| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 71288-0163-30 | 71288-0163 | Leucovorin calcium | Leucovorin calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | In Use | |
| 60505-0134-02 | 60505-0134 | Cyclosporine | Cyclosporine | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 29, 2002 | Dec 31, 2022 | In Use |
| 54868-3050-00 | 54868-3050 | Filgrastim | Neupogen | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous | Aug 14, 2006 | In Use | |
| 68083-0195-01 | 68083-0195 | Dexrazoxane for Injection | Dexrazoxane | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec 5, 2016 | In Use | |
| 00006-0464-01 | 00006-0464 | Aprepitant | Emend | 40.0 mg/1 | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Oral | Mar 26, 2003 | In Use | |
| 54868-5738-03 | 54868-5738 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Dec 29, 2006 | In Use | |
| 82448-0150-14 | 82448-0150 | Nirogacestat | OGSIVEO | 150.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Oral | Nov 27, 2023 | In Use | |
| 55513-0028-01 | 55513-0028 | Darbepoetin alfa | Aranesp | 200.0 ug/.4mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Aug 14, 2006 | In Use | ||
| 35356-0652-30 | 35356-0652 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 3, 2012 | Jun 1, 2016 | No Longer Used |
| 00944-2655-03 | 00944-2655 | Human Immunoglobulin G | Gammagard S/D | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | May 10, 1994 | In Use | ||
| 70518-1394-00 | 70518-1394 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Aug 29, 2018 | In Use | |
| 63629-4014-01 | 63629-4014 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | May 29, 2009 | In Use | |
| 00555-0484-01 | 00555-0484 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jun 30, 1990 | In Use | |
| 00781-1681-31 | 00781-1681 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 25, 2007 | Nov 30, 2019 | No Longer Used |
| 63629-4014-02 | 63629-4014 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Dec 12, 2013 | In Use | |
| 72865-0140-30 | 72865-0140 | Dutasteride | Dutasteride | 0.5 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Mar 9, 2020 | In Use | |
| 68071-1658-01 | 68071-1658 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Sep 14, 2017 | Dec 31, 2019 | In Use |
| 63629-4023-02 | 63629-4023 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Mar 18, 2010 | 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 | |
| 68152-0114-01 | 68152-0114 | levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Antiemetic | Antidote | Intravenous | Jan 2, 2019 | In Use | |
| 59353-0003-10 | 59353-0003 | Epoetin alfa-epbx | RETACRIT | 3000.0 [iU]/mL, 3000.0 [iU]/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Jun 18, 2018 | In Use | ||
| 72266-0152-01 | 72266-0152 | Zoledronic acid | Zoledronic acid | 5.0 mg/100mL | Ancillary Therapy | Bisphosphonate | Intravenous | Jun 12, 2023 | In Use | ||
| 68071-1904-01 | 68071-1904 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Feb 22, 2017 | In Use | |
| 00944-2625-03 | 00944-2625 | Human Immunoglobulin G, Immune Globulin Intravenous (Human) | GAMMAGARD | Ancillary Therapy | Immunostimulant | Human Immunoglobulin G | May 10, 1994 | Jun 21, 2014 | In Use | ||
| 63629-4093-02 | 63629-4093 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 3, 2009 | In Use |
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