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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
00591-2436-15 00591-2436 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral April 29, 2021 In Use
63629-4413-01 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
63629-4413-02 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
63629-4413-03 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
63629-4413-04 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
63629-4413-05 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
63629-4413-06 63629-4413 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 7, 2011 In Use
59651-0299-60 59651-0299 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
59651-0300-30 59651-0300 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
59651-0300-90 59651-0300 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Aug. 14, 2020 In Use
68462-0135-08 68462-0135 Abiraterone acetate Abiraterone acetate 250.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Oct. 16, 2019 In Use
68382-0245-05 68382-0245 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68382-0245-06 68382-0245 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68382-0245-16 68382-0245 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68382-0245-78 68382-0245 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68382-0244-05 68382-0244 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68382-0244-16 68382-0244 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
68001-0491-04 68001-0491 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral March 26, 2021 In Use
70771-1395-03 70771-1395 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
70771-1395-05 70771-1395 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
70771-1395-08 70771-1395 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
70771-1395-09 70771-1395 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
70771-1394-05 70771-1394 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
70771-1394-09 70771-1394 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 21, 2021 In Use
72606-0556-01 72606-0556 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 6, 2019 In Use
72606-0557-01 72606-0557 Imatinib mesylate Imatinib mesylate 400.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Nov. 6, 2019 In Use
59762-0055-01 59762-0055 Medroxyprogesterone acetate Medroxyprogesterone acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Aug. 20, 2018 In Use
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
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
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
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
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
63187-0561-60 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63187-0561-90 63187-0561 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 1, 2015 In Use
63629-4129-01 63629-4129 Dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 8, 2010 In Use

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