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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
00069-0324-01 00069-0324 Pegfilgrastim-apgf NYVEPRIA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Dec 15, 2020 In Use
00069-0293-10 00069-0293 filgrastim-aafi Nivestym 300.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Mar 11, 2019 In Use
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
65862-0391-66 65862-0391 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 12, 2010 In Use
55513-0267-10 55513-0267 Epoetin alfa Epogen 3000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Apr 30, 1990 In Use
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 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
00338-0008-01 00338-0008 Fosaprepitant Dimeglumine Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use
00781-1681-13 00781-1681 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Dec 1, 2015 No Longer Used
55513-0025-01 55513-0025 Darbepoetin alfa Aranesp 100.0 ug/.5mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Feb 18, 2011 In Use
00143-2424-07 00143-2424 Ondansetron Ondansetron 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2008 Dec 31, 2014 In Use
68083-0278-01 68083-0278 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
63323-0710-59 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
52125-0268-08 52125-0268 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 6, 2016 Dec 6, 2016 No Longer Used
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
00006-4109-06 00006-4109 Human Papillomavirus 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 May 6, 2011 In Use
43288-0104-10 43288-0104 Ondansetron Zuplenz Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 5, 2010 Nov 30, 2015 No Longer Used
65219-0371-10 65219-0371 pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Oct 6, 2022 In Use
69452-0350-01 69452-0350 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2022 In Use
70114-0101-01 70114-0101 pegfilgrastim-cbqv UDENYCA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 2, 2018 In Use
70121-1571-07 70121-1571 Filgrastim RELEUKO 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Feb 25, 2022 In Use
53217-0382-10 53217-0382 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 15, 2018 In Use
25021-0201-69 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 13, 2019 In Use
54868-5673-01 54868-5673 Erythropoietin Procrit 20000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Mar 24, 2008 In Use
69543-0371-10 69543-0371 Palonosetron hydrochloride Palonosetron hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sep 19, 2018 Jan 31, 2026 In Use

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