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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
63323-0710-50 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
63323-0710-59 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
63323-0711-00 63323-0711 Leucovorin Calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
63323-0735-10 63323-0735 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 19, 2002 Aug 27, 2015 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
59676-0340-00 59676-0340 Erythropoietin Procrit 40000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 8, 2011 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
43598-0671-11 43598-0671 Fosaprepitant Fosaprepitant 150.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Mar 20, 2020 In Use
81952-0911-01 81952-0911 FOSAPREPITANT FOSAPREPITANT 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jul 14, 2023 In Use
55154-2396-00 55154-2396 cyclosporine Gengraf 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Mar 31, 2016 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
49884-0867-05 49884-0867 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
49884-0867-15 49884-0867 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
63629-1585-01 63629-1585 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 30, 2007 Feb 28, 2017 No Longer Used
53097-0572-60 53097-0572 Dronabinol MARINOL 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Mar 3, 2021 In Use
49884-0868-01 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
49884-0868-02 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 30, 2008 Feb 29, 2020 In Use
49884-0868-05 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
00069-0292-10 00069-0292 filgrastim-aafi Nivestym 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Sep 24, 2018 In Use
49884-0868-15 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
63629-4306-01 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2013 In Use
63629-4306-03 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2013 In Use
63629-4306-04 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 20, 2010 In Use
49884-0869-01 49884-0869 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
72205-0026-01 72205-0026 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use

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