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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
69315-0185-12 69315-0185 Leucovorin calcium Leucovorin calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69315-0185-24 69315-0185 Leucovorin calcium Leucovorin calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69315-0186-24 69315-0186 Leucovorin calcium Leucovorin calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69315-0187-25 69315-0187 Leucovorin calcium Leucovorin calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
57582-0101-01 57582-0101 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 14, 2018 In Use
57582-0101-02 57582-0101 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 14, 2019 In Use
68788-7833-02 68788-7833 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 5, 2021 In Use
76420-0193-21 76420-0193 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 16, 2021 In Use
69306-0400-21 69306-0400 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 18, 2021 In Use
70518-2864-00 70518-2864 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 28, 2020 In Use
63187-0382-10 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Feb. 1, 2019 In Use
63187-0382-20 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Sept. 1, 2016 In Use
63187-0382-30 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Sept. 1, 2016 In Use
63187-0382-40 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Sept. 1, 2016 In Use
63187-0382-60 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Sept. 1, 2016 In Use
63187-0382-90 63187-0382 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Sept. 1, 2016 In Use
63629-2612-01 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-02 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-03 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-04 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-05 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-06 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2612-07 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Aug. 17, 2007 In Use
63629-2614-01 63629-2614 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Dec. 3, 1996 In Use
63629-2614-02 63629-2614 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral July 7, 2015 In Use
63629-2614-03 63629-2614 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral July 7, 2015 In Use
63629-2614-04 63629-2614 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral July 7, 2015 In Use
63629-2614-05 63629-2614 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral July 7, 2015 In Use
50090-0491-00 50090-0491 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral Jan. 17, 2019 In Use
50090-0491-01 50090-0491 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 5.0 mg/1 Hormonal Therapy Progestin Oral June 29, 2016 In Use
72189-0008-21 72189-0008 Methylpred DP Methylpred DP 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 26, 2019 In Use
70518-0443-00 70518-0443 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral April 20, 2017 April 6, 2020 In Use
70518-0443-01 70518-0443 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral May 11, 2018 April 6, 2020 In Use
50090-0490-00 50090-0490 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral Jan. 17, 2019 In Use
50090-0490-02 50090-0490 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 2.5 mg/1 Hormonal Therapy Progestin Oral June 29, 2016 In Use
60760-0373-21 60760-0373 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 5, 2019 In Use
54348-0819-00 54348-0819 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 10, 2019 In Use
54348-0819-02 54348-0819 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 10, 2019 In Use
54348-0819-04 54348-0819 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 10, 2019 In Use
54348-0819-06 54348-0819 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 10, 2019 In Use
54348-0819-08 54348-0819 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 10, 2019 In Use
51662-1514-01 51662-1514 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 31, 2020 In Use
51662-1514-02 51662-1514 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 31, 2020 In Use
61919-0545-05 61919-0545 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2014 In Use
61919-0545-06 61919-0545 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2014 In Use
61919-0545-10 61919-0545 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec. 1, 2015 In Use
61919-0545-30 61919-0545 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2015 In Use
65862-0391-01 65862-0391 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 24, 2021 In Use
65862-0391-10 65862-0391 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use
65862-0391-30 65862-0391 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 12, 2010 In Use

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