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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
83008-0074-30 83008-0074 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 25, 2024 In Use
83858-0101-60 83858-0101 Dasatinib PHYRAGO 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0102-60 83858-0102 Dasatinib PHYRAGO 50.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0103-60 83858-0103 Dasatinib PHYRAGO 70.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0104-30 83858-0104 Dasatinib PHYRAGO 80.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0105-30 83858-0105 Dasatinib PHYRAGO 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
83858-0106-30 83858-0106 Dasatinib PHYRAGO 140.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Sept. 1, 2024 In Use
73116-0225-28 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 25, 2018 In Use
73116-0225-56 73116-0225 Duvelisib COPIKTRA 25.0 mg/1 Chemotherapy Enzyme Inhibitor PI3K Oral Sept. 28, 2018 In Use
51655-0012-03 51655-0012 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Aug. 11, 2014 In Use
80425-0075-02 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-03 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-04 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0075-05 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral July 31, 2007 In Use
80425-0230-01 80425-0230 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0231-01 80425-0231 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0242-02 80425-0242 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0255-01 80425-0255 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 11, 2023 In Use
80425-0328-01 80425-0328 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 24, 2023 In Use
80725-0610-25 80725-0610 Chlorambucil LEUKERAN 2.0 mg/1 Chemotherapy Alkylating Agent Nitrogen Mustard Oral May 15, 2023 In Use
80725-0620-25 80725-0620 Busulfan MYLERAN 2.0 mg/1 Chemotherapy Alkylating Agent Alkylsulfonate Oral May 15, 2023 In Use
80725-0630-25 80725-0630 Thioguanine TABLOID 40.0 mg/1 Chemotherapy Antimetabolite Purine Analog Oral May 15, 2023 In Use
00002-4184-02 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Jan. 1, 2023 In Use
00002-4184-07 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 Nov. 30, 2019 In Use
00002-4184-30 00002-4184 Raloxifene Hydrochloride Evista 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 16, 2016 In Use

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