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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
76189-0534-30 76189-0534 Ponatinib Hydrochloride Iclusig 45.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0534-90 76189-0534 Ponatinib Hydrochloride Iclusig 45.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-30 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-60 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-80 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
00054-0482-13 00054-0482 Everolimus Everolimus 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 7, 2021 In Use
00009-0050-02 00009-0050 Medroxyprogesterone Acetate Provera 10.0 mg/1 Hormonal Therapy Progestin Oral Dec. 1, 1959 Nov. 30, 2021 In Use
00009-0050-11 00009-0050 Medroxyprogesterone Acetate Provera 10.0 mg/1 Hormonal Therapy Progestin Oral Dec. 1, 1959 Nov. 30, 2021 In Use
00093-7290-01 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 In Use
00093-7290-10 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 April 30, 2018 In Use
00093-7290-56 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 In Use
00179-0224-01 00179-0224 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 12, 2017 Feb. 29, 2020 No Longer Used
00409-3218-05 00409-3218 Methylprednisolone Sodium Succinate A-Methapred 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 6, 2006 July 1, 2010 No Longer Used
00409-3218-15 00409-3218 Methylprednisolone Sodium Succinate A-Methapred 125.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Oct. 6, 2006 July 1, 2010 No Longer Used
00409-4856-05 00409-4856 Hydrocortisone Sodium Succinate A-Hydrocort 100.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Dec. 14, 2006 July 1, 2010 No Longer Used
00409-4856-15 00409-4856 Hydrocortisone Sodium Succinate A-Hydrocort 100.0 mg/2mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Dec. 14, 2006 July 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
00378-8170-91 00378-8170 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 March 31, 2016 No Longer Used
00378-8171-91 00378-8171 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 June 30, 2016 No Longer Used
00378-8172-91 00378-8172 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 May 31, 2016 No Longer Used
00409-3414-01 00409-3414 Metoclopramide Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Feb. 2, 2006 In Use
00409-4759-01 00409-4759 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov. 7, 2006 In Use
00517-0745-01 00517-0745 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous July 16, 2010 Aug. 24, 2012 No Longer Used

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