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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status (Ascending)
60687-0375-01 60687-0375 DRONABINOL DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral July 16, 2018 In Use
62112-8068-01 62112-8068 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 10, 2002 In Use
62112-8068-02 62112-8068 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 10, 2002 In Use
65862-0149-01 65862-0149 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
65862-0149-05 65862-0149 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
65862-0149-30 65862-0149 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
65862-0149-61 65862-0149 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral June 30, 2011 Oct. 25, 2011 In Use
65862-0149-90 65862-0149 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct. 30, 2007 In Use
64380-0763-04 64380-0763 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 9, 2016 In Use
64380-0763-05 64380-0763 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 10, 2016 In Use
68084-0879-25 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 30, 2015 In Use
68084-0879-95 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sept. 30, 2015 In Use
68084-0921-25 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov. 3, 2015 In Use
68084-0921-95 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb. 26, 2015 In Use
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec. 5, 2016 In Use
69097-0439-35 69097-0439 Palonsetron hydrochloride Palonosetron hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Oct. 10, 2021 In Use
70860-0210-51 70860-0210 Zoledronic Acid Zoledronic Acid 4.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous March 13, 2019 In Use
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 8, 2017 In Use
55513-0530-01 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
55513-0530-10 55513-0530 Filgrastim Neupogen 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous May 19, 1997 In Use
55513-0546-01 55513-0546 Filgrastim Neupogen 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous April 7, 1997 In Use
55513-0546-10 55513-0546 Filgrastim Neupogen 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous April 7, 1997 In Use
55513-0924-01 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0924-10 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
55513-0924-91 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct. 2, 2000 In Use
63323-0318-01 63323-0318 GRANISETRON HYDROCHLORIDE Granisetron 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 In Use
63323-0319-04 63323-0319 GRANISETRON HYDROCHLORIDE Granisetron 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Nov. 20, 2009 In Use
64679-0661-01 64679-0661 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous June 30, 2008 In Use
64679-0661-02 64679-0661 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous June 30, 2008 Dec. 31, 2019 In Use
64679-0661-03 64679-0661 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous June 30, 2008 In Use
63629-8439-01 63629-8439 Pilocarpine hydrchloride Pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Feb. 9, 2022 In Use
67457-0207-25 67457-0207 Dexrazoxane Dexrazoxane Hydrochloride Ancillary Therapy Chemoprotective Detoxifying Agent Nov. 18, 2011 In Use
67457-0208-50 67457-0208 Dexrazoxane Dexrazoxane Hydrochloride Ancillary Therapy Chemoprotective Detoxifying Agent Nov. 18, 2011 In Use
67457-0390-54 67457-0390 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous March 10, 2014 In Use
67457-0528-10 67457-0528 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 23, 2019 In Use
67457-0529-20 67457-0529 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous July 23, 2019 In Use
67457-0833-06 67457-0833 pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous July 9, 2018 In Use
00078-0846-19 00078-0846 Tisagenlecleucel Kymriah 2000000.0 1/1 Immunotherapy CAR-T CD19 Intravenous Aug. 30, 2017 In Use
50242-0077-01 50242-0077 Trastuzumab and Hyaluronidase-oysk Herceptin Hylecta 10000.0 U/5mL, 10000.0 U/5mL, 600.0 mg/5mL Immunotherapy Monoclonal Antibody HER2 Subcutaneous Feb. 28, 2019 In Use
50242-0109-01 50242-0109 Rituximab and hyaluronidase Rituxan Hycela 2000.0 U/mL, 2000.0 U/mL, 120.0 mg/mL Immunotherapy Monoclonal Antibody CD20 Subcutaneous June 22, 2017 In Use
55513-0206-01 55513-0206 Bevacizumab-awwb MVASI 100.0 mg/4mL, 100.0 mg/4mL Immunotherapy Monoclonal Antibody VEGFR Intravenous June 1, 2018 In Use
55513-0207-01 55513-0207 Bevacizumab-awwb MVASI 400.0 mg/16mL, 400.0 mg/16mL Immunotherapy Monoclonal Antibody VEGFR Intravenous June 1, 2018 In Use
57894-0503-01 57894-0503 Daratumumab and hyaluronidase-fihj (human recombinant) Darzalex Faspro 1800.0 mg/15mL, 4.9 mg/15mL, 18.4 mg/15mL, 30000.0 U/15mL, 13.5 mg/15mL, 6.0 mg/15mL, 735.1 mg/15mL Immunotherapy Monoclonal Antibody CD38 Subcutaneous May 1, 2020 In Use
00078-0860-01 00078-0860 Ribociclib Kisqali 200.0 mg/1, 200.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 13, 2017 In Use
00310-1349-30 00310-1349 Osimertinib Tagrisso 40.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Nov. 13, 2015 In Use
60687-0286-11 60687-0286 Bromocriptine Mesylate Bromocriptine Mesylate 2.5 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral July 7, 2017 In Use
60687-0286-21 60687-0286 Bromocriptine Mesylate Bromocriptine Mesylate 2.5 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral July 7, 2017 In Use
60763-0601-13 60763-0601 Mercaptopurine PURINETHOL 50.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral Jan. 15, 2022 In Use
62856-0708-05 62856-0708 Lenvatinib Lenvima 4.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FGF, PDGFR, KIT, RET Oral May 13, 2016 In Use
62856-0708-30 62856-0708 Lenvatinib Lenvima 4.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR, FGF, PDGFR, KIT, RET Oral May 13, 2016 In Use

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