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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 (Ascending) Package Discontinuation Date Status
00555-0484-18 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 Feb. 6, 2012 In Use
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00555-0485-27 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00052-0602-02 00052-0602 BACILLUS CALMETTE-GUERIN TICE BCG 50.0 mg/50mL Immunotherapy Biological Response Modifier Live Vaccine Intravesical Aug. 24, 1990 In Use
61703-0303-46 61703-0303 Cytarabine Cytarabine 20.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Aug. 31, 1990 In Use
00703-3524-01 00703-3524 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Aug. 31, 1990 March 31, 2011 No Longer Used
00703-3524-03 00703-3524 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Aug. 31, 1990 March 31, 2011 No Longer Used
00310-0604-60 00310-0604 Tamoxifen Citrate Nolvadex Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Sept. 1, 1990 March 31, 2008 No Longer Used
00013-2526-86 00013-2526 Idarubicin Hydrochloride Idamycin Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Sept. 27, 1990 June 1, 2010 No Longer Used
00517-4901-25 00517-4901 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL, 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue Sept. 30, 1990 Nov. 8, 2016 No Longer Used
00517-4905-25 00517-4905 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL, 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue Sept. 30, 1990 Nov. 8, 2016 No Longer Used
00517-4930-25 00517-4930 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL, 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intra-articular, Intralesional, IM, IV, Intralesional, Intramuscular, Intravenous, Soft Tissue Sept. 30, 1990 Nov. 8, 2016 No Longer Used
55154-5707-05 55154-5707 Dexamethasone Phosphate Dexamethasone Sodium Phosphates 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Sept. 30, 1990 Oct. 31, 2011 No Longer Used
68682-0085-31 68682-0085 Fluorouracil Fluorouracil Chemotherapy Antimetabolite Pyrimidine Analog Topical Sept. 30, 1990 Jan. 31, 2010 No Longer Used
00555-0301-02 00555-0301 Methylprednisolone Methylprednisolone Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 30, 1990 July 31, 2012 No Longer Used
00555-0301-04 00555-0301 Methylprednisolone Methylprednisolone Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 30, 1990 July 31, 2012 No Longer Used
00555-0301-38 00555-0301 Methylprednisolone Methylprednisolone Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 30, 1990 July 31, 2012 No Longer Used
21695-0111-00 21695-0111 Methotrexate sodium Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 15, 1990 In Use
21695-0111-30 21695-0111 Methotrexate sodium Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 15, 1990 In Use
00555-0572-02 00555-0572 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Nov. 1, 1990 In Use
00555-0572-35 00555-0572 Methotrexate Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Nov. 1, 1990 In Use
62856-0001-10 62856-0001 Altretamine Hexalen 50.0 mg/1 Chemotherapy Alkylating Agent Triazines Oral Dec. 26, 1990 Dec. 31, 2019 No Longer Used
00173-0442-00 00173-0442 ondansetron hydrochloride Zofran 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb. 4, 1991 Feb. 28, 2018 No Longer Used
00173-0442-02 00173-0442 ondansetron hydrochloride Zofran 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb. 4, 1991 July 5, 2012 No Longer Used
50419-0050-14 50419-0050 Sargramostim Leukine Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor March 5, 1991 Sept. 21, 2012 No Longer Used

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