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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
64764-0800-28 64764-0800 MARIBAVIR Livtencity 200.0 mg/1 Ancillary Therapy Miscellaneous Agent CMV Antiviral Oral Nov 23, 2021 In Use
69639-0105-01 69639-0105 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Intravenous Jun 15, 2020 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
59676-0310-02 59676-0310 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 1, 1989 In Use
52125-0834-01 52125-0834 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb 10, 2014 Feb 10, 2015 No Longer Used
51655-0196-04 51655-0196 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 27, 2023 In Use
68071-1987-02 68071-1987 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 23, 2017 In Use
63629-5073-02 63629-5073 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 In Use
49884-0867-01 49884-0867 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Jun 27, 2008 In Use
63629-4306-03 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2013 In Use
63459-0910-12 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
68152-0102-01 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 15, 2011 Feb 28, 2019 No Longer Used
76310-0017-50 76310-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jan 1, 2020 In Use
51672-4109-00 51672-4109 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 28, 2011 In Use
54868-5114-01 54868-5114 Dutasteride Avodart 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jul 16, 2004 In Use
55513-0520-06 55513-0520 Palifermin Kepivance Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Dec 15, 2004 Dec 15, 2009 No Longer Used
00069-1305-10 00069-1305 epoetin alfa-epbx RETACRIT 2000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 18, 2018 In Use
63459-0910-15 63459-0910 tbo-filgrastim Granix 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
68001-0285-38 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Oct 25, 2016 No Longer Used
80425-0228-03 80425-0228 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 22, 2024 In Use
51862-0460-47 51862-0460 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 In Use
70786-0090-01 70786-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug 3, 2016 Aug 5, 2016 No Longer Used
68071-3268-06 68071-3268 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 23, 2017 In Use
68001-0247-55 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 13, 2018 Mar 13, 2019 In Use

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