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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
25021-0814-67 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec. 1, 2013 Dec. 31, 2020 In Use
63187-0657-30 63187-0657 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 1, 2018 Dec. 31, 2020 In Use
63187-0657-60 63187-0657 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 1, 2018 Dec. 31, 2020 In Use
63187-0657-90 63187-0657 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec. 1, 2018 Dec. 31, 2020 In Use
00781-5238-06 00781-5238 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 19, 2011 Dec. 31, 2020 In Use
00781-5239-06 00781-5239 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 19, 2011 Dec. 31, 2020 No Longer Used
00781-5239-64 00781-5239 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 13, 2007 Dec. 31, 2020 No Longer Used
48102-0046-01 48102-0046 dexamethasone Dexamethasone 0.75 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2018 Dec. 31, 2020 In Use
48102-0048-01 48102-0048 dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral June 1, 2018 Dec. 31, 2020 In Use
63187-0482-30 63187-0482 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 2, 2015 Dec. 31, 2020 In Use
63187-0482-60 63187-0482 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 2, 2015 Dec. 31, 2020 In Use
63187-0482-90 63187-0482 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Feb. 2, 2015 Dec. 31, 2020 In Use
00143-9740-01 00143-9740 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 3, 2009 Dec. 31, 2020 No Longer Used
00143-9738-10 00143-9738 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 3, 2009 Dec. 31, 2020 No Longer Used
63739-0269-42 63739-0269 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral May 8, 2019 Dec. 31, 2020 In Use
57962-0560-71 57962-0560 Ibrutinib IMBRUVICA 560.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor Bruton's Tyrosine Kinase (Btk) /BCR Oral Feb. 6, 2019 Dec. 31, 2020 In Use
43063-0560-02 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 4, 2016 Jan. 18, 2021 No Longer Used
43063-0560-03 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 4, 2016 Jan. 18, 2021 No Longer Used
43063-0560-04 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 4, 2016 Jan. 18, 2021 No Longer Used
43063-0560-05 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 12, 2015 Jan. 18, 2021 No Longer Used
43063-0560-06 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 12, 2015 Jan. 18, 2021 No Longer Used
43063-0560-10 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 12, 2015 Jan. 18, 2021 No Longer Used
43063-0560-20 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb. 12, 2015 Jan. 18, 2021 No Longer Used
42292-0051-05 42292-0051 Erlotinib hydrochloride Erlotinib Hydrochloride 25.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 28, 2019 Jan. 31, 2021 No Longer Used
42292-0053-05 42292-0053 Erlotinib hydrochloride Erlotinib Hydrochloride 150.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral May 28, 2019 Jan. 31, 2021 No Longer Used

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