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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
69639-0105-01 69639-0105 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Intravenous Jun 15, 2020 In Use
57237-0062-90 57237-0062 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 30, 2007 In Use
76045-0103-20 76045-0103 ONDANSETRON HYDROCHLORIDE Ondansetron 4.0 mg/2mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 10, 2015 In Use
57237-0077-10 57237-0077 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 12, 2010 In Use
70518-3512-01 70518-3512 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 29, 2022 In Use
69784-0712-15 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 15, 2022 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
57881-0444-10 57881-0444 Ondansetron Zuplenz 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 8, 2014 In Use
57881-0448-01 57881-0448 Ondansetron Zuplenz 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 8, 2014 In Use
00074-0541-30 00074-0541 Cyclosporine Gengraf 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 20, 2016 Apr 27, 2018 No Longer Used
54868-5429-00 54868-5429 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Mar 20, 2008 Jun 30, 2013 No Longer Used
00172-7313-20 00172-7313 Cyclosporine Cyclosporine 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Mar 29, 2005 In Use
00172-7311-00 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Apr 28, 2005 Feb 28, 2017 No Longer Used
00591-2222-15 00591-2222 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec 1, 2008 Dec 31, 2017 In Use
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
80725-0712-04 80725-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 15, 2022 In Use
61919-0465-30 61919-0465 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2014 In Use
58118-0240-05 58118-0240 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 Jun 26, 2017 No Longer Used
58118-0240-08 58118-0240 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 Jun 26, 2017 No Longer Used
58118-0458-05 58118-0458 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
58118-1459-09 58118-1459 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
54868-5443-02 54868-5443 Anagrelide Hydrochloride Anagrelide Hydrochloride 0.5 mg/1 Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Jul 19, 2007 In Use
72162-1118-01 72162-1118 Pilocarpine hydrchloride Pilocarpine hydrchloride 5.0 mg/1 Ancillary Therapy Miscellaneous Agent Cholinergic Agonist Oral Oct 6, 2023 In Use
00172-7310-46 00172-7310 Cyclosporine Modified Cyclosporine Modified 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Mar 29, 2005 Mar 31, 2017 No Longer Used
69189-7732-01 69189-7732 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 4, 2016 May 24, 2017 No Longer Used

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