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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
00006-4119-01 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 In Use
50111-0823-76 50111-0823 Ondansetron Ondansetron Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Feb 14, 2017 Feb 16, 2017 No Longer Used
54868-5522-00 54868-5522 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb 10, 2006 In Use
00378-8170-91 00378-8170 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov 1, 2011 Mar 31, 2016 No Longer Used
80425-0075-01 80425-0075 Ondansetron HCL Ondansetron HCL 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
70860-0777-20 70860-0777 Ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Mar 1, 2018 Feb 28, 2023 In Use
51079-0520-56 51079-0520 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 26, 2009 Jul 31, 2015 No Longer Used
61314-0312-10 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
00555-0484-02 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
51655-0415-87 51655-0415 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 24, 2018 In Use
69784-0712-04 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 15, 2022 In Use
68475-0509-01 68475-0509 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Jun 8, 2022 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
16714-0522-10 16714-0522 Finasteride Finasteride Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Sep 19, 2012 Aug 31, 2014 No Longer Used
52125-0569-02 52125-0569 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 25, 2014 Dec 12, 2016 No Longer Used
54868-5749-01 54868-5749 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 16, 2007 In Use
68788-7644-03 68788-7644 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 28, 2020 In Use
23155-0196-43 23155-0196 Ondansetron Hydrochloride Ondansetron Hydrochloride 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jan 18, 2013 Jul 31, 2020 In Use
00069-1441-25 00069-1441 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous May 4, 2013 Dec 31, 2017 No Longer Used
63187-0657-30 63187-0657 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 1, 2018 Dec 31, 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
44206-0458-24 44206-0458 HUMAN IMMUNOGLOBULIN G Hizentra 0.2 g/mL Ancillary Therapy Immunostimulant Human Immunoglobulin G Subcutaneous Jan 1, 2020 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
70518-2363-02 70518-2363 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 26, 2021 In Use

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