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NDC-11 (Package) (Ascending) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
69238-1174-03 69238-1174 Isotretinoin Isotretinoin 10.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1175-03 69238-1175 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1176-03 69238-1176 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Oct. 2, 2017 In Use
69238-1250-01 69238-1250 Bexarotene Bexarotene 75.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Sept. 4, 2018 In Use
69238-1423-01 69238-1423 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 29, 2017 In Use
69238-1423-06 69238-1423 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 29, 2017 In Use
69238-1754-06 69238-1754 ABIRATERONE ABIRATERONE ACETATE 500.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor CYP17 Inhibitor Oral Jan. 7, 2019 In Use
69238-2088-06 69238-2088 Bexarotene Bexarotene 10.0 mg/g Hormonal Therapy Immunomodulator Retinoic Acid Derivative Topical May 4, 2022 In Use
69238-2122-09 69238-2122 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 27, 2022 In Use
69306-0400-21 69306-0400 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 18, 2021 In Use
69315-0164-01 69315-0164 Hydroxyurea Hydroxyurea 500.0 mg/1 Chemotherapy Miscellaneous Agent Antimetabolite/Organooxygen Oral July 9, 2020 In Use
69315-0184-01 69315-0184 Leucovorin calcium Leucovorin calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
69315-0184-03 69315-0184 Leucovorin calcium Leucovorin calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov. 16, 2020 In Use
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
69339-0168-03 69339-0168 Gefitinib Gefitinib 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral June 5, 2023 In Use
69339-0171-03 69339-0171 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0171-05 69339-0171 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0172-03 69339-0172 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69339-0172-05 69339-0172 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct. 24, 2022 In Use
69367-0190-50 69367-0190 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Feb. 2, 2023 In Use
69448-0001-05 69448-0001 Mitomycin Mutamycin 5.0 mg/10mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous July 25, 2017 In Use
69448-0002-11 69448-0002 Mitomycin Mutamycin 20.0 mg/40mL Chemotherapy Antitumor Antibiotic Alkylating Agent/ Mitomycin Intravenous July 25, 2017 In Use

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