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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Ascending) Package Effective Date Package Discontinuation Date Status
80739-0812-12 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
80739-0812-18 80739-0812 Adagrasib KRAZATI 200.0 mg/1 Immunotherapy RAS Inhibitor KRAS G12C Oral Dec. 12, 2022 In Use
00378-3097-85 00378-3097 everolimus everolimus 5.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 15, 2022 In Use
16714-0671-01 16714-0671 Ondansetron Hydrochloride Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 28, 2007 Oct. 31, 2016 In Use
16714-0671-02 16714-0671 Ondansetron Hydrochloride Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov. 28, 2007 In Use
50090-0091-00 50090-0091 Dexamethasone Dexamethasone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Nov. 28, 2014 In Use
51991-0005-33 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Dec. 19, 2019 Dec. 31, 2022 In Use
51991-0005-90 51991-0005 Exemestane Exemestane 25.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Nov. 15, 2020 In Use
60505-0133-00 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0133-01 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0133-02 60505-0133 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-00 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 In Use
60505-0134-01 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
60505-0134-02 60505-0134 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 29, 2002 Dec. 31, 2022 In Use
61919-0087-10 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-15 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-20 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 10, 2017 In Use
61919-0087-30 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug. 29, 2019 In Use
61919-0087-60 61919-0087 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral March 10, 2017 In Use
61919-0326-21 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 18, 2019 In Use
61919-0326-05 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2014 In Use
61919-0326-30 61919-0326 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Sept. 19, 2022 In Use
63539-0688-03 63539-0688 palbociclib Ibrance 125.0 mg/1 Chemotherapy Cyclin Dependent Kinase Inhibitor CDK 4/6 Oral March 30, 2020 In Use
70934-0259-21 70934-0259 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 25, 2019 In Use
70934-0259-30 70934-0259 Prednisone Prednisone 10.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Feb. 4, 2019 In Use

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