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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 (Ascending) Package Discontinuation Date Status
70518-2675-00 70518-2675 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 7, 2020 In Use
70934-0448-83 70934-0448 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral April 8, 2020 In Use
71905-0400-11 71905-0400 Dexamethasone Dexabliss 1.5 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
70934-0218-10 70934-0218 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
70934-0674-12 70934-0674 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 9, 2020 In Use
51655-0410-52 51655-0410 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral April 10, 2020 In Use
00703-3071-01 00703-3071 Romidepsin Romidepsin 5.0 mg/mL Chemotherapy Enzyme Inhibitor HDAC Intravenous April 14, 2020 In Use
00703-4004-01 00703-4004 Romidepsin Romidepsin 5.0 mg/mL Chemotherapy Enzyme Inhibitor HDAC Intravenous April 14, 2020 In Use
67457-0418-00 67457-0418 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0418-05 67457-0418 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0419-00 67457-0419 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0419-01 67457-0419 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0483-00 67457-0483 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2020 In Use
67457-0483-10 67457-0483 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 10.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous April 15, 2020 In Use
67457-0484-00 67457-0484 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
67457-0484-30 67457-0484 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-Articular, Intralesional, Intramuscular, Intravenous, Soft Tissue April 15, 2020 In Use
00006-5033-02 00006-5033 Trastuzumab Ontruzant 150.0 mg/1 Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
00006-5034-02 00006-5034 Ontruzant Ontruzant Immunotherapy Monoclonal Antibody HER2 Intravenous April 15, 2020 Sept. 30, 2023 No Longer Used
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
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 16, 2020 In Use
00310-0610-60 00310-0610 SELUMETINIB KOSELUGO 10.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 2020 In Use
00310-0625-60 00310-0625 SELUMETINIB KOSELUGO 25.0 mg/1 Chemotherapy MEK Inhibitor MEK 1/2 Oral April 16, 2020 In Use
50881-0026-01 50881-0026 Pemigatinib PEMAZYRE 4.5 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use
50881-0027-01 50881-0027 Pemigatinib PEMAZYRE 9.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor FGFR1, FGFR2, FGFR3 Oral April 17, 2020 In Use

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