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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
72603-0402-01 72603-0402 Pegflilgrastim-fpgk STIMUFEND 6.0 mg/.6mL Ancillary Therapy Immunostimulant Granulocyte colony stimulating factor Subcutaneous Dec 29, 2025 In Use
83831-0149-50 83831-0149 Leucovorin calcium VYKOURA 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 16, 2026 In Use
00143-9771-06 00143-9771 Ondansetron Hydrochloride and Dextrose Ondansetron Hydrochloride and Dextrose 32.0 mg/50mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Aug 4, 2009 In Use
76310-0002-01 76310-0002 Dexrazoxane Cardioxane 500.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jul 28, 2017 In Use
80175-0017-05 80175-0017 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 11, 2018 In Use
63629-4093-07 63629-4093 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 27, 2010 In Use
00006-3884-32 00006-3884 Fosaprepitant Dimeglumine Emend Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Jan 25, 2008 Jul 31, 2012 No Longer Used
83831-0148-35 83831-0148 Leucovorin calcium VYKOURA 350.0 mg/35mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 16, 2026 In Use
63187-0526-12 63187-0526 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 20, 2023 In Use
51079-0525-01 51079-0525 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 9, 2007 Apr 30, 2019 No Longer Used
00603-3633-21 00603-3633 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 22, 2006 Feb 28, 2018 No Longer Used
71288-0155-01 71288-0155 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous Jul 24, 2023 In Use
00006-4045-01 00006-4045 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 In Use
00172-7311-46 00172-7311 Cyclosporine Modified Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Apr 28, 2005 Feb 28, 2017 No Longer Used
55513-0924-91 55513-0924 Filgrastim Neupogen 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Oct 2, 2000 In Use
51407-0704-03 51407-0704 APREPITANT APREPITANT 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Jun 11, 2025 In Use
60760-0313-10 60760-0313 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 2, 2020 In Use
71930-0018-52 71930-0018 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 6, 2020 In Use
70786-0090-03 70786-0090 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Aug 3, 2016 Aug 5, 2016 No Longer Used
55150-0175-01 55150-0175 Granisetron Hydrochloride Granisetron Hydrochloride 1.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Jul 6, 2016 In Use
68001-0669-15 68001-0669 Aprepitant Aprepitant 80.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Feb 3, 2026 In Use
00179-0175-88 00179-0175 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral May 26, 2015 Jul 31, 2020 No Longer Used
25021-0782-20 25021-0782 ondansetron hydrochloride Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Aug 30, 2012 Nov 30, 2021 No Longer Used
00088-1208-06 00088-1208 Dolasetron mesylate Anzemet 12.5 mg/.625mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Sep 11, 1997 Aug 31, 2016 No Longer Used
55513-0048-01 55513-0048 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Feb 10, 2004 Feb 28, 2009 No Longer Used

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