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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
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
00185-0933-86 00185-0933 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 21, 2015 Feb 28, 2020 No Longer Used
70518-1585-04 70518-1585 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 9, 2023 In Use
16714-0890-01 16714-0890 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
55513-0005-01 55513-0005 Darbepoetin alfa Aranesp 100.0 ug/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Sep 11, 2006 In Use
68788-9559-05 68788-9559 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 27, 2013 In Use
47335-0581-40 47335-0581 Amifostine Amifostine 50.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 14, 2008 Jul 31, 2013 No Longer Used
80425-0072-05 80425-0072 Ondansetron 4mg, Ondansetron HCL Ondansetron HCL 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
00054-4496-25 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 In Use
25021-0778-01 25021-0778 Granisetron Hydrochloride Granisetron Hydrochloride 0.1 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Dec 1, 2010 Feb 1, 2017 No Longer Used
68788-9402-03 68788-9402 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 12, 2012 In Use
50436-0133-01 50436-0133 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 2, 2007 In Use
68462-0105-30 68462-0105 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 In Use
53270-0101-01 53270-0101 Levoleucovorin Fusilev Ancillary Therapy Chemoprotective Antidote Aug 15, 2008 Feb 24, 2010 No Longer Used
68084-0879-95 68084-0879 Cyclosporine Cyclosporine 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Sep 30, 2015 In Use
00006-4121-01 00006-4121 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
00074-6479-32 00074-6479 Cyclosporine Modified Gengraf 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral May 24, 2010 Sep 16, 2017 No Longer Used
61314-0312-01 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
61786-0302-02 61786-0302 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jun 22, 2016 Mar 28, 2017 No Longer Used
68382-0074-30 68382-0074 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 5, 2017 Dec 3, 2019 In Use
00173-0447-00 00173-0447 Ondansetron Hydrochloride Zofran 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Feb 11, 1993 Feb 29, 2020 No Longer Used
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
55111-0172-90 55111-0172 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 28, 2007 In Use
00378-5036-05 00378-5036 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Oct 20, 2015 Feb 28, 2019 No Longer Used
51672-4110-05 51672-4110 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 28, 2011 In Use

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