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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
63459-0912-15 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Nov 11, 2013 In Use
54868-5887-01 54868-5887 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 8, 2008 In Use
54868-5522-00 54868-5522 Cyclosporine Cyclosporine 100.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Feb 10, 2006 In Use
53217-0300-13 53217-0300 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 In Use
55111-0153-78 55111-0153 Ondansetron Hydrochloride ONDANSETRON 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
63629-4306-07 63629-4306 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 20, 2010 In Use
55111-0156-78 55111-0156 Ondansetron Hydrochloride ONDANSETRON 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
68001-0366-25 68001-0366 Zoledronic Acid Zoledronic Acid 4.0 mg/5mL Ancillary Therapy Bisphosphonate Intravenous Oct 5, 2018 May 31, 2022 No Longer Used
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jul 31, 2020 In Use
00078-0246-15 00078-0246 Cyclosporine NeOral 25.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Jul 14, 1995 In Use
54868-2523-01 54868-2523 Erythropoietin Procrit 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 11, 1994 In Use
54868-3310-04 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
55513-0144-10 55513-0144 Epoetin alfa Epogen 10000.0 [iU]/mL Ancillary Therapy Erythropoiesis-Stimulating Agent Intravenous, Subcutaneous Aug 16, 1993 In Use
80425-0228-01 80425-0228 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 11, 2023 In Use
00944-2658-04 00944-2658 Human Immunoglobulin G Gammagard S/D Ancillary Therapy Immunostimulant Human Immunoglobulin G May 10, 1994 In Use
00069-0294-10 00069-0294 filgrastim-aafi Nivestym 480.0 ug/1.6mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Mar 11, 2019 In Use
63459-0912-36 63459-0912 tbo-filgrastim Granix 480.0 ug/.8mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Subcutaneous Mar 2, 2015 In Use
68084-0220-11 68084-0220 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 16, 2012 In Use
68788-7705-03 68788-7705 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 1, 2020 In Use
54569-6168-01 54569-6168 Ondansetron, ondansetron hydrochloride Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 9, 2016 In Use
54868-5089-03 54868-5089 Ondansetron Zofran ODT Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 9, 2004 Jun 30, 2011 No Longer Used
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jun 12, 1997 Sep 30, 2023 No Longer Used
58160-0830-05 58160-0830 Human Papillomavirus Bivalent Vaccine, Recombinant Cervarix 20.0 ug/.5mL, 20.0 ug/.5mL Ancillary Therapy Protective Agent HPV Vaccine Intramuscular Mar 20, 2012 Nov 29, 2016 No Longer Used
55154-3680-00 55154-3680 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 27, 2007 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

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