| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 70114-0130-01 | 70114-0130 | pegfilgrastim-cbqv | UDENYCA | 6.0 mg/.6mL | Ancillary Therapy | Immunostimulant | Granulocyte Colony-Stimulating Factor | Subcutaneous | Dec 22, 2023 | In Use | |
| 00527-1450-06 | 00527-1450 | Dronabinol | Dronabinol | 2.5 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | May 18, 2018 | In Use | |
| 65862-0189-11 | 65862-0189 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 24.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jul 31, 2007 | In Use | |
| 51991-0735-20 | 51991-0735 | Granisetron Hydrochloride | Granisetron Hydrochloride | 1.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 22, 2009 | In Use | |
| 83980-0012-01 | 83980-0012 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Jun 19, 2025 | In Use | |
| 11994-0016-01 | 11994-0016 | samarium Sm 153 lexidronam | Quadramet | 50.0 mCi/mL | Ancillary Therapy | Radiopharmaceutical | Samarium Sm 153 | Intravenous | May 19, 1997 | In Use | |
| 00185-0932-87 | 00185-0932 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Sep 23, 2014 | Nov 21, 2015 | No Longer Used |
| 55648-0186-01 | 55648-0186 | Zoledronic Acid | Zoledronic Acid | 4.0 mg/5mL | Ancillary Therapy | Bisphosphonate | Intravenous | Mar 2, 2013 | In Use | ||
| 25021-0826-67 | 25021-0826 | Zoledronic Acid | Zoledronic Acid | 0.04 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | Sep 1, 2015 | In Use | ||
| 61703-0325-18 | 61703-0325 | Pamidronate Disodium | Pamidronate Disodium | 6.0 mg/mL | Ancillary Therapy | Bisphosphonate | Intravenous | Jul 28, 2003 | In Use | ||
| 35356-0210-30 | 35356-0210 | Dutasteride | Avodart | 0.5 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Mar 26, 2012 | Dec 31, 2016 | No Longer Used |
| 00006-4109-01 | 00006-4109 | 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 | |
| 65862-0391-02 | 65862-0391 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Apr 12, 2024 | In Use | |
| 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 | |
| 00555-0485-04 | 00555-0485 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jun 30, 1990 | In Use | |
| 36000-0012-25 | 36000-0012 | Ondansetron Hydrochloride | Ondansetron Hydrochloride | 2.0 mg/mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intramuscular, Intravenous | Mar 13, 2013 | No Longer Used | |
| 68084-0174-01 | 68084-0174 | Dronabinol | Dronabinol | 2.5 mg/1 | Ancillary Therapy | Antiemetic | CB1/CB2 | Oral | Jun 2, 2010 | Jan 31, 2020 | No Longer Used |
| 82448-0100-14 | 82448-0100 | Nirogacestat | OGSIVEO | 100.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Ɣ Secretase Inhibitor | Oral | Nov 27, 2023 | In Use | |
| 54868-5636-01 | 54868-5636 | Finasteride | Finasteride | 5.0 mg/1 | Ancillary Therapy | Protective Agent | 5-alpha Reductase Inhibitor | Oral | Jun 30, 2006 | In Use | |
| 60505-0133-01 | 60505-0133 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | May 29, 2002 | Dec 31, 2022 | In Use |
| 70934-0206-95 | 70934-0206 | Ondansetron | Ondansetron | 8.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Feb 4, 2019 | In Use | |
| 52125-0568-02 | 52125-0568 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Sep 20, 2013 | Nov 10, 2015 | No Longer Used |
| 64380-0127-02 | 64380-0127 | Cyclosporine | Cyclosporine | 25.0 mg/1 | Ancillary Therapy | Immunomodulator | Calcineurin Inhibitor | Oral | Aug 16, 2022 | In Use | |
| 63323-0317-01 | 63323-0317 | Granisetron hydrochloride | Granisetron | 0.1 mg/mL | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Intravenous | Nov 20, 2009 | May 31, 2016 | In Use |
| 68071-1968-04 | 68071-1968 | Ondansetron | Ondansetron | 4.0 mg/1 | Ancillary Therapy | Antiemetic | 5HT3 Receptor Antagonist | Oral | Feb 23, 2017 | Dec 31, 2019 | No Longer Used |
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