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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 Package Discontinuation Date Status
67457-0528-10 67457-0528 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 23, 2019 In Use
00338-0720-01 00338-0720 PEMETREXED PEMETREXED 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Aug 18, 2022 In Use
00703-5140-01 00703-5140 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb 1, 1994 Sep 30, 2023 No Longer Used
83703-0561-01 83703-0561 PEMETREXED PEMETREXED 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Aug 18, 2022 In Use
68001-0648-36 68001-0648 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Aug 14, 2025 In Use
70121-2453-01 70121-2453 Pemetrexed disodium PEMRYDI RTU 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Jun 6, 2023 In Use
71288-0166-10 71288-0166 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous May 25, 2022 In Use
00143-9554-01 00143-9554 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 28, 1988 In Use
83654-0105-01 83654-0105 Penpulimab Penpulimab 100.0 mg/10mL Immunotherapy Monoclonal Antibody PD-1 Intravenous Apr 23, 2025 In Use
68001-0416-36 68001-0416 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 In Use
71288-0161-20 71288-0161 Leucovorin calcium Leucovorin calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 In Use
72603-0325-01 72603-0325 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Oct 1, 2024 In Use
63759-3048-01 63759-3048 Pemetrexed disodium Pemetrexed 100.0 mg/10mL Chemotherapy Antimetabolite Folic Acid Analog Intravenous Jan 1, 2024 In Use
55150-0305-10 55150-0305 Dexamethasone Sodium Phosphate Dexamethasone Sodium Phosphate 100.0 mg/10mL Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Intramuscular, Intravenous Jun 7, 2019 In Use
00703-5748-11 00703-5748 Cisplatin Cisplatin 100.0 mg/100mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Jun 1, 2000 In Use
47781-0610-23 47781-0610 Cisplatin Cisplatin 100.0 mg/100mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Sep 25, 2017 Mar 1, 2020 No Longer Used
83858-0105-30 83858-0105 Dasatinib PHYRAGO 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Aug 1, 2024 In Use
50419-0391-01 50419-0391 LAROTRECTINIB VITRAKVI 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor TRK Oral Jul 26, 2019 In Use
00078-0248-15 00078-0248 cyclosporine NeOral 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 14, 1995 In Use
40051-0606-51 40051-0606 Temozolomide Temozolomide 100.0 mg/1 Chemotherapy Alkylating Agent Tetrazine Oral Aug 1, 2016 In Use
70771-1394-09 70771-1394 Imatinib mesylate Imatinib mesylate 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Jan 21, 2021 In Use
72064-0210-90 72064-0210 pralsetinib GAVRETO 100.0 mg/1 Chemotherapy Enzyme Inhibitor RET, DDR1, TRKC, FLT3, JAK1/2, TRKA, VEGFR2, PDGFRB, FGFR1 Oral Sep 4, 2020 Apr 30, 2022 No Longer Used
68084-0921-95 68084-0921 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb 26, 2015 In Use
66828-0030-01 66828-0030 Imatinib Mesylate Gleevec 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral May 15, 2001 In Use
00310-0512-28 00310-0512 Acalabrutinib Calquence 100.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BTK Oral Apr 1, 2018 Jul 31, 2021 In Use

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