| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 55513-0546-20 | 55513-0546 | Filgrastim | Neupogen | 480.0 ug/1.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Oct 1, 2025 | In Use | |
| 55154-2395-00 | 55154-2395 | Cyclosporine Modified | Gengraf | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 1, 2013 | In Use | |
| 68071-3380-03 | 68071-3380 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jul 18, 2017 | In Use | |
| 69639-0102-01 | 69639-0102 | Fosnetupitant and Palonosetron | AKYNZEO | 260.0 mg/1, 0.28 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 | Intravenous | Apr 20, 2018 | In Use | |
| 50090-1200-01 | 50090-1200 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Nov 28, 2014 | In Use | |
| 64380-0763-04 | 64380-0763 | Dutasteride | Dutasteride | 0.5 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Dec 9, 2016 | In Use | |
| 68788-9044-09 | 68788-9044 | Dutasteride | Avodart | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Dec 10, 2002 | Nov 30, 2013 | No Longer Used | |
| 55111-0172-30 | 55111-0172 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Feb 28, 2007 | In Use | |
| 55513-0091-91 | 55513-0091 | Darbepoetin alfa | Aranesp | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Sep 25, 2006 | Feb 28, 2009 | No Longer Used | |||
| 00054-4499-11 | 00054-4499 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 68001-0648-36 | 68001-0648 | Leucovorin Calcium | Leucovorin Calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 10, 2025 | In Use | |
| 80425-0074-05 | 80425-0074 | Ondansetron HCL | Ondansetron HCL | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Sep 16, 2020 | In Use | |
| 00185-0933-87 | 00185-0933 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 23, 2014 | Nov 21, 2015 | No Longer Used |
| 57881-0448-10 | 57881-0448 | Ondansetron | Zuplenz | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Oct 8, 2014 | In Use | |
| 00074-3108-32 | 00074-3108 | Cyclosporine | Gengraf | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Nov 1, 2015 | In Use | |
| 55513-0005-01 | 55513-0005 | Darbepoetin alfa | Aranesp | 100.0 ug/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Sep 11, 2006 | In Use | ||
| 42291-0280-30 | 42291-0280 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Feb 26, 2013 | Nov 4, 2015 | In Use |
| 54868-5801-00 | 54868-5801 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 30, 2007 | In Use | |
| 68071-4044-03 | 68071-4044 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Aug 10, 2017 | Dec 31, 2019 | No Longer Used |
| 83980-0012-01 | 83980-0012 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 19, 2025 | In Use | |
| 67457-0600-20 | 67457-0600 | Levoleucovorin | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Oct 21, 2015 | Apr 30, 2019 | No Longer Used |
| 55154-4396-00 | 55154-4396 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jul 13, 2015 | In Use | |
| 55513-0478-01 | 55513-0478 | Epoetin alfa | Epogen | 20000.0 [iU]/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Mar 3, 1997 | In Use | ||
| 42806-0358-01 | 42806-0358 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 16, 2020 | In Use | |
| 63459-0920-59 | 63459-0920 | tbo-filgrastim | GRANIX | 480.0 ug/1.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Nov 7, 2018 | Sep 30, 2026 | In Use |
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