| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
| 60687-0375-21 | 60687-0375 | DRONABINOL | DRONABINOL | 2.5 mg/1 | Ancillary Therapy | Antiemetic | Cannabinoid | Oral | Apr 29, 2024 | May 31, 2026 | In Use |
| 00006-4121-02 | 00006-4121 | Human Papillomavirus 9-valent Vaccine, Recombinant | GARDASIL 9 | 40.0 ug/.5mL, 60.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL, 30.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Dec 10, 2014 | In Use | |
| 00093-7302-56 | 00093-7302 | Ondansetron | Ondansetron | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 3, 2007 | Feb 23, 2010 | No Longer Used | |
| 59676-0312-00 | 59676-0312 | Erythropoietin | Procrit | 10000.0 [iU]/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Aug 8, 2011 | In Use | ||
| 63187-0693-20 | 63187-0693 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 1, 2016 | In Use | |
| 00054-0143-08 | 00054-0143 | Granisetron Hydrochloride | Granisetron Hydrochloride | 1.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Dec 31, 2007 | In Use | |
| 57237-0078-50 | 57237-0078 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Sep 30, 2024 | In Use | |
| 55513-0283-10 | 55513-0283 | Epoetin alfa | Epogen | 10000.0 [iU]/mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Dec 5, 1994 | In Use | ||
| 00006-3061-04 | 00006-3061 | Fosaprepitant Dimeglumine | Emend | 150.0 mg/5mL | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Intravenous | Feb 3, 2017 | May 25, 2021 | 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 |
| 63187-0636-15 | 63187-0636 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | May 2, 2016 | In Use | |
| 00006-3941-01 | 00006-3941 | Fosaprepitant Dimeglumine | Emend | 150.0 mg/5mL | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Intravenous | Nov 19, 2010 | In Use | |
| 63323-0673-05 | 63323-0673 | Palonosetron | Palonosetron | 0.25 mg/5mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intravenous | Sep 19, 2018 | In Use | |
| 51862-0458-01 | 51862-0458 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Jul 18, 2016 | In Use | |
| 00703-7971-03 | 00703-7971 | Granisetron Hydrochloride | Granisetron Hydrochloride | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Jan 3, 2008 | Feb 29, 2012 | No Longer Used | ||
| 65862-0686-90 | 65862-0686 | Finasteride | Finasteride | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Nov 5, 2013 | Sep 30, 2015 | No Longer Used | |
| 00378-1003-94 | 00378-1003 | Granisetron Hydrochloride | Granisetron Hydrochloride | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 30, 2008 | Nov 30, 2012 | No Longer Used | |
| 25021-0826-66 | 25021-0826 | Zoledronic Acid | Zoledronic Acid | 0.04 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | Sep 1, 2015 | Nov 30, 2018 | In Use | |
| 68788-8365-05 | 68788-8365 | Ondansetron Hydrochloride | Ondansetron | 4.0 mg/5mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Feb 1, 2023 | Nov 1, 2024 | No Longer Used |
| 00078-0241-61 | 00078-0241 | Cyclosporine | Sandimmune | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Mar 22, 2010 | In Use | |
| 00078-0246-61 | 00078-0246 | Cyclosporine | NeOral | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 13, 2012 | In Use | |
| 00078-0248-61 | 00078-0248 | cyclosporine | NeOral | 100.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 13, 2012 | In Use | |
| 00378-8170-91 | 00378-8170 | Dronabinol | Dronabinol | 2.5 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | Nov 1, 2011 | Mar 31, 2016 | No Longer Used |
| 66658-0113-03 | 66658-0113 | Palifermin | KEPIVANCE | 5.16 mg/1.2mL | Ancillary Therapy | Epithelial Growth Factor | Keratinocyte Growth Factor/rHuKGF | Intravenous | Aug 4, 2023 | In Use |
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