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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
42806-0133-24 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
00555-0484-02 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 15, 2008 Feb 28, 2019 No Longer Used
52125-0453-02 52125-0453 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 12, 2013 Mar 12, 2014 No Longer Used
68083-0161-10 68083-0161 Mesna Injection Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 20, 2017 In Use
47335-0581-42 47335-0581 Amifostine Amifostine 50.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 14, 2008 Jul 31, 2013 No Longer Used
60687-0227-94 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 17, 2017 In Use
51991-0942-98 51991-0942 Dexrazoxane Hydrochloride Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jun 26, 2017 Aug 31, 2024 No Longer Used
55390-0347-01 55390-0347 Mesna Mesna Ancillary Therapy Chemoprotective Detoxifying Agent Mar 3, 2008 Jul 31, 2012 No Longer Used
72579-0121-01 72579-0121 Tislelizumab, Tislelizumab-jsgr TEVIMBRA 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Mar 14, 2024 In Use
44087-3535-01 44087-3535 Avelumab Bavencio 20.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Mar 23, 2017 In Use
00003-3774-12 00003-3774 Nivolumab Opdivo 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec 22, 2014 In Use
50242-0933-86 50242-0933 Atezolizumab and hyaluronidase-tqjs Tecentriq Hybreza 1875.0 mg/15mL, 30000.0 U/15mL Immunotherapy Checkpoint Inhibitor PD-L1 Subcutaneous Sep 12, 2024 In Use
00003-3772-11 00003-3772 Nivolumab Opdivo 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec 22, 2014 In Use
50881-0006-03 50881-0006 Retifanlimab-dlwr ZYNYZ 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Mar 22, 2023 In Use
72579-0125-00 72579-0125 Tislelizumab-jsgr TEVIMBRA 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Jul 13, 2026 In Use
00006-5083-01 00006-5083 Pembrolizumab and berahyaluronidase alfa-pmph KEYTRUDA QLEX 2000.0 U/mL, 165.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Sep 19, 2025 In Use
83444-0301-10 83444-0301 Cosibelimab UNLOXCYT 300.0 mg/5mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Jun 30, 2025 In Use
83718-0000-01 83718-0000 Toripalimab-tpzi LOQTORZI 240.0 mg/6mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Oct 27, 2023 In Use
00173-0898-03 00173-0898 dostarlimab Jemperli 50.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Apr 22, 2021 In Use
00003-3756-14 00003-3756 nivolumab OPDIVO 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug 30, 2021 In Use
00003-3734-13 00003-3734 Nivolumab OPDIVO 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Dec 8, 2017 In Use
50242-0918-86 50242-0918 Atezolizumab TECENTRIQ 840.0 mg/14mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Mar 8, 2019 Mar 18, 2019 In Use

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