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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
82982-0059-10 82982-0059 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 28, 2023 In Use
82982-0061-10 82982-0061 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 30, 2023 In Use
00002-4184-02 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Jan. 1, 2023 In Use
00002-4184-07 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Nov. 30, 2019 In Use
00002-4184-30 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use
00003-0852-11 00003-0852 Dasatinib Sprycel 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral June 3, 2009 Jan. 26, 2011 In Use
00003-0852-22 00003-0852 Dasatinib Sprycel 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral May 30, 2008 In Use
00006-3066-01 00006-3066 Aprepitant Emend 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Dec. 17, 2015 In Use
00006-3066-03 00006-3066 Aprepitant Emend 125.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Dec. 17, 2015 In Use
00009-0056-02 00009-0056 Methylprednisolone Medrol 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 24, 1957 In Use
00009-0056-03 00009-0056 Methylprednisolone Medrol 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 24, 1957 April 30, 2008 In Use
00009-0056-04 00009-0056 Methylprednisolone Medrol 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 24, 1957 In Use
00009-0056-05 00009-0056 Methylprednisolone Medrol 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 24, 1957 Dec. 30, 2007 In Use
00046-1100-51 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 April 30, 2020 In Use
00046-1100-52 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Nov. 11, 2019 In Use
00046-1100-81 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1100-91 00046-1100 Estrogens, Conjugated Premarin 0.3 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1102-51 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 May 22, 2020 In Use
00046-1102-52 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Feb. 10, 2020 In Use
00046-1102-81 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1102-91 00046-1102 Estrogens, Conjugated Premarin 0.625 mg/1 Hormonal Therapy Estrogen Oral Jan. 1, 2006 In Use
00046-1104-51 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 April 30, 2013 In Use
00046-1104-81 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 In Use
00046-1104-91 00046-1104 Estrogens, Conjugated Premarin 1.25 mg/1 Hormonal Therapy Estrogen Oral Sept. 1, 2004 In Use
00074-7269-50 00074-7269 Cyclosporine Gengraf 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 25, 2010 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
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0246-61 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00078-0248-15 00078-0248 cyclosporine NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 14, 1995 In Use
00078-0248-61 00078-0248 cyclosporine NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug. 13, 2012 In Use
00078-0566-51 00078-0566 Everolimus Afinitor 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral March 31, 2009 In Use
00078-0566-61 00078-0566 Everolimus Afinitor 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral March 22, 2010 In Use
00078-0567-51 00078-0567 Everolimus Afinitor 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral March 31, 2009 In Use
00078-0567-61 00078-0567 Everolimus Afinitor 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral March 22, 2010 In Use
00078-0594-51 00078-0594 Everolimus Afinitor 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral July 9, 2010 In Use
00078-0594-61 00078-0594 Everolimus Afinitor 2.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral July 9, 2010 In Use
00078-0620-51 00078-0620 Everolimus Afinitor 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral July 29, 2011 In Use
00078-0620-61 00078-0620 Everolimus Afinitor 7.5 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral July 29, 2011 In Use
00078-0626-51 00078-0626 Everolimus Afinitor 2.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0626-61 00078-0626 Everolimus Afinitor 2.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0627-51 00078-0627 Everolimus Afinitor 3.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0627-61 00078-0627 Everolimus Afinitor 3.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0628-51 00078-0628 Everolimus Afinitor 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0628-61 00078-0628 Everolimus Afinitor 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Aug. 29, 2012 In Use
00078-0666-15 00078-0666 Trametinib Mekinist 0.5 mg/1 Chemotherapy MEK Inhibitor BRAF Oral March 17, 2016 Oct. 31, 2023 In Use
00078-0668-15 00078-0668 Trametinib Mekinist 2.0 mg/1 Chemotherapy MEK Inhibitor BRAF Oral March 17, 2016 April 30, 2024 In Use
00078-0670-66 00078-0670 Pazopanib Hydrochloride Votrient 200.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FGF, PDGFR, KIT, Lck, FMS Oral July 12, 2016 Oct. 31, 2024 In Use

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