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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
25021-0802-10 25021-0802 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan 15, 2010 Dec 31, 2014 No Longer Used
25021-0803-10 25021-0803 Pamidronate Disodium Pamidronate Disodium 9.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jan 15, 2010 Dec 31, 2014 No Longer Used
25021-0814-30 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
25021-0816-30 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
25021-0816-67 25021-0816 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jan 31, 2022 In Use
70121-1568-07 70121-1568 Filgrastim RELEUKO 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb 25, 2022 In Use
67457-0472-10 67457-0472 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous May 10, 2011 Nov 30, 2018 No Longer Used
55154-2873-05 55154-2873 Ondansetron Hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Nov 19, 2010 Mar 28, 2018 No Longer Used
70625-0300-01 70625-0300 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov 5, 2019 In Use
55390-0045-01 55390-0045 Mesna Mesna Ancillary Therapy Chemoprotective Detoxifying Agent Feb 23, 2004 Jul 31, 2012 No Longer Used
55154-2876-05 55154-2876 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 26, 2006 In Use
55154-4567-00 55154-4567 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 In Use
57881-0448-10 57881-0448 Ondansetron Zuplenz 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 8, 2014 In Use
55154-2877-05 55154-2877 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 26, 2006 In Use
55154-6295-00 55154-6295 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 5, 2012 Oct 31, 2017 In Use
42806-0359-25 42806-0359 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 16, 2020 In Use
77651-1112-01 77651-1112 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2020 In Use
77651-1113-02 77651-1113 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 19, 2020 In Use
00093-9018-65 00093-9018 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 8, 2021 In Use
55154-6349-00 55154-6349 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sep 1, 2010 Oct 31, 2010 No Longer Used
25021-0826-66 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sep 1, 2015 Nov 30, 2018 In Use
25021-0826-67 25021-0826 Zoledronic Acid Zoledronic Acid 0.04 mg/mL Ancillary Therapy Bisphosphonate Intravenous Sep 1, 2015 In Use
68083-0388-01 68083-0388 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 16, 2019 In Use

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