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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
55513-0025-01 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb 18, 2011 In Use
83008-0026-10 83008-0026 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 12, 2023 Jun 30, 2026 In Use
58160-0830-43 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Jul 25, 2011 Nov 29, 2016 No Longer Used
55513-0924-91 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
63629-9166-01 63629-9166 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Feb 21, 2022 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
00006-4119-02 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 May 22, 2019 In Use
55513-0209-91 55513-0209 Filgrastim Neupogen 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
00781-3201-94 00781-3201 Levoleucovorin Levoleucovorin 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Apr 23, 2015 Apr 30, 2023 No Longer Used
68001-0285-29 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Oct 25, 2016 Feb 1, 2021 No Longer Used
68788-9519-09 68788-9519 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 6, 2014 May 21, 2020 No Longer Used
31722-0165-31 31722-0165 Fosaprepitant dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jul 29, 2021 In Use
68001-0285-36 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Feb 1, 2021 No Longer Used
63323-0734-10 63323-0734 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 19, 2002 Aug 27, 2015 No Longer Used
23155-0547-42 23155-0547 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jun 15, 2012 In Use
00703-7239-39 00703-7239 Ondansetron and Dextrose Ondansetron and Dextrose Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 22, 2006 Mar 31, 2011 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
63304-0347-05 63304-0347 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 10, 2012 In Use
50090-1015-00 50090-1015 ondansetron hydrochloride Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 28, 2014 Mar 31, 2019 In Use
63459-0912-17 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
43063-0560-06 43063-0560 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 12, 2015 Jan 18, 2021 No Longer Used
00703-7239-31 00703-7239 Ondansetron and Dextrose Ondansetron and Dextrose Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 22, 2006 Mar 31, 2011 No Longer Used
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
00054-4497-10 00054-4497 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 In Use
50742-0181-01 50742-0181 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use

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