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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
00004-0357-99 00004-0357 Peginterferon alfa-2a Pegasys 180.0 ug/.5mL Immunotherapy Cytokine Interferon Subcutaneous Aug. 22, 2011 Sept. 19, 2014 In Use
63459-0920-59 63459-0920 tbo-filgrastim GRANIX 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
63459-0918-59 63459-0918 tbo-filgrastim GRANIX 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov. 7, 2018 In Use
68382-0224-01 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
68382-0224-05 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
68382-0224-06 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
68382-0224-10 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
68382-0224-30 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
68382-0224-77 68382-0224 Bicalutamide Bicalutamide 50.0 mg/1 Hormonal Therapy Androgen Receptor Inhibitor Non-Steroidal Oral July 6, 2009 In Use
63629-2612-01 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-02 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-03 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-04 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-05 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-06 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
63629-2612-07 63629-2612 Medroxyprogesterone Acetate Medroxyprogesterone Acetate 10.0 mg/1 Hormonal Therapy Progestin Oral Nov. 29, 2022 In Use
68382-0826-01 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
68382-0826-05 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 Dec. 5, 2019 In Use
68382-0826-06 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 Dec. 5, 2019 In Use
68382-0826-14 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
68382-0826-16 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
68382-0826-28 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 In Use
68382-0826-77 68382-0826 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 3, 2018 Dec. 5, 2019 In Use
52584-0239-30 52584-0239 dexamethasone sodium phosphate DEXAMETHASONE SODIUM PHOSPHATE 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Aug. 9, 2019 Aug. 31, 2023 In Use
52584-0420-10 52584-0420 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous May 26, 2014 Jan. 31, 2024 In Use

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