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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
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
00641-6078-01 00641-6078 Ondansetron Ondansetron 2.0 mg/mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intramuscular, Intravenous Dec 26, 2006 In Use
69639-0106-01 69639-0106 Fosnetupitant and Palonosetron AKYNZEO 260.0 mg/20mL, 0.28 mg/20mL Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist, Substance P/Neurokinin 1 Intravenous Aug 1, 2023 In Use
69468-0151-20 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
65862-0189-22 65862-0189 Ondansetron Hydrochloride Ondansetron Hydrochloride 24.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jul 31, 2007 Nov 7, 2011 In Use
35356-0652-30 35356-0652 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 3, 2012 Jun 1, 2016 No Longer Used
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
52125-0453-02 52125-0453 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 12, 2013 Mar 12, 2014 No Longer Used
66658-0112-06 66658-0112 Palifermin Kepivance 6.25 mg/1.2mL Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF Intravenous Dec 15, 2009 Apr 20, 2023 No Longer Used
58118-6666-04 58118-6666 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 14, 2013 Aug 25, 2016 No Longer Used
47335-0715-81 47335-0715 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Nov 25, 2022 No Longer Used
55700-0631-30 55700-0631 Ondansetron Hydrochloride Ondansetron Hydrochloride 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral May 25, 2018 Jan 31, 2028 In Use
51655-0016-87 51655-0016 Ondansetron Hydrochloride Ondansetron Hydrochloride 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Sep 21, 2022 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
62856-0798-01 62856-0798 Palonosetron hydrochloride Aloxi 0.075 mg/1.5mL Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Intravenous May 28, 2014 Jun 30, 2018 In Use
16714-0159-01 16714-0159 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Apr 6, 2021 In Use
63629-8862-01 63629-8862 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Sep 30, 2021 In Use
67457-0889-10 67457-0889 Fosaprepitant Fosaprepitant 150.0 mg/5mL Ancillary Therapy Antiemetic Substance P/Neurokinin 1 Intravenous Sep 5, 2019 In Use
60760-0567-10 60760-0567 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Aug 25, 2022 In Use
51655-0809-87 51655-0809 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Nov 30, 2020 In Use
50090-1658-03 50090-1658 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jan 16, 2017 In Use
60505-0764-02 60505-0764 Granisetron Hydrochloride Granisetron Hydrochloride Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Dec 31, 2007 Dec 31, 2009 No Longer Used
68788-6976-06 68788-6976 Finasteride Finasteride 5.0 mg/1 Ancillary Therapy Protective Agent 5-alpha Reductase Inhibitor Oral Jun 6, 2017 In Use
00378-7732-05 00378-7732 Ondansetron Ondansetron 4.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Jun 25, 2007 Oct 9, 2014 No Longer Used
52125-0569-14 52125-0569 Ondansetron Ondansetron 8.0 mg/1 Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Oral Oct 28, 2014 Apr 8, 2017 No Longer Used

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