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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
69315-0184-01 69315-0184 Leucovorin calcium Leucovorin calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
69656-0101-02 69656-0101 Rolapitant Varubi 90.0 mg/1 Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Oral Oct 7, 2015 Oct 31, 2021 No Longer Used
00088-1203-05 00088-1203 Dolasetron mesylate Anzemet 100.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 11, 1997 Jun 30, 2017 No Longer Used
69784-0712-04 69784-0712 Dutasteride AVODART 0.5 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Dec 15, 2022 In Use
00781-3312-75 00781-3312 Palonosetron Hydrochloride Palonosetron Hydrochloride 0.25 mg/5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous Mar 23, 2018 In Use
55390-0148-10 55390-0148 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oct 28, 2014 Nov 30, 2009 No Longer Used
00703-4502-93 00703-4502 Metoclopramide Metoclopramide 5.0 mg/mL Ancillary Therapy Antiemetic Dopamine-2 Receptor Antagonist Intramuscular, Intravenous Sep 4, 2024 In Use
50090-1200-02 50090-1200 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 28, 2014 In Use
69315-0185-12 69315-0185 Leucovorin calcium Leucovorin calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
55111-0172-05 55111-0172 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Feb 28, 2007 In Use
60505-4631-03 60505-4631 Cyclosporine CycloSPORINE, Modfied 50.0 mg/1 Ancillary Therapy Immunomodulator Calcineurin Inhibitor Oral Nov 5, 2019 Aug 31, 2023 In Use
63629-4014-07 63629-4014 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Mar 20, 2013 In Use
54868-5429-00 54868-5429 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Mar 20, 2008 Jun 30, 2013 No Longer Used
67296-1562-04 67296-1562 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 In Use
55513-0097-01 55513-0097 Darbepoetin alfa Aranesp Ancillary Therapy Erythropoiesis-Stimulating Agent Sep 25, 2006 Feb 28, 2009 No Longer Used
55111-0156-11 55111-0156 Ondansetron Hydrochloride ONDANSETRON 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
55111-0153-13 55111-0153 Ondansetron Hydrochloride ONDANSETRON 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Dec 26, 2006 In Use
00378-5036-01 00378-5036 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov 4, 2015 Dec 4, 2017 No Longer Used
20482-0335-30 20482-0335 Dronabinol SYNDROS 5.0 mg/mL Ancillary Therapy Antiemetic CB1/CB2 Oral Jul 27, 2017 In Use
50090-1523-09 50090-1523 Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant, Human 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
00703-7973-01 00703-7973 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Jun 30, 2008 Apr 30, 2012 No Longer Used
00006-3941-01 00006-3941 Fosaprepitant Dimeglumine Emend 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Nov 19, 2010 In Use
61314-0304-01 61314-0304 filgrastim-sndz Zarxio 300.0 ug/.5mL, 300.0 ug/.5mL Ancillary Therapy Immunostimulant Granulocyte Colony-Stimulating Factor Intravenous, Subcutaneous Sep 3, 2015 Feb 28, 2021 No Longer Used
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 15, 2008 Feb 28, 2019 No Longer Used
72162-2642-02 72162-2642 Plerixafor Plerixafor 24.0 mg/1.2mL Ancillary Therapy Immunostimulant Stem Cell Mobilizer Subcutaneous May 6, 2026 In Use

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