| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00006-4109-06 | 00006-4109 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | 40.0 ug/.5mL, 40.0 ug/.5mL, 20.0 ug/.5mL, 20.0 ug/.5mL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Jun 8, 2006 | May 6, 2011 | In Use |
| 55513-0546-20 | 55513-0546 | Filgrastim | Neupogen | 480.0 ug/1.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Oct 1, 2025 | In Use | |
| 60687-0227-11 | 60687-0227 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan 24, 2017 | In Use | |
| 51655-0196-87 | 51655-0196 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Mar 13, 2023 | In Use | |
| 35356-0210-30 | 35356-0210 | Dutasteride | Avodart | 0.5 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Mar 26, 2012 | Dec 31, 2016 | No Longer Used |
| 54348-0819-08 | 54348-0819 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 10, 2019 | In Use | |
| 54868-5867-00 | 54868-5867 | Darbepoetin alfa | Aranesp | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Mar 20, 2008 | Jun 30, 2013 | No Longer Used | |||
| 25021-0826-67 | 25021-0826 | Zoledronic Acid | Zoledronic Acid | 0.04 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | Sep 1, 2015 | In Use | ||
| 72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan 2, 2019 | Oct 31, 2023 | No Longer Used |
| 68084-0879-95 | 68084-0879 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 30, 2015 | In Use | |
| 55513-0209-20 | 55513-0209 | Filgrastim | Neupogen | 480.0 ug/.8mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Oct 1, 2025 | In Use | |
| 00054-4497-05 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 43063-0052-04 | 43063-0052 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 16, 2010 | Aug 20, 2018 | No Longer Used |
| 67457-0472-10 | 67457-0472 | Pamidronate Disodium | Pamidronate Disodium | 3.0 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | May 10, 2011 | Nov 30, 2018 | No Longer Used | |
| 70121-1694-02 | 70121-1694 | Plerixafor | Plerixafor | 24.0 mg/1.2mL | Ancillary Therapy | Immunostimulant | Stem Cell Mobilizer | Subcutaneous | Jul 25, 2023 | In Use | |
| 60505-0133-01 | 60505-0133 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 29, 2002 | Dec 31, 2022 | 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 |
| 70121-1568-07 | 70121-1568 | Filgrastim | RELEUKO | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Intravenous, Subcutaneous | Feb 25, 2022 | In Use | |
| 65862-0391-02 | 65862-0391 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 12, 2024 | In Use | |
| 65862-0188-10 | 65862-0188 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 31, 2007 | In Use | |
| 68071-1547-01 | 68071-1547 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 26, 2017 | Dec 31, 2019 | In Use |
| 50090-1936-02 | 50090-1936 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Feb 25, 2022 | In Use | |
| 00143-9552-01 | 00143-9552 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Apr 20, 2000 | In Use | |
| 55648-0662-02 | 55648-0662 | Granisetron Hydrochloride | Granisetron Hydrochloride | 0.1 mg/mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intravenous | Mar 3, 2008 | In Use | |
| 65862-0149-61 | 65862-0149 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jun 30, 2011 | Oct 25, 2011 | In Use |
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