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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
63459-0910-17 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 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
54569-5873-02 54569-5873 Ondansetron, ondansetron hydrochloride Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 4, 2016 In Use
00093-5742-65 00093-5742 Cyclosporine Cyclosporine Modified 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Jan 31, 2023 No Longer Used
63629-8439-01 63629-8439 Pilocarpine hydrchloride Pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Feb 9, 2022 In Use
44206-0457-95 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
00187-1221-03 00187-1221 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral Nov 1, 2009 Nov 13, 2017 No Longer Used
59923-0603-10 59923-0603 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Aug 6, 2013 In Use
55154-2873-05 55154-2873 Ondansetron Hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 19, 2010 Mar 28, 2018 No Longer Used
00006-4109-02 00006-4109 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant GARDASIL 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jun 8, 2006 In Use
00069-1311-10 00069-1311 epoetin alfa-epbx RETACRIT 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Nov 9, 2020 In Use
50268-0621-15 50268-0621 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 5, 2016 In Use
42254-0077-30 42254-0077 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 In Use
63629-4023-00 63629-4023 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 18, 2013 In Use
52125-0334-16 52125-0334 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 25, 2013 Nov 26, 2013 No Longer Used
70114-0130-01 70114-0130 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 22, 2023 In Use
51662-1245-03 51662-1245 ONDANSETRON ONDANSETRON 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Sep 23, 2018 In Use
55390-0060-02 55390-0060 Dexrazoxane Dexrazoxane Ancillary Therapy Chemoprotective Detoxifying Agent Mar 31, 2005 May 31, 2013 No Longer Used
35356-0679-30 35356-0679 ONDANSETRON HYDROCHLORIDE ONDANSETRON HYDROCHLORIDE 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 30, 2019 In Use
58118-1459-06 58118-1459 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
00781-3010-72 00781-3010 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jun 27, 2007 Mar 31, 2017 No Longer Used
55154-6976-05 55154-6976 ONDANSETRON Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Oct 16, 2008 In Use
55513-0126-01 55513-0126 Epoetin alfa Epogen 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 30, 1989 In Use
17478-0546-05 17478-0546 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Oct 1, 2009 In Use
54868-5089-05 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 9, 2004 Jun 30, 2011 No Longer Used

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