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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
67457-0530-35 67457-0530 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan 2, 2019 In Use
68001-0418-38 68001-0418 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 In Use
25021-0816-67 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jan 31, 2022 In Use
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jun 12, 1997 Sep 30, 2023 No Longer Used
00143-9552-01 00143-9552 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 20, 2000 In Use
00703-5145-91 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 13, 2013 Apr 30, 2023 No Longer Used
68001-0650-38 68001-0650 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 10, 2025 In Use
57894-0501-01 57894-0501 Amivantamab Rybrevant 350.0 mg/1 Immunotherapy Monoclonal Antibody EGFR, MET Intravenous May 21, 2021 In Use
70436-0119-80 70436-0119 Leucovorin calcium Leucovorin Calcium 350.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 27, 2024 In Use
59651-0635-03 59651-0635 ISOTRETINOIN ISOTRETINOIN 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Jan 29, 2024 In Use
00591-2501-15 00591-2501 Isotretinoin Isotretinoin 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Apr 29, 2021 In Use
10631-0134-31 10631-0134 Isotretinoin Absorica 35.0 mg/1 Hormonal Therapy Immunomodulator Retinoic Acid Derivative Oral Feb 17, 2015 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
72187-0102-03 72187-0102 Elacestrant ORSERDU 345.0 mg/1 Hormonal Therapy Estrogen Receptor Antagonist ERĪ± Oral Jan 27, 2023 In Use
55513-0504-50 55513-0504 Sotorasib LUMAKRAS 320.0 mg/1 Chemotherapy RAS Inhibitor KRAS G12C Oral Feb 2, 2023 In Use
36000-0014-06 36000-0014 ondansetron hydrochloride and dextrose Ondansetron hydrochloride and dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Apr 14, 2009 Feb 23, 2018 No Longer Used
00143-9771-06 00143-9771 Ondansetron Hydrochloride and Dextrose Ondansetron Hydrochloride and Dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Aug 4, 2009 In Use
00069-0700-12 00069-0700 Ondansetron hydrochloride and dextrose Ondansetron hydrochloride and dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 1, 2009 Nov 1, 2012 In Use
47426-0401-10 47426-0401 APREPITANT APONVIE 32.0 mg/4.4mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Mar 6, 2023 In Use
68001-0560-55 68001-0560 Methylprednisolone Methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Jan 31, 2023 In Use
68382-0919-05 68382-0919 methylprednisolone methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2018 In Use
67296-1759-01 67296-1759 Methylprednisolone Methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2018 In Use
68382-0919-77 68382-0919 methylprednisolone methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2018 In Use
70771-1351-08 70771-1351 methylprednisolone methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 1, 2018 In Use
59762-0051-01 59762-0051 Methylprednisolone Methylprednisolone 32.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Mar 25, 2013 In Use

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