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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
47781-0622-22 47781-0622 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 29, 2018 Mar 1, 2020 In Use
42291-0449-60 42291-0449 dronabinol DRONABINOL 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Mar 16, 2020 In Use
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
52584-0450-39 52584-0450 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug 1, 2010 Jan 17, 2017 No Longer Used
50742-0494-17 50742-0494 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 Jul 31, 2021 In Use
71288-0104-10 71288-0104 Levoleucovorin calcium Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 22, 2019 Apr 30, 2024 No Longer Used
50090-1200-03 50090-1200 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 17, 2017 In Use
00143-9890-05 00143-9890 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 26, 2006 Jul 15, 2014 In Use
58118-7355-08 58118-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 22, 2013 Sep 14, 2016 No Longer Used
72893-0004-01 72893-0004 Levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan 2, 2019 In Use
45963-0500-08 45963-0500 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Mar 28, 2007 Jul 31, 2019 In Use
60760-0654-10 60760-0654 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 22, 2022 In Use
23155-0196-43 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan 18, 2013 Jul 31, 2020 In Use
55111-0694-07 55111-0694 Palonosetron Palonosetron 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Mar 23, 2018 In Use
63187-0065-60 63187-0065 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 1, 2014 In Use
72266-0152-01 72266-0152 Zoledronic acid Zoledronic acid 5.0 mg/100mL Ancillary Therapy Bisphosphonate Intravenous Jun 12, 2023 In Use
68071-1987-04 68071-1987 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 23, 2017 In Use
55513-0006-01 55513-0006 Darbepoetin alfa Aranesp 200.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sep 11, 2006 In Use
00054-4496-13 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 In Use
68001-0355-25 68001-0355 Palonosetron Palonosetron 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 30, 2018 In Use
68084-0221-11 68084-0221 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 3, 2012 In Use
44206-0457-22 44206-0457 Human Immunoglobulin G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
00173-0570-00 00173-0570 ondansetron hydrochloride ZOFRAN 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 1, 1999 Feb 28, 2018 No Longer Used
55513-0005-01 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sep 11, 2006 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

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