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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
24724-0030-01 24724-0030 Letrozole Letrozole 2.5 mg/1 Hormonal Therapy Aromatase Inhibitor Oral Jun 15, 2011 In Use
42806-0133-24 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
71205-0908-00 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
69315-0186-24 69315-0186 Leucovorin calcium Leucovorin calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
67457-0530-35 67457-0530 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan 2, 2019 In Use
71205-0908-11 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
00703-5145-91 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 13, 2013 Apr 30, 2023 No Longer Used
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 15, 2018 In Use
60687-0227-94 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 24, 2017 In Use
42806-0134-34 42806-0134 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
55390-0824-01 55390-0824 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Jun 28, 1996 Apr 30, 2014 No Longer Used
69315-0187-25 69315-0187 Leucovorin calcium Leucovorin calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
25021-0813-10 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
54868-3310-03 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jul 31, 2020 In Use
71288-0161-20 71288-0161 Leucovorin calcium Leucovorin calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 In Use
42806-0134-24 42806-0134 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
54868-3310-04 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
52125-0453-02 52125-0453 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 12, 2013 Mar 12, 2014 No Longer Used
69315-0185-24 69315-0185 Leucovorin calcium Leucovorin calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use

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