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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
51862-0460-47 51862-0460 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral July 18, 2016 In Use
51862-0449-18 51862-0449 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral July 18, 2016 July 31, 2019 No Longer Used
51862-0449-60 51862-0449 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral July 18, 2016 Feb. 28, 2019 No Longer Used
51862-0450-30 51862-0450 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral July 18, 2016 March 31, 2019 No Longer Used
51862-0450-90 51862-0450 Tamoxifen Citrate Tamoxifen Citrate 20.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral July 18, 2016 July 31, 2019 No Longer Used
62559-0173-31 62559-0173 Nilutamide Nilutamide 150.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 18, 2016 In Use
69189-0678-01 69189-0678 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral July 21, 2016 May 24, 2017 No Longer Used
00078-0811-81 00078-0811 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-0818-81 00078-0818 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00078-0825-81 00078-0825 Octreotide Acetate Sandostatin LAR Depot Hormonal Therapy Somatostatin Analog July 22, 2016 In Use
00310-0482-93 00310-0482 Gefitinib IRESSA 250.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral July 25, 2016 Aug. 31, 2019 In Use
69189-0679-01 69189-0679 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 26, 2016 May 24, 2017 No Longer Used
66220-0017-03 66220-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Aug. 1, 2016 Oct. 31, 2020 No Longer Used
63187-0526-15 63187-0526 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 1, 2016 In Use
40051-0604-11 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0604-12 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0604-13 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0604-51 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0604-52 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0604-53 40051-0604 Temozolomide Temozolomide 5.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0605-11 40051-0605 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0605-12 40051-0605 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0605-13 40051-0605 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0605-51 40051-0605 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use
40051-0605-52 40051-0605 Temozolomide Temozolomide 20.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug. 1, 2016 In Use

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