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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
54868-5802-00 54868-5802 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 13, 2007 In Use
54868-5867-00 54868-5867 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Mar 20, 2008 Jun 30, 2013 No Longer Used
25021-0779-01 25021-0779 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec 1, 2010 Jun 1, 2019 No Longer Used
25021-0779-04 25021-0779 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec 1, 2010 Oct 15, 2012 No Longer Used
25021-0781-04 25021-0781 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec 1, 2010 Aug 1, 2019 No Longer Used
25021-0782-20 25021-0782 ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Aug 30, 2012 Nov 30, 2021 No Longer Used
25021-0783-05 25021-0783 palonosetron hydrochloride palonosetron hydrochloride 0.05 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jun 15, 2018 In Use
25021-0784-10 25021-0784 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Dec 15, 2019 In Use
25021-0802-10 25021-0802 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan 15, 2010 Dec 31, 2014 No Longer Used
25021-0803-10 25021-0803 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan 15, 2010 Dec 31, 2014 No Longer Used
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0816-67 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jan 31, 2022 In Use
43598-0233-11 43598-0233 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Aug 21, 2023 In Use
54868-5887-00 54868-5887 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 8, 2008 In Use
43598-0308-23 43598-0308 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Nov 6, 2023 In Use
25021-0826-67 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sep 1, 2015 In Use
25021-0826-82 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Mar 2, 2013 In Use
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Mar 11, 2019 In Use
54868-5887-01 54868-5887 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 8, 2008 In Use
54868-5888-00 54868-5888 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 8, 2008 In Use
30698-0120-05 30698-0120 Dolasetron mesylate Anzemet 50.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 May 24, 2021 In Use
30698-0121-05 30698-0121 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 May 24, 2021 In Use

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