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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
68001-0417-37 68001-0417 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 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
52584-0450-39 52584-0450 Metoclopramide Hydrochloride Metoclopramide 10.0 mg/2mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intramuscular, intravenous, Intravenous Aug 1, 2010 Jan 17, 2017 No Longer Used
68001-0246-04 68001-0246 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 13, 2018 In Use
77651-1112-01 77651-1112 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2020 In Use
54868-5749-01 54868-5749 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 16, 2007 In Use
00409-3414-11 00409-3414 Metoclopramide Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Aug 26, 2024 In Use
00078-0387-25 00078-0387 Zoledronic Acid Zometa 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Aug 20, 2001 Nov 30, 2020 No Longer Used
00006-4119-03 00006-4119 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
00078-0680-19 00078-0680 Ondansetron Hydrochloride ZOFRAN 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 23, 2017 Oct 31, 2019 No Longer Used
67457-0208-50 67457-0208 Dexrazoxane Dexrazoxane Hydrochloride Ancillary Therapy Chemoprotective Detoxifying Agent Nov 18, 2011 In Use
70121-1570-07 70121-1570 Filgrastim RELEUKO 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb 25, 2022 In Use
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
68788-8377-09 68788-8377 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 28, 2023 In Use
64380-0129-02 64380-0129 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Aug 16, 2022 In Use
62584-0827-21 62584-0827 Cyclosporine Cyclosporine Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Dec 11, 2009 Sep 30, 2011 No Longer Used
66220-0637-31 66220-0637 Granisetron SANCUSO 3.1 mg/24h Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Transdermal Jul 16, 2024 In Use
16729-0365-66 16729-0365 palonosetron hydrochloride palonosetron hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Mar 23, 2018 Nov 30, 2022 No Longer Used
16714-0221-01 16714-0221 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 29, 2008 Aug 31, 2021 No Longer Used
55111-0156-30 55111-0156 Ondansetron Hydrochloride ONDANSETRON 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
63323-0373-02 63323-0373 ONDANSETRON HYDROCHLORIDE Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 18, 2009 In Use
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Mar 11, 2019 In Use
70518-2378-02 70518-2378 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan 3, 2020 Oct 28, 2020 No Longer Used
16714-0200-30 16714-0200 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 27, 2021 In Use

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