111-0172 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb. 28, 2007 In Use
55111-0172-05 55111-0172 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb. 28, 2007 In Use

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