| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 50742-0464-50 | 50742-0464 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Nov 23, 2018 | In Use | |
| 70436-0120-80 | 70436-0120 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 10, 2023 | In Use | |
| 55390-0825-01 | 55390-0825 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | Sep 28, 2001 | May 31, 2013 | No Longer Used | ||
| 00054-4497-05 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 69315-0185-12 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 50633-0220-20 | 50633-0220 | Uridine triacetate | VISTOGARD | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 31, 2024 | In Use | |
| 24535-0831-01 | 24535-0831 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 20, 2017 | In Use | |
| 70518-0916-01 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 18, 2019 | In Use | |
| 55154-7143-00 | 55154-7143 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 12, 2008 | Sep 30, 2024 | No Longer Used |
| 51407-0909-01 | 51407-0909 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 22, 2024 | In Use | |
| 60429-0265-01 | 60429-0265 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 26, 2012 | Dec 31, 2024 | No Longer Used |
| 54868-4773-00 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 54868-4773-01 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 68084-0284-01 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 17, 2008 | In Use | |
| 10135-0702-01 | 10135-0702 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jan 28, 2022 | In Use | |
| 70069-0820-01 | 70069-0820 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jun 18, 2024 | In Use | |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | In Use | |
| 54868-4773-02 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 68084-0284-11 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Aug 13, 2008 | In Use | |
| 54868-4773-03 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 67046-1619-03 | 67046-1619 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 2, 2025 | In Use | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | In Use | |
| 42291-0321-01 | 42291-0321 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jul 23, 2013 | In Use | |
| 70518-0916-00 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 20, 2017 | In Use | |
| 69315-0164-01 | 69315-0164 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jul 9, 2020 | In Use |
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