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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
70121-1627-01 70121-1627 Pegfilgrastim FYLNETRA 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous May 31, 2022 In Use
71288-0163-30 71288-0163 Leucovorin calcium Leucovorin calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 In Use
52125-0568-08 52125-0568 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 24, 2013 Jun 24, 2014 No Longer Used
63629-4014-09 63629-4014 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 9, 2012 In Use
65862-0187-30 65862-0187 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
51862-0458-01 51862-0458 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 18, 2016 No Longer Used
53270-0101-01 53270-0101 Levoleucovorin Fusilev Ancillary Therapy Chemoprotective Antidote Aug 15, 2008 Feb 24, 2010 No Longer Used
55513-0090-91 55513-0090 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Sep 25, 2006 Feb 28, 2009 No Longer Used
62756-0356-64 62756-0356 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 In Use
61919-0465-30 61919-0465 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 1, 2014 In Use
55390-0052-10 55390-0052 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Aug 31, 2014 No Longer Used
80056-0801-30 80056-0801 Granisetron hydrochloride Granisol 2.0 mg/10mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 4, 2025 In Use
55700-0508-30 55700-0508 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Mar 3, 2017 Jun 30, 2019 In Use
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
00024-5844-01 00024-5844 Sargramostim Leukine 500.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Dec 1, 1996 Dec 30, 2021 No Longer Used
63187-0513-10 63187-0513 ondansetron hydrochloride Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 1, 2018 In Use
50090-1201-00 50090-1201 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 28, 2014 In Use
80425-0227-01 80425-0227 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 11, 2023 In Use
63187-0065-90 63187-0065 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 1, 2014 In Use
58118-1459-05 58118-1459 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Jun 26, 2017 No Longer Used
70436-0120-80 70436-0120 Leucovorin calcium Leucovorin Calcium 500.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 10, 2023 In Use
59676-0304-00 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 8, 2011 In Use
55390-0148-10 55390-0148 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oct 28, 2014 Nov 30, 2009 No Longer Used
58118-0240-00 58118-0240 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 Jun 26, 2017 No Longer Used
68788-9402-06 68788-9402 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 23, 2017 In Use

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