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NDC-11 (Package) NDC-9 (Product) (Descending) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
42806-0358-01 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
42806-0358-30 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
42806-0134-34 42806-0134 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
42806-0134-24 42806-0134 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
42806-0133-24 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan. 1, 2021 In Use
42806-0089-01 42806-0089 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0089-05 42806-0089 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0089-09 42806-0089 Estradiol Estradiol 2.0 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0088-01 42806-0088 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0088-05 42806-0088 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0087-01 42806-0087 Estradiol Estradiol 0.5 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42806-0087-05 42806-0087 Estradiol Estradiol 0.5 mg/1 Hormonal Therapy Estrogen Oral April 10, 2017 In Use
42799-0816-01 42799-0816 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 25.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2023 In Use
42799-0815-01 42799-0815 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 15.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2023 In Use
42799-0813-01 42799-0813 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 20.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 11, 2011 In Use
42799-0812-01 42799-0812 Prednisolone Sodium Phosphate Prednisolone Sodium Phosphate 10.0 mg/5mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 11, 2011 In Use
42747-0761-01 42747-0761 mogamulizumab-kpkc POTELIGEO 4.0 mg/mL Immunotherapy Monoclonal Antibody CCR4 Intravenous Aug. 8, 2018 In Use
42747-0726-01 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
42747-0726-72 42747-0726 Granisetron Sancuso 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Sept. 12, 2008 In Use
42747-0327-07 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 Oct. 27, 2016 In Use
42747-0327-30 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 In Use
42747-0327-72 42747-0327 Toremifene Citrate Fareston 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral June 30, 1997 In Use
42737-0110-01 42737-0110 Decitabine Decitabine 50.0 mg/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Oct. 31, 2019 Dec. 5, 2019 In Use

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