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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
50242-0917-01 50242-0917 Atezolizumab Tecentriq 1200.0 mg/20mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous May 18, 2016 In Use
70114-0340-01 70114-0340 Toripalimab-tpzi LOQTORZI 240.0 mg/6mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Oct 27, 2023 In Use
00003-6120-01 00003-6120 Nivolumab and hyaluronidase-nvhy OPDIVO QVANTIG 2000.0 U/mL, 120.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Subcutaneous Jan 2, 2025 In Use
50242-0933-01 50242-0933 Atezolizumab and hyaluronidase-tqjs Tecentriq Hybreza 1875.0 mg/15mL, 30000.0 U/15mL Immunotherapy Checkpoint Inhibitor PD-L1 Subcutaneous Sep 12, 2024 In Use
00006-3029-02 00006-3029 Pembrolizumab Keytruda 50.0 mg/2mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Sep 4, 2014 Dec 21, 2015 In Use
44087-3535-01 44087-3535 Avelumab Bavencio 20.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-L1 Intravenous Mar 23, 2017 In Use
72579-0121-01 72579-0121 Tislelizumab, Tislelizumab-jsgr TEVIMBRA 10.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Mar 14, 2024 In Use
00006-3026-04 00006-3026 Pembrolizumab Keytruda 25.0 mg/mL Immunotherapy Checkpoint Inhibitor PD-1 Intravenous Aug 1, 2019 In Use
00703-5140-01 00703-5140 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb 1, 1994 Sep 30, 2023 No Longer Used
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb 14, 2017 Jul 31, 2019 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
63323-0710-59 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jun 12, 1997 Sep 30, 2023 No Longer Used
67457-0148-10 67457-0148 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 3, 2012 Sep 30, 2016 No Longer Used
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
67457-0529-20 67457-0529 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 23, 2019 In Use
55390-0825-01 55390-0825 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Sep 28, 2001 May 31, 2013 No Longer Used
63323-0711-00 63323-0711 Leucovorin Calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
66220-0017-03 66220-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Aug 1, 2016 Oct 31, 2020 No Longer Used
72266-0120-01 72266-0120 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 In Use
63323-0710-50 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
25021-0201-68 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 13, 2019 In Use
55390-0009-01 55390-0009 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Jun 8, 2000 Jun 30, 2013 No Longer Used
00703-4805-03 00703-4805 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 1, 2002 Jan 31, 2013 No Longer Used
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 8, 2017 In Use

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