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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
76189-0113-18 76189-0113 Brigatinib Alunbrig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1/ EGFR Oral April 28, 2017 Dec. 12, 2020 No Longer Used
76189-0113-21 76189-0113 Brigatinib Alunbrig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1/ EGFR Oral April 28, 2017 Dec. 12, 2020 No Longer Used
76189-0533-30 76189-0533 Ponatinib Hydrochloride Iclusig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral April 22, 2015 July 26, 2020 No Longer Used
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
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
00555-0484-01 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00555-0484-02 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
00555-0484-05 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral June 30, 1990 In Use
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
11399-0005-01 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used
11399-0005-07 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used
11399-0005-30 11399-0005 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 April 30, 2016 No Longer Used

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