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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
00904-6208-46 00904-6208 Ondansetron, Ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2008 Sep 30, 2014 No Longer Used
00074-6479-32 00074-6479 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Sep 16, 2017 No Longer Used
68001-0285-39 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Oct 25, 2016 No Longer Used
00527-1450-06 00527-1450 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral May 18, 2018 In Use
50090-1523-01 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human 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
16714-0221-32 16714-0221 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 29, 2008 Aug 31, 2021 No Longer Used
69639-0106-01 69639-0106 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 Intravenous Aug 1, 2023 In Use
68001-0247-01 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 13, 2014 Feb 27, 2018 In Use
53270-0101-01 53270-0101 Levoleucovorin Fusilev Ancillary Therapy Chemoprotective Antidote Aug 15, 2008 Feb 24, 2010 No Longer Used
00088-1203-05 00088-1203 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 Jun 30, 2017 No Longer Used
00944-2655-04 00944-2655 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G Jan 3, 2011 Aug 26, 2015 In Use
23155-0549-31 23155-0549 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jun 15, 2012 In Use
67457-0833-06 67457-0833 Pegfilgrastim Fulphila 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Jul 9, 2018 May 31, 2026 In Use
00378-7732-05 00378-7732 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Oct 9, 2014 No Longer Used
55390-0250-10 55390-0250 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Jul 28, 2008 Nov 30, 2009 No Longer Used
33261-0417-09 33261-0417 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
00378-5036-93 00378-5036 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 20, 2015 Jun 30, 2019 No Longer Used
00143-9384-01 00143-9384 FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 8, 2020 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
70518-3802-00 70518-3802 ONDANSETRON Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jul 24, 2023 In Use
00078-0274-22 00078-0274 Cyclosporine NeOral 100.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 14, 1995 In Use
00703-4094-01 00703-4094 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Mar 23, 2018 In Use
52125-0569-38 52125-0569 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 27, 2013 May 8, 2016 No Longer Used
00409-4760-13 00409-4760 Ondansetron Hydrochloride and Dextrose Ondansetron Hydrochloride and Dextrose Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Feb 2, 2007 Nov 1, 2011 No Longer Used
61314-0312-01 61314-0312 filgrastim-sndz Zarxio 480.0 ug/.8mL, 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sep 3, 2015 Feb 28, 2021 No Longer Used

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