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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
55513-0924-01 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
00143-9771-06 00143-9771 Ondansetron Hydrochloride and Dextrose Ondansetron Hydrochloride and Dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Aug 4, 2009 In Use
63304-0347-05 63304-0347 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 10, 2012 In Use
00781-3497-75 00781-3497 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 2, 2020 Feb 29, 2024 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
63304-0347-69 63304-0347 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 10, 2012 In Use
00006-4121-01 00006-4121 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
55513-0095-91 55513-0095 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Sep 25, 2006 Feb 28, 2009 No Longer Used
53217-0382-10 53217-0382 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 15, 2018 In Use
43063-0560-20 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 12, 2015 Jan 18, 2021 No Longer Used
13668-0453-74 13668-0453 Anagrelide Anagrelide 0.5 mg/1, 0.5 mg/1 Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Jun 30, 2017 In Use
61314-0304-01 61314-0304 filgrastim-sndz Zarxio 300.0 ug/.5mL, 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sep 3, 2015 Feb 28, 2021 No Longer Used
63304-0346-69 63304-0346 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 10, 2012 In Use
00093-7355-05 00093-7355 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Mar 14, 2008 In Use
00078-0676-15 00078-0676 ondansetron hydrochloride ZOFRAN 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 12, 2017 May 31, 2022 No Longer Used
00006-4109-09 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 In Use
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
51655-0415-43 51655-0415 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 28, 2017 In Use
68788-0822-01 68788-0822 Ondansetron Hydrochloride Ondansetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 May 10, 2011 No Longer Used
42291-0280-10 42291-0280 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jan 31, 2014 Feb 5, 2015 In Use
49884-0868-05 49884-0868 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
50436-0133-01 50436-0133 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 In Use
68001-0366-87 68001-0366 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Feb 10, 2020 Aug 24, 2021 No Longer Used
68554-3025-03 68554-3025 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Mar 4, 2016 In Use
55513-0478-20 55513-0478 Epoetin alfa Epogen 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Apr 14, 2025 In Use

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