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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
00069-1318-04 00069-1318 epoetin alfa-epbx RETACRIT 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Dec 1, 2020 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
64720-0198-98 64720-0198 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 31, 2007 Mar 11, 2016 No Longer Used
00185-0933-86 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 21, 2015 Feb 28, 2020 No Longer Used
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
78206-0153-02 78206-0153 FINASTERIDE PROSCAR 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jun 1, 2021 In Use
55289-0559-05 55289-0559 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 6, 2010 Aug 2, 2018 No Longer Used
63187-0379-05 63187-0379 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 2, 2017 In Use
65862-0188-10 65862-0188 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
68001-0650-38 68001-0650 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 10, 2025 In Use
35356-0679-30 35356-0679 ONDANSETRON HYDROCHLORIDE ONDANSETRON HYDROCHLORIDE 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 30, 2019 In Use
54092-0064-01 54092-0064 Anagrelide Agrylin Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Mar 14, 1997 Mar 31, 2008 No Longer Used
00185-0155-05 00185-0155 Anagrelide Hydrochloride Anagrelide Hydrochloride Ancillary Therapy Platelet-Reducing Agent PDE-3 Inhibitor Oral Apr 18, 2005 Mar 31, 2012 No Longer Used
58177-0364-22 58177-0364 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 1, 2009 Jun 28, 2011 No Longer Used
52584-0414-01 52584-0414 Metoclopramide Hydrochloride Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Sep 13, 2016 May 1, 2023 No Longer Used
55390-0824-01 55390-0824 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Jun 28, 1996 Apr 30, 2014 No Longer Used
60687-0252-67 60687-0252 Ondansetron Ondansetron 4.0 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 11, 2019 May 31, 2019 In Use
55289-0559-06 55289-0559 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 21, 2017 Aug 2, 2018 No Longer Used
00781-3010-95 00781-3010 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Jun 27, 2007 Mar 31, 2017 No Longer Used
58118-1459-08 58118-1459 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
55513-0823-01 55513-0823 Epoetin alfa Epogen Ancillary Therapy Erythropoiesis-Stimulating Agent Mar 3, 1997 Jul 31, 2010 No Longer Used
54868-5915-00 54868-5915 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 8, 2008 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
45865-0563-30 45865-0563 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 1, 2015 In Use
16714-0815-01 16714-0815 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous May 30, 2018 Aug 31, 2025 In Use

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