| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00006-4119-03 | 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 | |
| 49349-0858-08 | 49349-0858 | Ondansetron | Zofran | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Dec 19, 2011 | Oct 25, 2016 | No Longer Used |
| 17856-0691-07 | 17856-0691 | Ondansetron | Ondansetron | 4.0 mg/5mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 17, 2024 | In Use | |
| 00338-1305-03 | 00338-1305 | Mesna | Mesnex | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec 30, 1988 | In Use | |
| 51655-0813-54 | 51655-0813 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 10, 2021 | In Use | |
| 55289-0559-05 | 55289-0559 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 6, 2010 | Aug 2, 2018 | No Longer Used |
| 33261-0761-01 | 33261-0761 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 27, 2007 | In Use | |
| 50742-0184-25 | 50742-0184 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 54868-5429-00 | 54868-5429 | Darbepoetin alfa | Aranesp | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Mar 20, 2008 | Jun 30, 2013 | No Longer Used | |||
| 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 |
| 00781-3312-75 | 00781-3312 | Palonosetron Hydrochloride | Palonosetron Hydrochloride | 0.25 mg/5mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intravenous | Mar 23, 2018 | In Use | |
| 35356-0652-20 | 35356-0652 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 3, 2012 | Jun 1, 2016 | No Longer Used |
| 69315-0186-24 | 69315-0186 | Leucovorin calcium | Leucovorin calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 00006-0464-05 | 00006-0464 | Aprepitant | Emend | 40.0 mg/1 | Ancillary Therapy | Antiemetic | Substance P/Neurokinin 1 | Oral | Mar 26, 2003 | Dec 31, 2020 | In Use |
| 52125-0833-01 | 52125-0833 | Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant | GARDASIL | Ancillary Therapy | Protective Agent | HPV Vaccine | Intramuscular | Feb 13, 2014 | Feb 11, 2015 | No Longer Used | |
| 63187-0199-10 | 63187-0199 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Oct 1, 2014 | In Use | |
| 70518-3512-06 | 70518-3512 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jan 14, 2024 | In Use | |
| 63459-0910-36 | 63459-0910 | tbo-filgrastim | Granix | 300.0 ug/.5mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Mar 2, 2015 | In Use | |
| 55513-0025-01 | 55513-0025 | Darbepoetin alfa | Aranesp | 100.0 ug/.5mL | Ancillary Therapy | Erythropoiesis-Stimulating Agent | Intravenous, Subcutaneous | Feb 18, 2011 | In Use | ||
| 63187-0693-10 | 63187-0693 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 1, 2016 | In Use | |
| 63739-0495-40 | 63739-0495 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Nov 22, 2010 | Sep 30, 2012 | In Use |
| 68084-0175-11 | 68084-0175 | Dronabinol | Dronabinol | 5.0 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | Sep 23, 2010 | Oct 31, 2019 | No Longer Used |
| 71288-0160-10 | 71288-0160 | Leucovorin calcium | Leucovorin calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | In Use | |
| 51655-0196-53 | 51655-0196 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 20, 2022 | In Use | |
| 49884-0867-02 | 49884-0867 | Dronabinol | Dronabinol | 2.5 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | Jun 30, 2008 | Jan 31, 2020 | In Use |
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