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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
58181-3030-05 58181-3030 Lomustine Lomustine 10.0 mg/1 Chemotherapy Alkylating Agent Nitrosourea Oral Jul 29, 2014 Jan 14, 2016 No Longer Used
58181-3031-05 58181-3031 Lomustine Lomustine 40.0 mg/1 Chemotherapy Alkylating Agent Nitrosourea Oral Jul 29, 2014 Jan 14, 2016 No Longer Used
58181-3032-05 58181-3032 Lomustine Lomustine 100.0 mg/1 Chemotherapy Alkylating Agent Nitrosourea Oral Sep 27, 2013 Jan 14, 2016 No Longer Used
64764-0800-56 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov 23, 2021 In Use
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov 23, 2021 In Use
47335-0082-50 47335-0082 Doxorubicin Hydrochloride LIPODOX 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Feb 9, 2012 May 29, 2015 In Use
47335-0083-50 47335-0083 Doxorubicin Hydrochloride Lipodox 50 2.0 mg/mL Chemotherapy Antitumor Antibiotic Anthracycline Intravenous Feb 9, 2012 May 29, 2015 In Use
61755-0008-01 61755-0008 cemiplimab-rwlc LIBTAYO 50.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sep 28, 2018 In Use
70121-1099-01 70121-1099 Levoleucovorin Levoleucovorin 50.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intravenous Feb 13, 2017 In Use
50742-0495-25 50742-0495 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 Jun 30, 2021 In Use
50742-0494-17 50742-0494 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 Jul 31, 2021 In Use
00591-4130-54 00591-4130 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb 6, 2017 May 31, 2019 No Longer Used
00781-3201-94 00781-3201 Levoleucovorin Levoleucovorin 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Apr 23, 2015 Apr 30, 2023 No Longer Used
72266-0121-01 72266-0121 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 In Use
72266-0120-01 72266-0120 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
71288-0104-10 71288-0104 Levoleucovorin calcium Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 22, 2019 Apr 30, 2024 No Longer Used
00143-9558-01 00143-9558 Levoleucovorin Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jul 7, 2016 In Use
68083-0279-01 68083-0279 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb 14, 2017 Jul 31, 2019 In Use
16714-0915-01 16714-0915 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 16, 2019 In Use
68083-0278-01 68083-0278 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
43598-0773-11 43598-0773 LEVOLEUCOVORIN LEVOLEUCOVORIN 250.0 mg/25mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use

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