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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
57664-0021-97 57664-0021 Isotretinoin Isotretinoin 20.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0022-97 57664-0022 Isotretinoin Isotretinoin 25.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0023-97 57664-0023 Isotretinoin Isotretinoin 30.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0024-97 57664-0024 Isotretinoin Isotretinoin 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 In Use
57664-0025-97 57664-0025 Isotretinoin Isotretinoin 40.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Dec. 29, 2020 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
57377-0060-01 57377-0060 Testosterone, USP and Anastrozole Testozole 4.0 mg/1, 60.0 mg/1 Hormonal Therapy Androgen/Aromatase Inhibitor Subcutaneous Jan. 1, 2021 In Use
67296-1413-01 67296-1413 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2021 In Use
67296-1413-02 67296-1413 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2021 In Use
67296-1413-04 67296-1413 Dexamethasone Dexamethasone 6.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2021 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
67296-1331-07 67296-1331 Prednisone Prednisone 5.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 1, 2021 In Use
67296-0902-02 67296-0902 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 1, 2021 In Use
68788-7833-02 68788-7833 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 5, 2021 In Use
63629-5269-00 63629-5269 Anastrozole Anastrozole 1.0 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jan. 5, 2021 In Use
55513-0224-01 55513-0224 rituximab-arrx Riabni 100.0 mg/10mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 6, 2021 In Use
55513-0326-01 55513-0326 rituximab-arrx Riabni 500.0 mg/50mL Immunotherapy Monoclonal Antibody CD20 Intravenous Jan. 6, 2021 In Use
70700-0278-97 70700-0278 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Jan. 6, 2021 In Use
70518-1585-01 70518-1585 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan. 6, 2021 Aug. 11, 2021 In Use
70518-2982-00 70518-2982 Methylprednisolone Methylprednisolone 4.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan. 7, 2021 In Use
63020-0536-30 63020-0536 ponatinib hydrochloride Iclusig 10.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan. 11, 2021 In Use
51662-1297-03 51662-1297 DEXAMETHASONE SODIUM PHOSPHATE DEXAMETHASONE SODIUM PHOSPHATE 4.0 mg/mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intra-articular, Intralesional, Intramuscular, Intravenous, Soft Tissue Jan. 11, 2021 In Use
17856-0090-01 17856-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan. 11, 2021 In Use

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