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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
70771-1184-09 70771-1184 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70771-1185-00 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70771-1185-01 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70771-1185-03 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70771-1185-04 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 Dec. 5, 2019 In Use
70771-1185-05 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 Dec. 5, 2019 In Use
70771-1185-06 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70771-1185-09 70771-1185 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
70518-3070-00 70518-3070 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral April 10, 2021 Sept. 1, 2021 In Use
70518-3070-01 70518-3070 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 11, 2021 In Use
72647-0331-01 72647-0331 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 12, 2019 Jan. 31, 2024 In Use
72647-0331-04 72647-0331 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 12, 2019 Jan. 31, 2024 In Use
00378-3096-85 00378-3096 Everolimus Everolimus 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 15, 2022 In Use
00378-3098-85 00378-3098 Everolimus Everolimus 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 15, 2022 In Use
42858-0869-06 42858-0869 DRONABINOL DRONABINOL 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral June 26, 2018 In Use
00480-5425-89 00480-5425 Sorafenib Sorafenib 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FLT, PDGFR, KIT, RET, RET/PTC, CRAF, BRAF Oral Jan. 3, 2023 In Use
60760-0654-10 60760-0654 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 22, 2022 In Use
63187-0256-20 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 1, 2017 In Use
63187-0256-30 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral June 1, 2017 In Use
63187-0256-05 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 28, 2022 In Use
63187-0256-10 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 28, 2022 In Use
63187-0256-15 63187-0256 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 28, 2022 In Use
69784-0712-04 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2022 In Use
69784-0712-15 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 15, 2022 In Use
70518-3612-00 70518-3612 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 8, 2023 In Use
70518-3615-00 70518-3615 HYDROXYUREA HYDROXYUREA 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral Jan. 10, 2023 In Use
80425-0074-04 80425-0074 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 16, 2020 In Use
80425-0074-01 80425-0074 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 16, 2020 In Use
80425-0074-02 80425-0074 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 16, 2020 In Use
80425-0074-03 80425-0074 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 16, 2020 In Use
80425-0074-05 80425-0074 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sept. 16, 2020 In Use
80425-0222-01 80425-0222 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 12, 2023 In Use
80425-0227-01 80425-0227 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 11, 2023 In Use
80739-0812-12 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
80739-0812-18 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
00378-3097-85 00378-3097 everolimus everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 15, 2022 In Use
00904-3571-61 00904-3571 Megestrol Acetate Megestrol Acetate 40.0 mg/1 Hormonal Therapy Progestin Analog Oral Feb. 16, 2004 July 31, 2023 In Use
16714-0671-01 16714-0671 Ondansetron Hydrochloride Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 28, 2007 Oct. 31, 2016 In Use
16714-0671-02 16714-0671 Ondansetron Hydrochloride Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 28, 2007 In Use
48102-0051-01 48102-0051 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2021 Dec. 31, 2023 In Use
48102-0051-20 48102-0051 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2021 June 1, 2021 In Use
48102-0051-40 48102-0051 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2021 June 1, 2021 In Use
50090-0091-00 50090-0091 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 28, 2014 In Use
51079-0582-01 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 In Use
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug. 27, 1997 June 30, 2023 In Use
51991-0005-33 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 19, 2019 Dec. 31, 2022 In Use
51991-0005-90 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 15, 2020 In Use
55154-4949-00 55154-4949 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 13, 2003 In Use
55154-4949-09 55154-4949 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 13, 2003 Oct. 31, 2012 In Use
60505-0133-00 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use

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