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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 (Ascending) Status
00023-5902-04 00023-5902 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist June 15, 2000 In Use
00023-5904-12 00023-5904 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist June 29, 2001 In Use
00023-5906-23 00023-5906 Triptorelin Pamoate Trelstar Hormonal Therapy GnRH Agonist March 11, 2010 In Use
00115-1696-06 00115-1696 Hydrocortisone Hydrocortisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
00115-1697-01 00115-1697 Hydrocortisone Hydrocortisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
00115-1700-01 00115-1700 Hydrocortisone Hydrocortisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral March 30, 2007 In Use
13925-0166-04 13925-0166 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 5.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Oct. 18, 2013 In Use
16714-0070-02 16714-0070 fulvestrant FULVESTRANT 50.0 mg/mL Hormonal Therapy Estrogen Receptor Antagonist Intramuscular Aug. 23, 2021 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sept. 26, 2018 In Use
17856-0090-01 17856-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 11, 2021 In Use
17856-0691-01 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-02 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-04 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-05 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-06 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-07 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 28, 2021 In Use
17856-0691-08 17856-0691 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 10, 2021 In Use
17856-0759-01 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 20, 2021 In Use
17856-0759-02 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 20, 2021 In Use
17856-0759-03 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 20, 2021 In Use
17856-0759-04 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 20, 2021 In Use
17856-0759-05 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 20, 2021 In Use
17856-0759-06 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 14, 2021 In Use
17856-0759-07 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 14, 2021 In Use
17856-0759-08 17856-0759 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 14, 2021 In Use

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