| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 70436-0210-80 | 70436-0210 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug 1, 2023 | In Use | |
| 55390-0053-01 | 55390-0053 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | May 1, 1996 | Apr 30, 2014 | No Longer Used | ||
| 69315-0184-03 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 51079-0581-01 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 26, 1996 | In Use | |
| 00054-4498-10 | 00054-4498 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 67457-0529-20 | 67457-0529 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 23, 2019 | 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 | |
| 25021-0201-68 | 25021-0201 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 30, 2013 | Sep 13, 2019 | In Use |
| 76126-0075-01 | 76126-0075 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Jul 19, 2014 | Sep 1, 2017 | No Longer Used |
| 68001-0285-40 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 55390-0009-01 | 55390-0009 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | Jun 8, 2000 | Jun 30, 2013 | No Longer Used | ||
| 50742-0181-30 | 50742-0181 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 00054-4497-05 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | 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 |
| 72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan 2, 2019 | Oct 31, 2023 | No Longer Used |
| 72205-0248-01 | 72205-0248 | Dexrazoxane | Dexrazoxane | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 9, 2025 | In Use | |
| 69315-0185-12 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 68001-0285-36 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 50742-0184-25 | 50742-0184 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 67457-0148-10 | 67457-0148 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 3, 2012 | Sep 30, 2016 | No Longer Used |
| 00703-4805-03 | 00703-4805 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | May 1, 2002 | Jan 31, 2013 | No Longer Used |
| 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 | |
| 70436-0116-82 | 70436-0116 | Leucovorin calcium | Leucovorin Calcium | 50.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 10, 2023 | 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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