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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
61314-0866-01 61314-0866 Pegfilgrastim-bmez ZIEXTENZO 6.0 mg/.6mL Ancillary Therapy Immunostimulant Colony-Stimulating Factor Subcutaneous Nov 4, 2019 Feb 28, 2026 In Use
00024-5843-01 00024-5843 Sargramostim Leukine 250.0 ug/mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Nov 5, 2013 Dec 30, 2021 No Longer Used
00517-0745-01 00517-0745 Pamidronate Disodium Pamidronate Disodium 3.0 mg/mL Ancillary Therapy Bisphosphonate Intravenous Jul 16, 2010 Aug 24, 2012 No Longer Used
70934-0634-82 70934-0634 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 18, 2020 Aug 31, 2023 In Use
70934-0148-03 70934-0148 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 19, 2018 Nov 30, 2023 In Use
80425-0072-01 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
00187-1221-03 00187-1221 Nabilone Cesamet 1.0 mg/1 Ancillary Therapy Antiemetic Cannabinoid Oral Nov 1, 2009 Nov 13, 2017 No Longer Used
00378-8009-77 00378-8009 Dutasteride Dutasteride 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jun 14, 2016 Dec 31, 2017 No Longer Used
00574-0866-10 00574-0866 Cyclosporine Cyclosporine 50.0 mg/mL Ancillary Therapy Immunomodulator Calcineurin Inhibitor Intravenous Oct 7, 2003 Aug 1, 2024 No Longer Used
59676-0304-02 59676-0304 Erythropoietin Procrit 4000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Jun 1, 1989 Jan 8, 2014 In Use
72162-1880-06 72162-1880 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Mar 30, 2023 In Use
11819-0365-01 11819-0365 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 26, 2011 In Use
68788-8377-03 68788-8377 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 28, 2023 In Use
68788-8582-02 68788-8582 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 12, 2024 In Use
71288-0418-10 71288-0418 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov 15, 2019 Mar 30, 2023 No Longer Used
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
68001-0247-16 68001-0247 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 13, 2014 In Use
51079-0524-20 51079-0524 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 9, 2007 Sep 30, 2019 No Longer Used
55154-2639-00 55154-2639 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 10, 2025 In Use
83008-0026-10 83008-0026 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 12, 2023 Jun 30, 2026 In Use
50090-1200-03 50090-1200 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 17, 2017 In Use
00093-5741-19 00093-5741 Cyclosporine Cyclosporine Modified 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jun 1, 2015 Jan 31, 2023 No Longer Used
00143-9642-01 00143-9642 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Jun 3, 2013 In Use
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
72189-0542-90 72189-0542 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Mar 11, 2024 In Use

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